Re: What does PPACA mean for the future of IBCLCs

[Guest guest]

I think that might be one of the issues. If You are only looking at it from a business person point of view and not the big picture; hospitals, WIC, community clinics etc. unless PP IBCLC start advocating and interacting with other circles; baby friendly initiatives, WIC Peer Program etc PP will suffer. And YES that means getting political!! Speaking from experience with another health care profession that went through similar changes and pp was eliminated.... Looking at the history of midwives, nurse practitioners and mid level dental providers may be helpful in understanding the seriousness of getting IBCLC as a stand alone profession and not viewed as an add on credential. If you only look at protecting your very small piece of the pie it will get eaten up.Again this is with all due respect and love for you all and this profession. from Minnesota Sent from my iPhone

I'm sorry that the discussion went in a political direction with my question. I am looking for guidance. If the Affordable Care Act covers Breastfeeding support - what does that mean? Support from IBCLC or CLC? If we are are lumped into the same category, that would have a serious impact on the continuation of my private practice. Should I be addressing this to USLCA? This is purely from a small business owner point of view. Dana Schmidt, BS, RN, IBCLCCradlehold Breastfeeding Education & Supportwww.cradlehold.netPlease follow us on Facebook at www.facebook.com/CradleholdBreastfeedingEducationSupport No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation.

[Guest guest]

:

Excellent point. Yes, we need to look exactly where we fit in and how we can

ensure that we survive. Private practitioners have a very valuable role to play

in serving women and we need to remain as part of the team. I see our role as

offering a unique contribution in the following ways:

1) We have the flexibility to do a thorough and complete assessment of feedings,

which takes 1-3 hours since babies should feed according to their own hunger and

satiety cues and not when they are full or sleepy

2) We have the flexibility to observe women in many settings rather than just

offices, where we can assess interactions between the home environment and

family members

3) We have the flexibility to develop innovative solutions to adapt to

individual needs of mothers and their babies -- thus acting as incubators for

future " baby friendlier " practices.

4) We observe the full spectrum of breastfeeding so we can may the links across

the various stages of breastfeeding that may help others who only work at one

stage or another -- thereby influencing a better continuum of practice.

This is just off the top of my head.

Best regards,

Burger

[Guest guest]

What worries me is that other non-IBCLC's make the claim that they do the same thing. I would like to see IBCLC in the Obama plan as it would say physician but I don't think it will be that specific. Dana Schmidt, BS, RN, IBCLCCradlehold Breastfeeding Education & Supportwww.cradlehold.netPlease follow us on Facebook at www.facebook.com/CradleholdBreastfeedingEducationSupport No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation.

[Guest guest]

Dear Dana, and others,

I am responding to the questions posed

about the Affordable Care Act.

Dana asks, “If the Affordable Care

Act covers Breastfeeding support - what does that mean? Support from IBCLC or

CLC?. Should I be addressing this to USLCA?”

states, “If You are only

looking at it from a business person point of view and not the big picture;

hospitals, WIC, community clinics etc. unless PP IBCLC start advocating and

interacting with other circles; baby friendly initiatives, WIC Peer Program etc

PP will suffer. And YES that means getting political!! And Looking at the

history of midwives, nurse practitioners and mid level dental providers may be

helpful in understanding the seriousness of getting IBCLC as a stand alone

profession and not viewed as an add on credential.”

IBCLC are not licensed practitioners. We

do not possess Title Protection or Practice Protection.

Title Protection means a

license would be required for a person to call themselves a “lactation

consultant” but one could still practice breastfeeding support (or

lactation consulting) as they wished as long as they do not state they are a

“Lactation consultant”.

Practice protection is the

same as the current licensure for most health professionals like doctors and

nurses. If IBCLCs had Practice Protection then individuals who do not have the

IBCLC credential could not get a license and could not practice lactation

consulting.

The Affordable Care Act contains a

provision under the Women's Preventive Services Required Health Plan

Coverage Guidelines: The Act requires health plans to

cover preventive services for women with no cost sharing, including

breastfeeding support, supplies, and counseling. Non-grandfathered plans and

issuers are required to provide coverage without cost sharing consistent with

these guidelines in the first plan/policy year that begins on or after August

1, 2012.

This law does not say anything about who is to provide this coverage, it

just states the following:

Breastfeeding support,

supplies, and counseling.

Comprehensive lactation support and

counseling, by a trained provider during pregnancy and/or in the postpartum

period, and costs for renting breastfeeding equipment.

In conjunction with each birth.

There

are other provisions in the ACA which can be interpreted to include

lactation counseling requirements as well under the EPSDT and under the

Benchmark benefits, but the language is more vague. It remains to be seen if

lactation counseling will be mandated as part of these regulations.

Nonetheless, the above mandate make reimbursement a ‘given’ for

lactation counseling and is a huge step forward for breastfeeding families

regarding access to care. USLCA has worked hard to educate the policy makers in

order for this to happen. The USLCA has lobbied and worked to inform Medicaid,

private insurers, public health administrators, policy makers and others about

this issue. We have informed regarding Essential Health Benefits, WIC

Services, Benchmark Benefits, Insurance Exchange Plans, physician professional

organizations, Medicaid Administrators, and others as opportunities have arisen

at the local, state, and national levels in particular.

Therefore,

at the present time, despite USLCA efforts, any group or individual can be

qualified toffer these services. IBCLCs and these individuals will have to have

contracts with Medicaid or private insurers. This requires a process called

“credentialing” to be completed which will verify the

qualifications of the provider. There is a separate part of this process that

involves negotiating the fees for these services.

Regarding

Medicaid, there are federal regulations prohibiting the reimbursement of

“ANY” unlicensed providers so an IBCLC who has no other medical

license cannot be paid to render lactation services undeer the ACA by Medicaid.

See my article in June enews for the work around strategies.

Regarding

private insurers, they can choose to credential any providers they would like,

USLCA is advocating with these insurers for the credentialing process to be

based on the requirement of the IBCLC certification. We are currently setting

up the processes to credential IBCLCs this way, including applying for billing codes

specific for these services. That being said, if an individual or group

advocates for another “certificate” rather that the “IBCLC

certification” and they succeed in credentialing themselves, there is

nothing to stop them. It is not illegal because IBCLCs are not a

licensed profession. See the IBLCE

June newsletter article on this at http://iblce.org/news-from-the-board#Certification

vs. Certificate.

The

USLCA works to promote IBCLCs as the provider of choice for lactation care and

services and to educate the stakeholders. This work is ongiong daily!!! However,

it will not happen unless IBCLCs support USLCA, in philosophy, by reading

our newsletters and staying informed, and financially, to carry out this

work. Also, licensure will require committed individuals in every state to initiate advocacy

for licensure legislation and coordinatelegislative support. This

will means hours of work volunteering each week or finding groups with funds

to hire lobbyists and others to do the work for you. It will not happen in a

vacuum.

I

hope this helps you all to understand and you will consider supporting USLCA in

this work in every way that you can.

Judith

L. Gutowski, BA, IBCLC, RLC

[Guest guest]

So, Judith,

Am I understanding correctly that if we tried to get "Practice Protection" we would essentially be making it impossible for LLL Leaders, WIC Peer Counselors, and others to help breastfeeding mothers? It would seem that Practice Protection for us would mean that others could not get a license and would therefore be liable to be accused of practicing without a license if they tried to help breastfeeding mothers. We surely don't want that to happen!

Dee Kassing

Dear Dana, and others,

I am responding to the questions posed about the Affordable Care Act.

Dana asks, “If the Affordable Care Act covers Breastfeeding support - what does that mean? Support from IBCLC or CLC?. Should I be addressing this to USLCA?â€

states, “If You are only looking at it from a business person point of view and not the big picture; hospitals, WIC, community clinics etc. unless PP IBCLC start advocating and interacting with other circles; baby friendly initiatives, WIC Peer Program etc PP will suffer. And YES that means getting political!! And Looking at the history of midwives, nurse practitioners and mid level dental providers may be helpful in understanding the seriousness of getting IBCLC as a stand alone profession and not viewed as an add on credential.â€

IBCLC are not licensed practitioners. We do not possess Title Protection or Practice Protection.

Title Protection means a license would be required for a person to call themselves a “lactation consultant†but one could still practice breastfeeding support (or lactation consulting) as they wished as long as they do not state they are a “Lactation consultantâ€.

Practice protection is the same as the current licensure for most health professionals like doctors and nurses. If IBCLCs had Practice Protection then individuals who do not have the IBCLC credential could not get a license and could not practice lactation consulting.

The Affordable Care Act contains a provision under the Women's Preventive Services Required Health Plan Coverage Guidelines: The Act requires health plans to cover preventive services for women with no cost sharing, including breastfeeding support, supplies, and counseling. Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan/policy year that begins on or after August 1, 2012.

This law does not say anything about who is to provide this coverage, it just states the following:

Breastfeeding support, supplies, and counseling.

Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.

In conjunction with each birth.

There are other provisions in the ACA which can be interpreted to include lactation counseling requirements as well under the EPSDT and under the Benchmark benefits, but the language is more vague. It remains to be seen if lactation counseling will be mandated as part of these regulations. Nonetheless, the above mandate make reimbursement a ‘given’ for lactation counseling and is a huge step forward for breastfeeding families regarding access to care. USLCA has worked hard to educate the policy makers in order for this to happen. The USLCA has lobbied and worked to inform Medicaid, private insurers, public health administrators, policy makers and others about this issue. We have informed regarding Essential Health Benefits, WIC Services, Benchmark Benefits, Insurance Exchange Plans, physician professional organizations, Medicaid Administrators, and others

as opportunities have arisen at the local, state, and national levels in particular.

Therefore, at the present time, despite USLCA efforts, any group or individual can be qualified toffer these services. IBCLCs and these individuals will have to have contracts with Medicaid or private insurers. This requires a process called “credentialing†to be completed which will verify the qualifications of the provider. There is a separate part of this process that involves negotiating the fees for these services.

Regarding Medicaid, there are federal regulations prohibiting the reimbursement of “ANY†unlicensed providers so an IBCLC who has no other medical license cannot be paid to render lactation services undeer the ACA by Medicaid. See my article in June enews for the work around strategies.

Regarding private insurers, they can choose to credential any providers they would like, USLCA is advocating with these insurers for the credentialing process to be based on the requirement of the IBCLC certification. We are currently setting up the processes to credential IBCLCs this way, including applying for billing codes specific for these services. That being said, if an individual or group advocates for another “certificate†rather that the “IBCLC certification†and they succeed in credentialing themselves, there is nothing to stop them. It is not illegal because IBCLCs are not a licensed profession. See the IBLCE June newsletter article on this at http://iblce.org/news-from-the-board#Certification vs. Certificate.

The USLCA works to promote IBCLCs as the provider of choice for lactation care and services and to educate the stakeholders. This work is ongiong daily!!! However, it will not happen unless IBCLCs support USLCA, in philosophy, by reading our newsletters and staying informed, and financially, to carry out this work. Also, licensure will require committed individuals in every state to initiate advocacy for licensure legislation and coordinatelegislative support. This will means hours of work volunteering each week or finding groups with funds to hire lobbyists and others to do the work for you. It will not happen in a vacuum.

I hope this helps you all to understand and you will consider supporting USLCA in this work in every way that you can.

Judith L. Gutowski, BA, IBCLC, RLC

[Guest guest]

Thank you Judith,You stated "Also, licensure will require committed individuals in every state to initiate advocacy for licensure legislation and coordinatelegislative support. This will means hours of work volunteering each week or finding groups with funds to hire lobbyists and others to do the....". Any groups formed ? It would be ideal if nationally a committee was formed and could be utilized as a template for regional or state advocacy/efforts. The last thing we need is to waste time or duplicate efforts. Thank you again for educating us with specific provisions and regulations. Fahning RDH, BS, IBCLC Founder & Executive Director; Healthy Teeth ClubOral Health & WIC Breastfeeding Coordinator Pine County President; East Central Breastfeeding CoalitionMembership Chair; Minnesota Oral Health CoalitionMinnesota Baby; Prenatal & Breastfeeding Support LLC Sent from my iPhone

Dear Dana, and others,

I am responding to the questions posed

about the Affordable Care Act.

Dana asks, “If the Affordable Care

Act covers Breastfeeding support - what does that mean? Support from IBCLC or

CLC?. Should I be addressing this to USLCA?â€

states, “If You are only

looking at it from a business person point of view and not the big picture;

hospitals, WIC, community clinics etc. unless PP IBCLC start advocating and

interacting with other circles; baby friendly initiatives, WIC Peer Program etc

PP will suffer. And YES that means getting political!! And Looking at the

history of midwives, nurse practitioners and mid level dental providers may be

helpful in understanding the seriousness of getting IBCLC as a stand alone

profession and not viewed as an add on credential.â€

IBCLC are not licensed practitioners. We

do not possess Title Protection or Practice Protection.

Title Protection means a

license would be required for a person to call themselves a “lactation

consultant†but one could still practice breastfeeding support (or

lactation consulting) as they wished as long as they do not state they are a

“Lactation consultantâ€.

Practice protection is the

same as the current licensure for most health professionals like doctors and

nurses. If IBCLCs had Practice Protection then individuals who do not have the

IBCLC credential could not get a license and could not practice lactation

consulting.

The Affordable Care Act contains a

provision under the Women's Preventive Services Required Health Plan

Coverage Guidelines: The Act requires health plans to

cover preventive services for women with no cost sharing, including

breastfeeding support, supplies, and counseling. Non-grandfathered plans and

issuers are required to provide coverage without cost sharing consistent with

these guidelines in the first plan/policy year that begins on or after August

1, 2012.

This law does not say anything about who is to provide this coverage, it

just states the following:

Breastfeeding support,

supplies, and counseling.

Comprehensive lactation support and

counseling, by a trained provider during pregnancy and/or in the postpartum

period, and costs for renting breastfeeding equipment.

In conjunction with each birth.

There

are other provisions in the ACA which can be interpreted to include

lactation counseling requirements as well under the EPSDT and under the

Benchmark benefits, but the language is more vague. It remains to be seen if

lactation counseling will be mandated as part of these regulations.

Nonetheless, the above mandate make reimbursement a ‘given’ for

lactation counseling and is a huge step forward for breastfeeding families

regarding access to care. USLCA has worked hard to educate the policy makers in

order for this to happen. The USLCA has lobbied and worked to inform Medicaid,

private insurers, public health administrators, policy makers and others about

this issue. We have informed regarding Essential Health Benefits, WIC

Services, Benchmark Benefits, Insurance Exchange Plans, physician professional

organizations, Medicaid Administrators, and others as opportunities have arisen

at the local, state, and national levels in particular.

Therefore,

at the present time, despite USLCA efforts, any group or individual can be

qualified toffer these services. IBCLCs and these individuals will have to have

contracts with Medicaid or private insurers. This requires a process called

“credentialing†to be completed which will verify the

qualifications of the provider. There is a separate part of this process that

involves negotiating the fees for these services.

Regarding

Medicaid, there are federal regulations prohibiting the reimbursement of

“ANY†unlicensed providers so an IBCLC who has no other medical

license cannot be paid to render lactation services undeer the ACA by Medicaid.

See my article in June enews for the work around strategies.

Regarding

private insurers, they can choose to credential any providers they would like,

USLCA is advocating with these insurers for the credentialing process to be

based on the requirement of the IBCLC certification. We are currently setting

up the processes to credential IBCLCs this way, including applying for billing codes

specific for these services. That being said, if an individual or group

advocates for another “certificate†rather that the “IBCLC

certification†and they succeed in credentialing themselves, there is

nothing to stop them. It is not illegal because IBCLCs are not a

licensed profession. See the IBLCE

June newsletter article on this at http://iblce.org/news-from-the-board#Certification

vs. Certificate.

The

USLCA works to promote IBCLCs as the provider of choice for lactation care and

services and to educate the stakeholders. This work is ongiong daily!!! However,

it will not happen unless IBCLCs support USLCA, in philosophy, by reading

our newsletters and staying informed, and financially, to carry out this

work. Also, licensure will require committed individuals in every state to initiate advocacy

for licensure legislation and coordinatelegislative support. This

will means hours of work volunteering each week or finding groups with funds

to hire lobbyists and others to do the work for you. It will not happen in a

vacuum.

I

hope this helps you all to understand and you will consider supporting USLCA in

this work in every way that you can.

Judith

L. Gutowski, BA, IBCLC, RLC

[Guest guest]

Dee, The way I Understand what Judith was saying was pertaining more to insurance and credentialing process for direct reimbursement.LLLL or Peers could still "Support" mothers as long as they did not look for direct or insurance reimbursement or call themselves "Lactation Consultants"Sent from my iPhone

So, Judith,

Am I understanding correctly that if we tried to get "Practice Protection" we would essentially be making it impossible for LLL Leaders, WIC Peer Counselors, and others to help breastfeeding mothers? It would seem that Practice Protection for us would mean that others could not get a license and would therefore be liable to be accused of practicing without a license if they tried to help breastfeeding mothers. We surely don't want that to happen!

Dee Kassing

Dear Dana, and others,

I am responding to the questions posed about the Affordable Care Act.

Dana asks, “If the Affordable Care Act covers Breastfeeding support - what does that mean? Support from IBCLC or CLC?. Should I be addressing this to USLCA?â€

states, “If You are only looking at it from a business person point of view and not the big picture; hospitals, WIC, community clinics etc. unless PP IBCLC start advocating and interacting with other circles; baby friendly initiatives, WIC Peer Program etc PP will suffer. And YES that means getting political!! And Looking at the history of midwives, nurse practitioners and mid level dental providers may be helpful in understanding the seriousness of getting IBCLC as a stand alone profession and not viewed as an add on credential.â€

IBCLC are not licensed practitioners. We do not possess Title Protection or Practice Protection.

Title Protection means a license would be required for a person to call themselves a “lactation consultant†but one could still practice breastfeeding support (or lactation consulting) as they wished as long as they do not state they are a “Lactation consultantâ€.

Practice protection is the same as the current licensure for most health professionals like doctors and nurses. If IBCLCs had Practice Protection then individuals who do not have the IBCLC credential could not get a license and could not practice lactation consulting.

The Affordable Care Act contains a provision under the Women's Preventive Services Required Health Plan Coverage Guidelines: The Act requires health plans to cover preventive services for women with no cost sharing, including breastfeeding support, supplies, and counseling. Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan/policy year that begins on or after August 1, 2012.

This law does not say anything about who is to provide this coverage, it just states the following:

Breastfeeding support, supplies, and counseling.

Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.

In conjunction with each birth.

There are other provisions in the ACA which can be interpreted to include lactation counseling requirements as well under the EPSDT and under the Benchmark benefits, but the language is more vague. It remains to be seen if lactation counseling will be mandated as part of these regulations. Nonetheless, the above mandate make reimbursement a ‘given’ for lactation counseling and is a huge step forward for breastfeeding families regarding access to care. USLCA has worked hard to educate the policy makers in order for this to happen. The USLCA has lobbied and worked to inform Medicaid, private insurers, public health administrators, policy makers and others about this issue. We have informed regarding Essential Health Benefits, WIC Services, Benchmark Benefits, Insurance Exchange Plans, physician professional organizations, Medicaid Administrators, and others

as opportunities have arisen at the local, state, and national levels in particular.

Therefore, at the present time, despite USLCA efforts, any group or individual can be qualified toffer these services. IBCLCs and these individuals will have to have contracts with Medicaid or private insurers. This requires a process called “credentialing†to be completed which will verify the qualifications of the provider. There is a separate part of this process that involves negotiating the fees for these services.

Regarding Medicaid, there are federal regulations prohibiting the reimbursement of “ANY†unlicensed providers so an IBCLC who has no other medical license cannot be paid to render lactation services undeer the ACA by Medicaid. See my article in June enews for the work around strategies.

Regarding private insurers, they can choose to credential any providers they would like, USLCA is advocating with these insurers for the credentialing process to be based on the requirement of the IBCLC certification. We are currently setting up the processes to credential IBCLCs this way, including applying for billing codes specific for these services. That being said, if an individual or group advocates for another “certificate†rather that the “IBCLC certification†and they succeed in credentialing themselves, there is nothing to stop them. It is not illegal because IBCLCs are not a licensed profession. See the IBLCE June newsletter article on this at http://iblce.org/news-from-the-board#Certification vs. Certificate.

The USLCA works to promote IBCLCs as the provider of choice for lactation care and services and to educate the stakeholders. This work is ongiong daily!!! However, it will not happen unless IBCLCs support USLCA, in philosophy, by reading our newsletters and staying informed, and financially, to carry out this work. Also, licensure will require committed individuals in every state to initiate advocacy for licensure legislation and coordinatelegislative support. This will means hours of work volunteering each week or finding groups with funds to hire lobbyists and others to do the work for you. It will not happen in a vacuum.

I hope this helps you all to understand and you will consider supporting USLCA in this work in every way that you can.

Judith L. Gutowski, BA, IBCLC, RLC

[Guest guest]

Thank you Judith for clearly spelling out what is known and unknown about this issue!Dee, yes, you are correct. If IBCLC's were to become licensed to provide lactation counseling then anyone providing lactation counseling without that license, regardless of what they call themselves, is "practicing lactation counseling without a license". It would mean that peer counselors, LLL leaders, CLCs would have to become IBCLCs or stop

practicing, or practice illegally. As Judith pointed out this is called "practice protection". Title protection is about what you can call yourself..."lactation consultant" v "lactation counselor" or "breastfeeding support person" for example. Reimbursement is about who is willing to pay you and may or may not have anything to do with whether you are licensed or not. It is up to the private insurance companies or each state (in the case of Medicaid) to set those guidelines. Just because you are licensed doesn't mean they will have to pay you. That is a whole separate battle.As we go forward, thinking about how to make our services more widely available and affordable for our clients, and how to make sure our talents and skills are recognized and reimbursed appropriately, it is so important to keep the big picture in mind! We certainly do not want LLL leaders to suddenly have to face sanctions for practicing without a license or to make the requirements for peer counselors so lofty that they are no longer truly "peers". I really believe "it takes a village" to support families and I think there is a place for practitioners of all levels of education, background and experience. I want to protect what is unique about IBCLCs

while creating a system that encompasses and values what all of these different players have to offer. We all know that some clients will prefer one helper over another while others want to see everyone in their community and piece together what is right for them. I would love to see a visioning session at the national level that would bring together people from all of these various backgrounds to define both our common goals and our unique strengths and create a template for an inclusive breastfeeding support network that would be widely recognized and seamless for our clients. Go ahead, call me idealistic! But really, wouldn't it be great to be united as "lactation professionals" rather than divided with our own separate titles and credentials and restrictions and

regulations....Thank you all for your hard work on behalf of mothers and babies! Blessings! Spang, CPM, IBCLC, CLC

[Guest guest]

Wic Peer Counselors are paid here in Ohio, also. I was shocked when I found this out since I had done so much volunteer work for so many years to get my hours. Cheryl To:

Sent: Sunday, July 8, 2012 9:34 AM Subject: Re: Re: What does PPACA mean for the future of IBCLCs

Whoa, Judy!

This does NOT protect WIC Peer Counselors! These wonderful ladies *are* paid, at least in IL. I am pretty sure the ones in Missouri are also paid. So, you've protected LLL, Breastfeeding USA, and Nursing Mothers Council volunteers, but there are others who *get paid* and you've knocked them into being illegal to continue their work with this wording.

Dee Kassing

Regarding La Leche League Leaders and other volunteers the model legislation we are proposing states:

Individuals who are members of board-recognized volunteer organizations shall be exempt from licensure requirements if:

(a) They do not hold themselves out as being licensed or having clinical skills and abilities associated with licensure.

( Their volunteer service is performed without fee or other form of compensation, monetary or otherwise, from the individuals or groups served.

© The individual volunteer receives no form of compensation, monetary or otherwise, except for administrative expenses such as mileage.

(d) This shall not prevent a licensed lactation consultant from providing care on a reduced or no-fee basis.

I am the Chair of the USLCA Committee for Licensure and Reimbursement. I am currently working with about 11 state initiatives. I am the person to contact if anyone is interested in helping with efforts. You can see our page on the USLCA website for information about licensure and reimbursement. PLEASE read your USLCA newsletters to receive ongoing information about Licensure and Reimbursement. There is something in almost every issue from Marsha or myself about this. There is no one single way to go about licensure because each state process is different. We have to figure it out state by state. It also depends on the folks in a state who are willing to work with us so it can be public health or legislators or non-profits who spearhead the work. In all cases we need to have the State Breastfeeding Coalition and the State USLCA Chapters on Board and

ideally

leading the work. You can find those here:

The state breastfeeding Coalitions http://www.usbreastfeeding.org/Coalitions/CoalitionsDirectory/tabid/74/Default.aspx

USLCA chapters http://www.ilca.org/i4a/pages/index.cfm?pageid=3887

If you are not involved in these groups they need you and you should be involved, not only for licensure and reimbursement, but for advocacy and to improve the “networking†of IBCLCs in your state and local communities. Networking is how we improve breastfeeding and how we progress as a profession.

On a separate note, is anyone else having their digests come through with words in the posts in a long column rather than lines?? It is so annoying.

Judy

Judith L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell Phone

Fax

[Guest guest]

Having been a peer counselor with WIC for the past 7 years before sitting for my exam I can tell you that there is a certain protocol we had to follow and anything beyond basic breastfeeding issues must be referred to an IBCLC. We referred to area hospital based IBCLC's as we didn't have one on staff. Now that I received my certification we don't have to refer out although I still do refer to a more experienced IBCLC if I am in doubt or need a second opinionLiz Brown,IBCLC, RLC, CLCPeer HelperColumbiana County WIC

Regarding La Leche League Leaders and other volunteers the model legislation we are proposing states:

Individuals who are members of board-recognized volunteer organizations shall be exempt from licensure requirements if:

(a) They do not hold themselves out as being licensed or having clinical skills and abilities associated with licensure.

( Their volunteer service is performed without fee or other form of compensation, monetary or otherwise, from the individuals or groups served.

© The individual volunteer receives no form of compensation, monetary or otherwise, except for administrative expenses such as mileage.

(d) This shall not prevent a licensed lactation consultant from providing care on a reduced or no-fee basis.

I am the Chair of the USLCA Committee for Licensure and Reimbursement. I am currently working with about 11 state initiatives. I am the person to contact if anyone is interested in helping with efforts. You can see our page on the USLCA website for information about licensure and reimbursement. PLEASE read your USLCA newsletters to receive ongoing information about Licensure and Reimbursement. There is something in almost every issue from Marsha or myself about this. There is no one single way to go about licensure because each state process is different. We have to figure it out state by state. It also depends on the folks in a state who are willing to work with us so it can be public health or legislators or non-profits who spearhead the work. In all cases we need to have the State Breastfeeding Coalition and the State USLCA Chapters on Board and

ideally leading the work. You can find those here: The state breastfeeding Coalitions http://www.usbreastfeeding.org/Coalitions/CoalitionsDirectory/tabid/74/Default.aspx USLCA chapters http://www.ilca.org/i4a/pages/index.cfm?pageid=3887 If you are not involved in these groups they need you and you should be involved, not only for licensure and reimbursement, but for advocacy and to improve the “networking†of IBCLCs in your state and local communities. Networking is how we improve breastfeeding and how we progress as a profession.

On a separate note, is anyone else having their digests come through with words in the posts in a long column rather than lines?? It is so annoying.

Judy Judith L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell Phone Fax

[Guest guest]

REPLIES TO YOUR CONCERNS ABOUT IBCLC

LICENSURE BELOW

Spring Wrote:

“ If IBCLC's were to become

licensed to provide lactation counseling then anyone providing lactation

counseling without that license, regardless of what they call themselves, is

" practicing lactation counseling without a license " . It would

mean that peer counselors, LLL leaders, CLCs would have to become IBCLCs or

stop practicing, or practice illegally. As Judith pointed out this is

called " practice protection " .”

THIS IS NOT TRUE AS THE MODEL LEGISLATION I ALREADY SHARED

HAS AN EXEMPTION FOR VOLUNTEERS!

Lynn wrote:

“Please clarify for me: we are not

lactation counselors, so would we not be licensed to practice lactation *consulting*

and then others like LLLLs could have the *counseling*?”

Multiple public policies which were created and implemented

without USLCA involvement have called the work of breastfeeding support “lactation

counseling”. Although I objected to this language, it is already in many

of the policies. This is part of the problem we face with the misunderstanding

about the IBCLC credential. Our attorneys advised us to use the language that

already existed in the policies, but in all of our work we define the “credential”

of the person to provide lactation counseling as the IBCLC.

And regarding peer counselors:

“Is there a way to have all??, it

doesn't have to be so cut and dry. It could be as simple as having clearly

defined scopes of practice.”

Dee writes:

“Whoa, Judy! This does NOT protect

WIC Peer Counselors! These wonderful ladies *are* paid.”

Peer counselors are a completely different legal entity. They

are not “lactation consultants” and should never call themselves by

that name, nor should they be working in the same scope of practice.

Peer Counselor’s should not be performing clinical

tasks. If they stay within their defined role they do not need a license.

Breastfeeding peer

counseling is “lay support” mothers helping mothers. From the WIC

Training Materials here is their definition and role:

WIC Peer Counselors are paraprofessional women, enthusiastic about

their breastfeeding success, who want to share their enthusiasm

and knowledge with women

of their culture and language. They work with WIC and medical providers to

promote and support breastfeeding in their communities.

Appropriate

Definition of a Peer Counselor

·

Paraprofessional*

·

Recruited and hired from target population

·

Available to WIC clients outside usual

clinic hours and outside the WIC clinic environment

The definition of Paraprofessional is :

Those without

extended professional training in health, nutrition, or the clinical management

of breastfeeding who are selected from the group to be served

and are trained and given ongoing supervision to

provide a basic service or function. Paraprofessionals provide specific tasks

within a defined scope of practice.

They

assist professionals, but are not licensed or credentialed as healthcare,

nutrition, or lactation consultant professionals.

writes:

WIC peer counselors are not universally

super used by IBCLC- a major hole in the program IMO.

Unfortunately this is very true. Few WIC programs employ

IBCLCs to supervise peer counselors.

Additionally,

CDC

National Immunization Survey Sociodemographic Breastfeeding Rates

Sociodemographic Factor 2007

Ever Breastfed %

Breastfeeding at 6 Months %

Breastfeeding at 12 Months %

United States

75

43

22.4

Receiving WIC

67.5

33.7

17.5

No WIC, but eligible

77.5

48.2

30.7

Ineligible

84.6

54.2

27.6

The Surgeon General’s Call to Action to Support

Breastfeeding also noted that disparities in breastfeeding rates are associated

in a negative way with “recommendations from WIC counselors.”[1]

Additionally,

evidence shows that inclusion of IBCLCs in WIC programs,

along with peer counselors, showed greater improvement in breastfeeding rates.

( Yun S et al. (2009) Evaluation of the Missouri WIC

(Special Supplement Nutrition Program for Women, Infants and Children)

breast-feeding peer counseling programme. Public Health Nutr 13, no. 2: 229-237. Available at http://journals.cambridge.org/action/displayAbstract?fromPage=online & aid=7078124

accessed on April 24, 2012.)a

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

[1] Ibid