A6067

An Act providing for the licensing of lactation consultants and supplementing Title 45 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. This act shall be known and may be cited as the "Lactation Consultants Licensing Act."

2. The Legislature finds and declares that:

a. The Legislature values and supports the work of all lactation personnel, but recognizes that the health, safety, and welfare of our citizens requires us to identify competencies of lactation personnel based on education and clinical training.

b. The application of specific knowledge and skill relating to breastfeeding is important to the health of mothers and babies, and acknowledges further that the rendering of sound clinical lactation care and services in hospitals, physician practices, private homes, and other settings requires trained and competent professionals.

c. It is the purpose of this act to protect the health, safety, and welfare of the public by providing for the licensure and regulation of the activities of persons engaged in clinical lactation care.

3. As used in this act:

“Board” means the New Jersey Board of Licensed Lactation Consultants.

“Breastfeeding education and basic support services” means activities whose purpose is to educate and support parents and children in meeting their breastfeeding goals, including providing general breastfeeding education; basic support and encouragement; sharing personal experiences; and giving nonclinical information. “Breastfeeding education and support services” may be performed by licensed or unlicensed individuals, including lactation consultants; breastfeeding and lactation educators or counselors; peer supporters; doulas; childbirth educators; community health workers; and home visitors.

“Clinical lactation care” means the clinical application of scientific principles and a multidisciplinary body of evidence to provide evaluation; problem identification; treatment; education; and consultation regarding the course of lactation and feeding to individual families. Clinical lactation care is described in the core competencies of the examining body, which include but are not limited to:

(1) taking maternal, child, and feeding histories;

(2) performing clinical assessments related to breastfeeding and human lactation through the systematic collection of subjective and objective information;

(3) analysis of data;

(4) development of a lactation management and child feeding plan with demonstration and instruction to parents;

(5) provision of lactation education to parents and health care providers;

(6) the recommendation and use of assistive devices;

(7) communicating to the primary health care practitioner and referring to other healthcare practitioners, as needed;

(8) conducting appropriate follow-ups with evaluation of outcomes; and

(9) documenting the encounter in a patient record.

“International Board Certified Lactation Consultant” or “IBCLC” means an individual who holds current certification from the International Board of Lactation Consultant Examiners (IBLCE), or its successor organization, or other equivalent national testing service approved by the board as a lactation consultant after demonstrating the appropriate education, knowledge, and experience necessary for independent clinical practice.

“International Board of Lactation Consultant Examiners” or “IBLCE” means the international organization that certifies IBCLCs and is independently accredited by the National Commission of Certifying Agencies.

“Lactation consultant” means a person in good standing as a lactation consultant with the IBLCE, or its successor organization, or other equivalent national testing service approved by the board who is licensed to provide clinical lactation care pursuant to the provisions of this act.

“License” means a license to practice as a lactation consultant pursuant to this act.

“Licensee” means any person holding a license under this act.

“Perinatal health worker” means a doula; community health worker; peer counselor; WIC (women, infants, and children) peer counselor; peer supporter; breastfeeding and lactation educator or counselor; childbirth educator; social worker; home visitor; or any other perinatal educator.

“Practice” means rendering or offering to render, for compensation, clinical lactation care to any person, or group of persons.

4. a. There is created within the Division of Consumer Affairs in the Department of Law and Public Safety, the New Jersey Board of Licensed Lactation Consultants. The board shall consist of seven members, to be appointed by the Governor, who are citizens of the United States and residents of the State as follows: one public member; one physician who is licensed pursuant to chapter 9 of Title 45 of the Revised Statutes; and the remaining five members, except for the members first appointed, licensed lactation consultants under the provisions of this act who have been actively engaged in providing clinical lactation care in the State, as an IBCLC, for at least five years immediately preceding their appointment. With regards to the five licensed lactation consultants to be appointed, at least one member shall be from each of the following areas of practice: hospital clinical lactation care; community or public health; and the private practice of clinical lactation care.

b. Members of the board shall take office on the first day of July immediately following the expired terms of that office and shall serve a term of three years. However on initial formation, not including the public member or licensed physician to be members of the board pursuant to subsection a. of this section, two members shall serve for a term of three years, two shall serve for a term of two years and one shall serve for a term of one year. Any vacancy in the membership of the board shall be filled for the unexpired term in the manner provided by the original appointment. No member of the board may serve more than two successive terms in addition to any unexpired term to which the member has been appointed.

5. Notwithstanding the provisions of section 2 of P.L.1977, c.285 (C.45:1-2.5) or any other law to the contrary, the members of the board shall serve without compensation, and shall not be entitled to receive any pension or health benefits based upon their service as members of the board, but shall be reimbursed for expenses and provided with office and meeting facilities pursuant to section 2 of P.L.1977, c.285 (C.45:1-2.5).

6. a. The board shall organize within 30 days after the appointment of its members and shall annually elect from among its members a chairperson and vice‑chairperson, and a secretary who need not be a member of the board. The board shall meet twice a year and may hold additional meetings as necessary to discharge its duties. A majority of the board membership shall constitute a quorum.

b. All members of the board shall take the constitutional oath of office.

c. The Governor may remove members of the board, after notice and opportunity for hearing, for incompetence; neglect of duty; unprofessional conduct; conviction of any felony; failure to meet the qualifications of this act; or for committing any act prohibited pursuant to subsection a. of section 12 of this act.

7. The board shall:

a. examine the applications and determine the qualifications and fitness of applicants for initial licensure and license renewal, reinstatement, or reactivation;

b. maintain a record of every lactation consultant licensed in this State, including the address for a place of business or a place of residence; and the date and number of their license;

c. conduct hearings on complaints concerning violations of this act and any rules or regulations promulgated thereto, pursuant to P.L.1978, c.73 (C.45:1-14 et seq.);

d. establish continuing education requirements if deemed necessary for licensure renewal, reactivation, or reinstatement;

e. set application fees for initial licensure and licensure renewal, reactivation, and reinstatement;

f. prepare information for consumers describing the regulatory functions of the board and describing the procedures by which consumer complaints are filed with and resolved by the board and other matters regarding lactation consulting the board deems appropriate;

g. adopt a seal which shall be affixed only in a manner as prescribed by the board;

h. adopt a code of ethics; and

i. enforce the provisions of this act. The board shall be granted all of the necessary duties, powers, and authority to carry out this responsibility.

8. No person shall provide clinical lactation care, on either a compensated or uncompensated basis, hold themselves out to the public as being authorized to provide clinical lactation care, or use any title or description stating or implying that the person is a lactation consultant who is licensed to provide clinical lactation care, unless the person holds a valid license pursuant to this act to practice as a lactation consultant in this State, except nothing in this act shall be construed to prohibit:

a. a person who is licensed to practice under any law, or who is an accredited member, volunteer, or perinatal health worker belonging to another profession or occupation, from providing general breastfeeding education and basic support services for which that person is licensed, regulated, accredited, or certified;

b. a student who is enrolled in a school or post-graduate course of clinical lactation care, recognized by the board, or who is enrolled in a lactation consultant credentialing pathway, approved by the board, from performing activities which are necessary to the student's course of study;

c. a peer counselor within the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from providing general breastfeeding education and support services that are within the job description of the peer counselor;

d. a nonresident IBCLC with a certificate from the IBLCE, or its successor organization, or other equivalent national testing service approved by the board from providing clinical lactation care in this State for up to five days per calendar year without licensure or up to 30 days per calendar year with licensure from another state if the requirements for licensure in that other state are substantially equivalent to the requirements contained in this act, as determined by the board;

e. a medical student, medical resident, or nursing student or other clinical medical professional student from providing clinical lactation care which is necessary to the student’s course of study;

f. a physician, nurse, or other medical professional to provide clinical lactation care that is within their scope of practice; and

g. persons performing breastfeeding education and support services from seeking compensation or reimbursement for services provided pursuant to P.L.2019, c.343 (C.17:48-6ss et al.).

9. To be eligible to be licensed as a lactation consultant, an applicant shall fulfill the following requirements:

a. be at least 18 years of age;

b. be of good moral character;

c. meet the international education and clinical standards established for the IBCLC by the IBLCE, or its successor organization, or other equivalent educational and clinical prerequisites, and satisfy national testing prerequisites, as approved by the board;

d. provide proof of successful completion of the IBLCE examination, or the examination of the successor organization, or other equivalentexamination as approved by the board;

e. have satisfactory results from a criminal background check report conducted by the State Bureau of Identification and the Federal Bureau of Investigation, as determined by the board. The submission of an application for a license pursuant to this section shall constitute express consent and authorization for the board to perform a criminal background check. Each applicant who submits an application to the board for licensure agrees to provide the board with the information necessary to run a criminal background check, including, but not limited to, a classifiable sets of fingerprints. The applicant shall be responsible for all fees associated with the performance of a criminal background check; and

f. completion of any other requirements as determined by the board.

10. a. After evaluating an application, the board shall notify each applicant that the application submitted is satisfactory and accepted or unsatisfactory and rejected. If rejected, a notice shall be sent and state the reasons for the rejection.

b. Upon acceptance of an application, the board shall issue a license. All licenses shall be issued for a five-year period upon the payment of the requisite fee as prescribed by the board, and shall be renewed upon:

(1) filing of a renewal application;

(2) the payment of a renewal fee; and

(3) presentation of satisfactory evidence of:

(a) passage of an examination by the IBLCE, or its successor organization, or another equivalent examination approved by the board; or

(b) any continuing education requirements prescribed by the board.

c. A license shall expire before the end of the five-year period if the certification granted to the IBCLC by the IBLCE, or its successor organization, or by any other equivalent national testing service approved by the board.

d. A license issued by the board is the property of the board and shall be surrendered on demand.

e. The licensee shall:

(1) publicly display the license in a clear and conspicuous manner; and

(2) inform the board of any change of business address.

f. A license that is expired for failure of the holder to renew on-time may be renewed after submission of an application and payment of the requisite fees for reactivation and late submission within the time period as established by the board and provided the applicant meets requirements as the board may establish by rule.

g. A license which has not been renewed by the end of the late renewal period shall be considered lapsed, revoked, and subject to reinstatement at the discretion of the board after meeting requirements as the board may establish.

h. Each person licensed under this act is responsible for renewing the license before the expiration date.

i. As prescribed by the board, a licensee may request to declare a license inactive. The licensee may apply to reactivate a license at any time and upon meeting requirements as prescribed by the board.

11. No person, business entity or its employees, agents, or representatives shall use the titles “lactation consultant,” “licensed lactation consultant,” “IBCLC,” or “licensed L.C.” unless licensed to provide clinical lactation care under the provisions of this act.

12. a. The board may revoke, suspend, deny, or refuse to issue or renew a license; place a licensee on probation; or issue a letter of admonition upon proof that the licensee or applicant:

(1) has procured or attempted to procure a license by fraud, deceit, misrepresentation, misleading omission, or material misstatement of fact;

(2) has been convicted of a felony or of any crime involving moral turpitude as provided under State law;

(3) has willfully or negligently acted in a manner inconsistent with the health or safety of persons under the care of the licensee;

(4) has had a license to practice a business or profession suspended or revoked or has otherwise been subject to discipline related to the licensee’s practice of a business or profession in any other jurisdiction;

(5) has committed a fraudulent act that materially affects the fitness of the licensee or applicant to practice a business or profession;

(6) excessively or habitually uses alcohol or drugs, provided that the board shall not discipline a licensee under this paragraph if a licensee is enrolled in a substance abuse program approved by the board; or

(7) has a physical or mental disability that renders the licensee incapable of safely administering clinical lactation care.

b. The board shall be authorized to conduct investigations into allegations of conduct described in subsection a. of this section.

c. In addition to revoking, suspending, denying, or refusing to renew a license, the board may fine a person, found to have violated any provision of this act or any rule promulgated thereof by the board, of not less than $100 or more than $500 for each violation.

13. It being the legislative intent in enacting this act that each section, subsection, paragraph, sentence, or part thereof be enacted separately and independent of each other, if any section, subsection, paragraph, sentence, or part thereof of this act shall be held to be invalid or unconstitutional, the invalidity or unconstitutionality shall not affect or impair the remaining provisions of this act unless it clearly appears that a provision is wholly and necessarily dependent upon a part held to be invalid or unconstitutional.

14. The board shall promulgate rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as necessary to effectuate the purposes of this act.

15. This act shall take effect immediately, except that section 8 of this act shall take effect one year after the date of enactment.

STATEMENT

This bill, which is designated the “Lactation Consultants Licensing Act,” provides for the licensure of lactation consultants in this State.

The bill establishes a seven-member Lactation Consultants Board (“the board”), in the Division of Consumer Affairs in the Department of Law and Public Safety, to license persons providing clinical lactation care. The board would consist of one public member, one licensed physician, and five licensed lactation consultants who have been actively engaged in providing clinical lactation care in the State as an International Board Certified Lactation Consultant (IBCLC) for at least five years immediately preceding appointment to the board, with at least one member from each of the following areas of practice: hospital clinical lactation care; community or public health; and the private practice of clinical lactation care. The members of the board are to be appointed by the Governor and are to serve without compensation but be reimbursed for expenses and provided with office and meeting facilities.

Under the bill, “clinical lactation care” means the clinical application of scientific principles and a multidisciplinary body of evidence to provide evaluation; problem identification; treatment; education; and consultation regarding breastfeeding and breast milk feeding to individual families. “Breastfeeding education and support services” means activities whose purpose is to educate and support mothers and children in meeting their breastfeeding goals including providing general breastfeeding education and encouragement, sharing personal experiences, and giving nonmedical advice.

The bill requires an applicant for licensure as a lactation consultant to be at least 18 years old, of good moral character, and to fulfill the following requirements: (1) meet the international education and clinical standards established for IBCLCs by the International Board of Lactation Consultant Examiners (IBLCE) or other equivalent educational and clinical prerequisites as approved by the board; and (2) provide proof of successful completion of the IBLCE examination or other equivalent examination as approved by the board.

The bill prohibits any person from providing clinical lactation care in this State on either a compensated or uncompensated basis, holding themselves out to the public as being authorized to provide clinical lactation care, or use any title or description stating or implying that the person is a lactation consultant licensed to provide clinical lactation care unless that person holds a valid license. However, the provisions of the bill are inapplicable to various individuals, including: (1) persons licensed to practice under any law or who are accredited members or volunteers of another profession or occupation providing breastfeeding education and support services for which a person is licensed, regulated, accredited, or certified; (2) students enrolled in a school or post-graduate course of clinical lactation care, recognized by the board, or who are enrolled in a lactation consultant credentialing pathway, approved by the board, performing activities necessary to the student’s course of study; and (3) a medical student, medical resident, nursing student or other clinical medical professional student providing clinical lactation care necessary to the student’s course of study.

The bill provides for the licensure, without examination, of lactation consultants who have been licensed or registered in another state with standards substantially equivalent to those of this State.