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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LACTATION COUNSELORS PRACTICE ACT

OF 2024

     Introduced By: Senators Mack, Euer, DiMario, Lauria, Acosta, Valverde, Quezada,
Ujifusa, Murray, and Sosnowski

     Date Introduced: February 12, 2024

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

amended by adding thereto the following chapter:

CHAPTER 13.8

LACTATION COUNSELORS PRACTICE ACT OF 2024

     23-13.8-1. Short title.

     This chapter shall be known and may be cited as the "Lactation Counselors Practice Act of

2024."

     23-13.8-2. Definitions.

     As used in this chapter, the following words and terms shall have the following meanings:

     (1) "Care extender" means an individual with lived experience who provides family

navigation, care coordination, and peer support services to individuals.

     (2) "Department" means the Rhode Island department of health.

     (3) "Director" means the director of the Rhode Island department of health, or designee.

     (4) "Lactation counselor" means an individual who holds current certification from the

Academy of Lactation Policy and Practice as a certified lactation counselor (CLC) or an advanced

lactation consultant (ALC) after demonstrating appropriate education and competency and passing

a criterion-referenced examination.

     (5) "Practice" means rendering or offering to render any lactation counseling services based

on the scope of work practice as a licensed lactation counselor, as defined in regulations, which

includes lactation counseling services provided to any individual, family, or group of individuals.

     23-13.8-3. Licensure requirements.

     (a) No individual shall practice unless the individual is licensed in accordance with the

provisions of this chapter.

     (b) A licensed lactation counselor shall provide lactation counseling services within the

scope of practice in the performance of the counselor’s duties.

     (c) A licensed lactation counselor is authorized to supervise the following individuals:

     (1) Licensed lactation counselor;

     (2) Students, interns, or individuals preparing for practice as a lactation counselor;

     (3) Care extenders and other team members as appropriate; and

     (4) Volunteers.

     (d) A licensed lactation counselor shall not delegate any of their duties or responsibilities

to any individual under their supervision who is not a licensed lactation counselor.

     23-13.8-4. Qualifications for licensure.

     An applicant for licensure as a lactation counselor shall:

     (1) Be at least eighteen (18) years of age;

     (2) Successfully complete an academic and practice program in lactation counseling;

     (3) Pass the examination offered by the Academy of Lactation Policy and Practice of CLC

and or ALC; and

     (4) Currently be certified as a CLC or ALC or comparable training determined by the

director.

     23-13.8-5. Licensure application.

     In order to apply for licensure as a lactation counselor, an applicant shall submit the

following on forms provided by the department:

     (1) A completed application including, but not limited to, name, address, date of birth,

social security number, telephone number, and email address; and

     (2) An application fee determined by the department, which fee shall be non-refundable

and non-returnable; and

     (3) Verification of current certification as a CLC or an ALC submitted to the department

by the Academy of Lactation Policy and Practice.

     23-13.8-6. Licensure by endorsement.

     In order to apply for a license by endorsement, an applicant shall submit the following on

forms provided by the department:

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     (1) A completed application including, but not limited to, name, address, date of birth,

social security number, telephone number and email address;

     (2) An application fee determined by the department, which shall be non-refundable and

non-returnable;

     (3) Verification of current certification as a CLC or an ALC submitted directly to the

department by the Academy of Lactation Policy and Practice; and

     (4) Verification that the applicant is in good standing from all states where the applicant is

currently certified and/or licensed as a lactation counselor submitted directly to the department by

the certifying and/or licensing authority.

     23-13.8-7. Issuance.

     A license as a lactation counselor shall be issued to an applicant who meets the relevant

requirements for licensure as required by this chapter.

     23-13.8-8. Expiration and renewal of licenses.

     (a) The license of every person licensed in accordance with this chapter shall expire on

January 31 of the next odd-numbered year following the issuance of the lactation counselor’s

license.

     (b) In order to renew a license, the licensee shall file a renewal application with the

department, together with a renewal fee on or before January 31 in each odd-numbered year. The

license renewal shall be effective on the first day of February.

     (c) If a licensee fails to renew their license on or before January 31 in each odd-numbered

year, as required by this chapter, the license shall expire. No one whose license is expired is

authorized to practice as a licensed lactation counselor or represent themselves as being able to

practice as a licensed lactation counselor in Rhode Island until they have renewed the expired

license in accordance with this chapter or have a terminated license reinstated in accordance with

this chapter.

     (d) A licensee may renew an expired license within one year of the expiration date. In order

to renew an expired license, the licensee shall submit the following:

     (1) A renewal application together with the current renewal fee plus an additional fee as

provided in applicable rules and regulations promulgated by the department. The fees shall be non-

refundable and non-returnable.

     (e) If a licensee fails to renew an expired license within one year of the date of its expiration,

the license will be terminated. In order to reinstate a terminated license, the licensee shall submit

the following:

     (1) A reinstatement application together with the current renewal fee, plus an additional

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fee as provided in applicable rules and regulations promulgated by the department. The fees shall

be non-refundable and non-returnable; and

     (b) Verification of current certification as a CLC or an ALC shall be submitted directly to

the department by the Academy of Lactation Policy and Practice.

     23-13.8-9. Scope of practice.

     (a) A licensed lactation counselor must provide lactation counseling services within the

scope of practice which will include, but not be limited to, referral, as appropriate, to a healthcare

professional both as defined by the director through the promulgation of regulations. Furthermore,

a licensed lactation counselor shall comply with the academy of lactation policy and practice; CLC,

in accordance with "Scope of Practice for CLCs"; ALC, in accordance with "Scope of Practice for

ALCs"; and/or a licensed lactation counselor shall limit the counselor’s practice to demonstrated

areas of competence as documented by relevant professional education, training, and experience.

     (b) A licensed lactation counselor shall conduct the counselor’s professional activities in

accordance with the "Scope of Practice for CLCs," and/or "Scope of Practice for ALCs".

     23-13.8-10. Maintenance of certification.

     (a) A licensee shall notify the department, in writing, within five (5) business days of

receiving notification from the academy of lactation policy and practice that their status as a CLC

or an ALC, as required in this chapter, has been revoked and/or subject to any restriction, limitation

or other sanction.

     (b) A licensee shall notify the department, in writing, within five (5) business days of

failure to renew or other lapse of their status as a CLC or an ALC.

     23-13.8-11. Persons and practices exempt.

     (a) Nothing in this chapter shall be construed to prevent qualified members of other

professions or other occupations or volunteers from performing functions consistent with the

accepted standards of their respective professions; provided, however, that they do not hold

themselves out to the public by any title or description stating or implying that they are licensed

lactation counselors.

     (b) Nothing in this chapter shall be construed to prevent the practice of lactation counseling

services by students, interns, or persons preparing for practice under the qualified supervision of a

licensee.

     (c) Lactation counseling services provided through the Federal Special Supplemental

Nutrition Program for Women, Infants and Children (WIC) program shall be considered exempt

from the requirements of this chapter.

     (d) Lactation counseling services provided through the state’s family home visiting

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programs shall be considered exempt from the requirements of this chapter.

     23-13.8-12. Promulgation of regulations.

     The director shall adopt, amend, promulgate, and enforce rules and regulations and

standards deemed necessary, not inconsistent with law, to carry out the purposes of this chapter.

     23-13.8-13. Grounds for refusal, revocation, or suspension.

     (a) Upon due notice and hearing in accordance with chapter 35 of title 42 ("administrative

procedures"), and the provisions of this chapter, any violation pursuant to the provisions of this

chapter, may be cause for denial, revocation, or suspension of license or for imposing a fine of not

more than one thousand dollars ($1,000).

     (b) Except as otherwise provided in this chapter, the inspection, enforcement, and penalties

for violations of this chapter or the rules and regulations of the department shall be in accordance

with the provisions and procedures set forth in §§ 23-1-19 through 23-1-25.

     23-13.8-14. Rules governing practices and procedures.

     All hearings and reviews required pursuant to the provisions of this chapter shall be held

in accordance with the provisions of this chapter and chapter 35 of title 42 ("administrative

procedures").

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- LACTATION COUNSELORS PRACTICE ACT

OF 2024

***

     This act would specify the requirements and procedures for licensing lactation counselors

as well as the renewal, expiration, termination, refusal, revocation and suspension of licenses.

     This act would take effect upon passage.

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