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A BILL TO BE ENTITLED
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AN ACT
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relating to the licensing and regulation of lactation consultants |
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and the creation of the Lactation Consultant Advisory Board; |
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requiring an occupational license; imposing fees; providing |
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penalties; creating a criminal offense. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 51.2031(a), Occupations Code, is amended |
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to read as follows: |
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(a) This section applies only to the regulation of the |
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following professions by the department: |
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(1) athletic trainers; |
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(2) behavior analysts; |
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(3) dietitians; |
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(4) hearing instrument fitters and dispensers; |
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(5) midwives; |
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(6) orthotists and prosthetists; [and] |
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(7) speech-language pathologists and audiologists; |
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and |
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(8) lactation consultants. |
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SECTION 2. Subtitle M, Title 3, Occupations Code, is |
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amended by adding Chapter 703 to read as follows: |
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CHAPTER 703. LACTATION CONSULTANTS |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 703.001. SHORT TITLE. This chapter may be cited as the |
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Texas Lactation Consultant Act. |
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Sec. 703.002. DEFINITIONS. In this chapter: |
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(1) "Advisory board" means the Lactation Consultant |
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Advisory Board. |
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(2) "Commission" means the Texas Commission of |
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Licensing and Regulation. |
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(3) "Department" means the Texas Department of |
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Licensing and Regulation. |
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(4) "Executive director" means the executive director |
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of the department. |
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(5) "Lactation consultant" means a health care |
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professional licensed under this chapter who specializes in the |
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clinical management of breastfeeding and works in a variety of |
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settings. |
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Sec. 703.003. APPLICABILITY. Unless the person uses the |
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title "lactation consultant" or "licensed lactation consultant" to |
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describe the person's activities, this chapter does not apply to: |
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(1) a person licensed in this state as a physician or |
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nurse; |
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(2) a health care professional licensed by this state |
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and operating within the scope of the person's license; |
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(3) a person acting as a paid or volunteer peer |
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counselor, La Leche League Leader, doula, or childbirth educator; |
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or |
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(4) a licensed midwife. |
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Sec. 703.004. APPLICATION OF SUNSET ACT. The Lactation |
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Consultant Advisory Board is subject to Chapter 325, Government |
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Code (Texas Sunset Act). Unless continued in existence as provided |
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by that chapter, the Lactation Consultant Advisory Board is |
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abolished and this chapter expires September 1, 2023. |
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SUBCHAPTER B. LACTATION CONSULTANT ADVISORY BOARD |
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Sec. 703.051. ADVISORY BOARD MEMBERSHIP. (a) The advisory |
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board consists of nine members appointed by the presiding officer |
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of the commission with the approval of the commission as follows: |
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(1) five lactation consultant members, each of whom |
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has at least three years' experience in the practice of lactation |
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consulting; |
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(2) one physician member who is certified by a |
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national professional organization of physicians that certifies: |
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(A) obstetricians and gynecologists; |
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(B) family practitioners; or |
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(C) pediatricians; |
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(3) one member who: |
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(A) is an advanced practice registered nurse; and |
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(B) practices in obstetrics, pediatrics, or |
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family practice; and |
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(4) two members who represent the public and are not |
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practicing or trained in a health care profession, at least one of |
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whom is a parent who has been assisted by a lactation consultant. |
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(b) Appointments to the advisory board shall be made without |
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regard to the race, color, disability, sex, religion, age, or |
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national origin of the appointee. |
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Sec. 703.052. DUTIES OF ADVISORY BOARD. The advisory board |
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shall provide advice and recommendations to the department on |
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technical matters relevant to the administration of this chapter. |
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Sec. 703.053. TERMS; VACANCIES. (a) Members of the |
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advisory board serve for staggered terms of six years. The terms |
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of three members expire on January 31 of each odd-numbered year. |
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(b) If a vacancy occurs during a member's term, the |
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presiding officer of the commission, with the commission's |
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approval, shall appoint a replacement who meets the qualifications |
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for the vacant position to serve for the remainder of the term. |
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Sec. 703.054. PRESIDING OFFICER. The presiding officer of |
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the commission shall designate a public member of the advisory |
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board to serve as the presiding officer of the advisory board to |
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serve for a term of one year. The presiding officer of the advisory |
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board may vote on any matter before the advisory board. |
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Sec. 703.055. MEETINGS. The advisory board shall meet at |
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the call of the presiding officer of the commission or the executive |
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director. |
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Sec. 703.056. APPLICABILITY OF OTHER LAW. Chapter 2110, |
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Government Code, does not apply to the composition or duration of |
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the advisory board or to the appointment of the advisory board's |
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presiding officer. |
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SUBCHAPTER C. POWERS AND DUTIES |
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Sec. 703.101. GENERAL POWERS AND DUTIES. (a) The executive |
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director shall administer and enforce this chapter. |
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(b) The commission shall adopt rules: |
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(1) prescribing the standards for the practice of |
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lactation consulting in this state; |
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(2) prescribing the type of courses and number of |
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hours required to meet the basic lactation consulting education |
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course and continuing lactation consulting education course |
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requirements; |
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(3) prescribing minimum standards for the approval and |
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revocation of approval of: |
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(A) basic lactation consulting education courses |
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and continuing lactation consulting education courses; and |
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(B) instructors or facilities offering basic |
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lactation consulting education courses and continuing lactation |
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consulting education courses; |
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(4) requiring lactation consultants to obtain each |
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patient's signature on a release advising the patient that |
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lactation consultation is not a substitute for conventional medical |
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care by a physician, including diagnosis, treatment, and well-child |
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care; and |
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(5) establishing requirements necessary to establish |
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eligibility for reciprocity for initial licensing under this |
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chapter. |
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(c) The standards prescribed under Subsection (b)(1) must |
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be equivalent to national standards prescribed by the International |
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Board of Lactation Consultant Examiners for an International Board |
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Certified Lactation Consultant. The standards must include ethical |
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requirements. |
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(d) The department shall: |
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(1) implement rules governing: |
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(A) basic lactation consulting education courses |
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and continuing lactation consulting education courses; and |
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(B) approval of instructors or facilities |
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offering basic lactation consulting education courses and |
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continuing lactation consulting education courses; |
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(2) adopt and provide information about basic |
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lactation consulting resources and instructor manuals; |
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(3) enter into agreements necessary to administer this |
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chapter; and |
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(4) establish a program to license lactation |
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consultants as prescribed by commission rules. |
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Sec. 703.102. REPORTS ON LACTATION CONSULTING. (a) The |
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department shall prepare and publish reports on the practice of |
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lactation consulting in this state. |
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(b) The Department of State Health Services shall publish a |
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statistical report of breastfeeding initiation and continuation |
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rates. |
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Sec. 703.103. COMPLAINTS. (a) For purposes of Section |
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51.252, the commission shall adopt rules to provide for the release |
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of any relevant lactation consulting or medical record to the |
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department, without the consent of the lactation consultant's |
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client, as necessary to conduct an investigation of a complaint. |
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(b) The department shall provide reasonable assistance to a |
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person who wishes to file a complaint with the department regarding |
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a person or activity regulated by this chapter. |
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Sec. 703.104. ROSTER. (a) The department shall maintain a |
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roster of each person licensed as a lactation consultant in this |
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state. |
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(b) The roster must contain for each person the information |
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required on the license form under this chapter and other |
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information the department determines necessary to accurately |
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identify each licensed lactation consultant. The information is |
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public information as defined by Chapter 552, Government Code. |
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SUBCHAPTER D. LICENSE REQUIREMENTS |
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Sec. 703.151. LICENSE REQUIRED. (a) A person may not |
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practice lactation consulting unless the person holds a license |
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issued under this chapter. |
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(b) The department shall issue a license to each person who |
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fulfills the licensing requirements. |
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(c) Unless the person holds a license issued under this |
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chapter, a person may not use: |
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(1) the title "lactation consultant"; |
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(2) the title "registered lactation consultant"; |
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(3) the letters "LC"; |
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(4) the letters "RLC"; or |
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(5) any other words, letters, abbreviations, or |
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insignia indicating or implying that the person is a licensed |
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lactation consultant. |
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Sec. 703.152. QUALIFICATIONS FOR INITIAL LICENSE. A person |
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is qualified to become a licensed lactation consultant under this |
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chapter if the person provides the department with documentary |
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evidence that the person has: |
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(1) satisfied each requirement for basic lactation |
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consulting education; and |
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(2) passed the comprehensive lactation consulting |
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examination and jurisprudence examination required by this |
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chapter. |
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Sec. 703.153. LICENSE APPLICATION. A person who practices |
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lactation consulting shall apply to the department for a lactation |
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consultant license in the manner and on a form prescribed by the |
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executive director. The application must: |
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(1) be accompanied by a nonrefundable application fee; |
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and |
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(2) include information required by commission rules. |
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Sec. 703.154. INITIAL LICENSE TERM. An initial license is |
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valid for one year. |
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Sec. 703.155. BASIC LACTATION CONSULTING EDUCATION. The |
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commission by rule shall establish requirements for basic lactation |
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consulting education. |
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Sec. 703.156. EXAMINATION. (a) The department shall: |
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(1) adopt standards for a comprehensive lactation |
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consulting examination for persons regulated under this chapter |
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that an applicant must pass before an initial license may be issued; |
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and |
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(2) establish eligibility requirements for persons |
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taking a comprehensive lactation consulting examination. |
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(b) The department may employ and cooperate with an |
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organization or consultant in preparing an appropriate |
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examination. |
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(c) Instead of preparing a department examination, the |
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department may accept the results of a criterion-referenced, |
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standardized national examination by an independent lactation |
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consultant organization that meets the standards set by the |
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department. |
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Sec. 703.157. JURISPRUDENCE EXAMINATION. (a) The |
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department shall develop a jurisprudence examination to determine |
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an applicant's knowledge of this chapter, commission rules under |
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this chapter, and any other applicable laws of this state affecting |
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the applicant's lactation consulting practice. The department |
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shall administer the examination at least twice each calendar year. |
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(b) The commission shall adopt rules to implement this |
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section, including rules related to the development and |
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administration of the examination, examination fees, guidelines |
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for reexamination, grading the examination, and providing notice of |
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examination results. |
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SUBCHAPTER E. LICENSE RENEWAL |
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Sec. 703.201. APPLICATION FOR LICENSE RENEWAL. An |
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applicant for renewal of a license under this chapter shall apply in |
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the manner provided by Section 703.153. |
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Sec. 703.202. RENEWAL LICENSE TERM. A renewal license is |
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valid for two years. |
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Sec. 703.203. CONTINUING LACTATION CONSULTING EDUCATION. |
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(a) The commission by rule shall establish requirements for |
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continuing lactation consulting education, including a minimum |
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number of hours of continuing education required to renew a license |
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under this chapter. |
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(b) On renewal of the license, a lactation consultant shall |
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provide the department with evidence of successful completion of |
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continuing lactation consulting education as prescribed by |
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commission rule. |
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(c) The commission by rule shall develop a process to |
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evaluate and approve continuing education courses. |
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Sec. 703.204. REQUIRED ATTENDANCE AT SPECIFIC LACTATION |
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CONSULTING EDUCATION COURSES. The department may assess the |
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continuing education needs of lactation consultants and may require |
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lactation consultants to attend continuing lactation consulting |
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education courses specified by the department. |
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Sec. 703.205. REFUSING RENEWAL FOR FAILURE TO PAY |
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ADMINISTRATIVE PENALTY. The department may refuse to renew the |
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license of a person who fails to pay an administrative penalty |
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unless enforcement of the penalty is stayed or a court has ordered |
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that the administrative penalty is not owed. |
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SUBCHAPTER F. DISCIPLINARY ACTIONS |
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Sec. 703.251. GROUNDS FOR DISCIPLINARY ACTION. (a) The |
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commission or executive director may take disciplinary action |
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against or refuse to issue or renew a license of an applicant or |
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license holder who: |
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(1) violates this chapter or a rule adopted under this |
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chapter; |
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(2) submits false or misleading information to the |
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department; |
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(3) is convicted of a misdemeanor involving moral |
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turpitude or a felony; |
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(4) uses alcohol or drugs intemperately; |
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(5) engages in unprofessional or dishonorable conduct |
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that may reasonably be determined to deceive or defraud the public; |
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(6) is unable to practice lactation consulting with |
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reasonable skill and safety because of illness, disability, or |
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psychological impairment; |
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(7) is determined by a court judgment to be mentally |
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impaired; or |
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(8) fails to practice lactation consulting in a manner |
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consistent with the public health and safety. |
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(b) The commission or executive director may take |
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disciplinary action against or refuse to issue or renew a license of |
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an applicant or license holder if disciplinary action is taken by |
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another jurisdiction that affects the applicant's or license |
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holder's authority to practice lactation consulting, including a |
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suspension, revocation, or other action. |
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Sec. 703.252. REFUND. (a) Subject to Subsection (b), the |
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commission or executive director may order a license holder to pay a |
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refund to a consumer as provided in an agreed settlement, default |
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order, or commission order instead of or in addition to imposing an |
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administrative penalty against the license holder. |
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(b) The amount of a refund ordered may not exceed the amount |
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the consumer paid to the license holder for a service regulated by |
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this chapter. The commission or executive director may not require |
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payment of other damages or estimate harm in a refund order. |
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SUBCHAPTER G. PENALTIES AND ENFORCEMENT PROVISIONS |
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Sec. 703.301. CIVIL PENALTY. (a) A person is liable for a |
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civil penalty if the person is required to be licensed under this |
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chapter and the person knowingly or intentionally practices |
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lactation consulting: |
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(1) without a license or while the person's license is |
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suspended or revoked; or |
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(2) in violation of a commission order. |
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(b) A civil penalty under this section may not exceed $250 |
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for each violation. Each day of violation may constitute a separate |
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violation for purposes of penalty assessment. In determining the |
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amount of the penalty, the court shall consider: |
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(1) the person's history of previous violations; |
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(2) the seriousness of the violation; |
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(3) any hazard to the health and safety of the public; |
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and |
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(4) the demonstrated good faith of the person charged. |
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Sec. 703.302. INJUNCTIONS. (a) In this section, "health |
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authority" means a physician who administers state and local laws |
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regulating public health under Chapter 121, Health and Safety Code. |
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(b) If the executive director or a health authority |
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determines that a person has violated this chapter, the executive |
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director may institute an action described by Section 51.352. |
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Sec. 703.303. VENUE. (a) Venue for a civil action arising |
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out of the imposition of an administrative penalty is in the county |
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in which the defendant resides or the violation occurred. |
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(b) Venue for the civil action may be changed only after a |
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good faith effort has been made to address the violation in the |
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county in which venue is proper. |
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Sec. 703.304. CRIMINAL PENALTY. (a) A person commits an |
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offense if the person is required to be licensed under this chapter |
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and the person knowingly practices lactation consulting without a |
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license. |
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(b) An offense under this section is a Class C misdemeanor. |
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Sec. 703.305. CEASE AND DESIST ORDER. A violation of a |
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cease and desist order issued by the executive director constitutes |
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grounds for imposing an administrative penalty. |
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SECTION 3. (a) As soon as practicable after the effective |
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date of this Act, the presiding officer of the Texas Commission of |
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Licensing and Regulation shall appoint the initial members to the |
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Lactation Consultant Advisory Board as required by Section 703.051, |
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Occupations Code, as added by this Act. In appointing the members, |
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the presiding officer shall appoint three members to terms expiring |
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January 31, 2023, three members to terms expiring January 31, 2025, |
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and three members to terms expiring January 31, 2027. |
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(b) Not later than June 1, 2022, the Texas Department of |
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Licensing and Regulation shall prescribe the forms and procedures |
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and the Lactation Consultant Advisory Board shall propose to the |
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Texas Commission of Licensing and Regulation the rules necessary to |
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implement Chapter 703, Occupations Code, as added by this Act. |
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(c) Notwithstanding Chapter 703, Occupations Code, as added |
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by this Act, a person is not required to hold a license under that |
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chapter before September 1, 2022. |
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(d) Subchapters F and G, Chapter 51, Occupations Code, do |
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not apply to conduct described by Section 703.151, Occupations |
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Code, as added by this Act, before September 1, 2022. |
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SECTION 4. (a) Except as provided by Subsection (b) of |
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this section, this Act takes effect September 1, 2021. |
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(b) Section 703.151, Occupations Code, and Subchapters F |
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and G, Chapter 703, Occupations Code, as added by this Act, take |
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effect September 1, 2022. |