Advocacy In Action

Lactation consultants make a difference every day in diverse settings and with a variety of people. You may think that you are too small to make a difference in the scheme of things. However, advocating a point of view is engaged in by almost all special interest groups in the United States. As individuals and/or groups, we have the right to lobby policy makers which insures that our interests and concerns are heard, as well as competing interests and views, so that legislators and policy makers have a broad base of information on which to base their decisions. Lobbying attempts to persuade an individual, agency, institution, or organization to support an idea, an issue, a certain course of action, etc. You lobby whenever you work to encourage someone to agree to your way of thinking or to embark on a new project or program. We call ourselves “advocates” because we speak for those whose voices are often silent – breastfeeding mothers and babies.

USLCA works to fulfill its vision and mission to see that IBCLCs are valued members of the health care team and that as an association it advocates for its members. However because USLCA is YOU, we are all needed to engage in advocacy activities. The power of “one” is strong and when one determined individual networks with others championing similar agendas, change happens. This website will serve as a central meeting place to share methods and ideas for advocating and lobbying for our common special interests of lactation support and services and breastfeeding reform.

 Essential Health Benefits Bulletin

The Department of Health and Human Services intends to allow states to use existing health plans as benchmarks for benefits that must be offered by individual and small group health insurance plans inside or outside exchange markets that are to start in 2014 under the health reform law, the agency said in a bulletin issued Dec. 16. The Center for Consumer Information and Insurance Oversight, part of HHS's Centers for Medicare & Medicaid Services, issued the information bulletin as guidance, saying it intends to pursue a rulemaking on the essential health benefits (EHBs) that plans will be required to cover under the Patient Protection and Affordable Care Act. The benefits coverage provision applies to nongrandfathered plans that went into effect after PPACA was enacted March 23, 2010, as well as plans modeled on Medicaid benchmarks and Basic Health Plans that states can elect to create.

As you may know, under the Affordable Care Act, health insurers will be required to pay for a range of preventative care services specifically aimed at women. This includes, "Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment." We have the opportunity to provide comments in  response to the Essential Health Benefits Bulletin released on December 16, 2011, to urge the Department of Health and Human Services (HHS) to take an active role to ensure that the Essential Health Benefits (EHB) are defined in accordance with the applicable statutory requirements.  In particular, we need to urge HHS to issue guidance regarding the ten benefit categories set forth in the Patient Protection and Affordable Care Act (ACA), including defining the “preventive and wellness services and chronic disease management” benefit category to include lactation consultant services provided by International Board Certified Lactation Consultants (IBCLCs). It is very important that IBCLCs are specifically mentioned in this policy. Please consider personalizing the sample letter included here and following the instructions for where to send it. The deadline for comments is January 31. Help us get the IBCLC written into this important preventive care service.

Marsha Walker, RN, IBCLC
Director of Public Policy

New York State Medicaid Redesign Team Recommendations to Cover International Board Certified Lactation Consultant Services as a Separately Billable Service Together with Breastfeeding Education and Ancillary Breast Pumps in Redesigning its Medicaid State Plan

Dear Medicaid Redesign Team Members:

The United States Lactation Consultant Association (USLCA) is a non-profit organization established to advocate for improved access to lactation care in the United States.  The USLCA appreciates this opportunity to comment regarding New York’s Medicaid Redesign Team (MRT) Recommendations.  

The USLCA recognizes that New York‘s MRT is dedicated to restructuring New York’s Medicaid program to achieve measurable improvement in health outcomes and sustainable cost control.  We want to commend several of the MRT Work Groups for including breastfeeding support in their recommendations.   We are also writing to urge the MRT to ensure that its recommendations are based on a complete understanding of the qualifications offered by International Board Certified Lactation Consultant (IBCLC) credential and the lactation services that IBCLCs offer, that such recommendations provide adequate compensation for such services, and that New York consider recognizing IBCLCs as Medicaid providers in their own right.  We also want to take this opportunity to recommend that New York extend coverage for ancillary breast pumps necessary to fully reap the benefits of these services. 

Our comments focus on the Basic Benefit Work Group Recommendation titled “Breastfeeding Support”; the Health Disparities Work Group recommendation titled “Enhance Services to Promote Maternal and Child Health”; and the goals of the Workforce Flexibility and Change of Scope of Practice Work Group.  We also provide an additional recommendation regarding the coverage of services ancillary to breastfeeding support services, which has not yet been addressed by any of the work groups.

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Is Lactation Consultation an Essential Health Benefit?  Share your thoughts with the DHHS beginning November 1.

Starting today, you have the opportunity to share your thoughts with the Department of Health and Human Services on the inclusion of IBCLC services as part of Essential Health Benefits that would be provided under a typical employer plan. The Affordable Care Act ensures Americans have access to quality, affordable health insurance.  To achieve this goal, the law ensures plans offered in the new Affordable Insurance Exchanges offer a package of essential health benefits, which are to be defined by the Department of Health and Human Services (HHS). The statute directs the Secretary of Health to consider the scope of benefits provided under a typical employer plan in defining essential health benefits. USLCA has submitted comments asking that the services of IBCLCs be considered as an essential health benefit and be included in employer-offered health insurance plans. Comment sessions are being held around the country as an opportunity for stakeholders to provide comments in person. Don't miss this important opportunity to advocate for your profession by testifying at one of these listening sessions. Check out the talking points in the USLCA testimony and speak up for your profession. The schedule of listening sessions and instructions are below.

(NOTE: We will be providing further information on the Seattle and San Francisco meetings shortly.)

The Affordable Care Act ensures Americans have access to quality, affordable health insurance.  To achieve this goal, the law ensures plans offered in the new Affordable Insurance Exchanges offer a package of essential health benefits, which are to be defined by the Department of Health and Human Services (HHS). 

The statute directs the Secretary to consider the scope of benefits provided under a typical employer plan in defining essential health benefits.  To inform the Department, HHS received a survey of employer-sponsored coverage conducted by the Department of Labor as well as recommendations from the Institute of Medicine on the criteria and methods for defining and updating essential health benefits. 

HHS is committed to receiving broad public input on essential health benefits from all stakeholders, including States, patients, providers, employers, legislators, insurers, and all other interested Americans. 

To that end, we are pleased to invite you to comment sessions for regional, state, and local stakeholders on essential health benefits.  Senior HHS officials will attend to listen to stakeholder feedback. 

If you plan to attend the session, we ask that you consider these questions in preparing your comments:

• In keeping with the title of the Institute of Medicine report “Essential Health Benefits-Balancing Coverage and Cost”, how can the Department best meet the dual goals of balancing the comprehensiveness of coverage included in essential health benefits and affordability?
• How might the Department ensure that essential health benefits reflect an appropriate balance among the categories so that they are not unduly weighted toward any category?
• What policy principles and criteria should be taken into account to prevent discrimination against individuals because of their age, disability status, or expected length of life as the Affordable Care Act requires? 
• What models should HHS consider in developing essential health benefits? 
• What criteria should be used to update essential health benefits over time and what should the process be for their modification?

To register for the event, please send an email with your name, organization, title, email address and phone number to the designated RSVP by the RSVP Due Date listed above.   (NOTE: In some locations, RSVPs are needed for building security and will be accepted on a first come, first serve basis)

The Department of Labor (DOL) has issued a Request for Information (RFI), asking for public comments on its interpretation of the reasonable break time for employed nursing mothers.

The Department of Labor (DOL) has issued a Request for Information (RFI), asking for public comments on its interpretation of the reasonable break time for employed nursing mothers. The public comments will help guide the DOL in implementing the new law contained in the Affordable Care Act. The RFI itself sets out the DOL's current interpretation of the law, but there are a number of questions and situations on which the DOL would like input. This presents us with an important opportunity to tell the stories of mothers who encounter difficulty in the work setting and to provide concrete suggestions regarding how to remedy the problems. The DOL is especially interested in solutions to non-traditional work settings and settings other than an office building. The RFI asks a number of questions with which lactation consultants may have experience. The deadline for comments is February 22, 2011. To read the RFI and obtain instructions for comments see http://webapps.dol.gov/FederalRegister/PdfDisplay.aspx?DocId=24540

To go directly to the comment site see http://www.regulations.gov/#!submitComment;D=WHD-2010-0003-0001

 The DOL has a web page at http://www.dol.gov/whd/nursingmothers/ that contains more information and resources on the new law.

 U.S. Surgeon General’s Call to Action: Increase Support for Breastfeeding Families

Breastfeeding support for new families was spotlighted in an unprecedented document issued today by the Surgeon General of the United States, Dr. Regina Benjamin.  The Call to Action to Support Breastfeeding challenges the entire nation to work toward removing obstacles that can make it difficult for women to achieve their breastfeeding goals, and serves as a model roadmap for governments across the world to robustly address similar challenges. Read USLCA's full Press Release.

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