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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
AHCCCS; lactation care; breastfeeding
Purpose
Requires contractors with the Arizona Health Care Cost Containment System (AHCCCS), subject to approval by the U.S. Centers for Medicare and Medicaid Services (CMS), to provide breastfeeding and lactation care services to members. Establishes a voluntary state certification for a lactation care provider (LCP) under the Department of Health Services (DHS) and an LCP Community Advisory Committee (Advisory Committee).
Background
AHCCCS contracts with health professionals to provide medically necessary
health and medical services to eligible members. AHCCCS contractors must provide
services and supplies, including, but not limited to: 1) inpatient and
outpatient hospital services; 2) laboratory and x-ray services; 3) prescription
medications; 4) medical supplies, durable medical equipment, insulin pumps and
prosthetic devices; 5) medical treatment of eye conditions; 6) early and
periodic health screening and diagnostic services; 7) family planning services;
8) podiatry services;
9) nonexperimental transplants; 10) emergency dental care; 11) ambulance and
nonambulance transportation; 12) hospice care; 13) orthotics; 14) chiropractic
services; 15) diabetes outpatient self-management training services; and 16)
traditional healing services, as specified (A.R.S.
§ 36-2907). According to AHCCCS, contractors providing maternity care
services must educate members about breastfeeding and direct members to
resources and programs that provide free breastfeeding support, including the
Department of Health Services Breastfeeding Hotline and the Special
Supplemental Nutrition Program for Women, Infants, and Children (AHCCCS).
DHS is established to protect the physical and mental health of Arizona’s
children and adults. DHS's responsibilities include: 1) the licensure and
regulation of health care and child care facilities and certain health care
professionals; 2) disease control; 3) immunization education and promotion; 4)
emergency preparedness; 5) emergency medical services; 6) the state laboratory;
7) the state hospital; 8) public health statistics; 9) radiation regulatory
programs; and 10) vital records which include birth and death certificates (A.R.S.
Title 36).
If there is a cost associated with expanding AHCCCS coverage to include breastfeeding and lactation care services or if there is a change in revenues to the Health Services Licensing Fund from fees collected from the state-certification of LCPs, there may be a fiscal impact to the state General Fund.
Provisions
AHCCCS Services
1. Requires AHCCCS contractors, subject to approval by CMS, to provide breastfeeding and lactation care services, including consultations, education and counseling, that are provided in inpatient, outpatient, home-based and group settings.
LCP Certification
2. Allows a person to apply to the DHS Director for an LCP certification on a form prescribed by the DHS Director that includes information required by the DHS Director.
3. States that it is not required for LCPs to be certified by DHS to practice in Arizona as an LCP.
4. Requires the DHS Director to grant an LCP certificate to a person who:
a) holds a current approved certification or otherwise meets minimum qualifications, education and training requirements established by the DHS Director;
b) is at least 18 years of age;
c) pays the applicable fees; and
d) possesses a valid fingerprint clearance card issued as prescribed.
5. Requires the DHS Director to prescribe, by rule, a sliding fee scale for all fees required for certification of LCPs.
6. States that an LCP certificate is valid for two years.
7. Requires the certificate holder to renew the certificate once every two years by applying to the DHS Director and paying the applicable renewal fee.
8. Requires a person to file an application for renewal at least 30 days and no more than 90 days before the date the current certificate expires.
Powers and Duties of the DHS Director
9. Requires the DHS Director, by rule, to:
a) outline the scope of practice and the core competencies of state-certified LCPs, including the skills and areas of knowledge that are essential to assist families and bring about expanded health and wellness in diverse communities;
b) describe and define reasonable education and training requirements for state-certified LCPs; and
c) establish criteria for granting, denying, suspending and revoking state-certified LCP certificates in order to protect the public health and safety.
10. Allows the DHS Director to adopt rules that:
a) are necessary for the proper administration and enforcement of the state-certified LCP statutes; and
b) allow for reciprocity agreements, including with the Indian Health Service.
11. Requires the DHS Director to waive the minimum education and training requirements for LCP certification for applicants who hold a current approved certification.
Denial, Suspension or Revocation of Certification
12. Allows the DHS Director to deny, suspend or revoke the certificate of any applicant for a certificate or any state-certified LCP who:
a) violates any provision of the state-certified LCP statutes or rule adopted;
b) has been convicted of a felony or misdemeanor involving moral turpitude; or
c) indulges in conduct or a practice that is detrimental to the public health or safety.
13. Allows an applicant or state-certified LCP, after receiving notification of a denial, suspension or revocation, to request a hearing to review the denial, suspension or revocation.
14. Requires DHS, if a hearing is requested, to conduct the hearing in accordance with the uniform administrative hearing procedures
15. Requires
a state-certified LCP who is employed by an Indian tribe and who violates the
state-certified LCP statutes to be under tribal government jurisdiction.
16. Allows the information provided to the DHS Director, if the state-certified LCP is determined to have violated the state-certified LCP statutes, to result in the denial, suspension or revocation of the state-certified LCP's certification.
17. Deems internal hearings, appeals or penalties resulting from disciplinary actions by a tribal government to be the final decision.
Investigations
18. Allows the DHS Director to investigate information that indicates a person may have violated or may be violating the state-certified LCP statutes.
19. Allows the DHS Director, in connection with an investigation, to examine and copy documents and other physical evidence, wherever located, that relate to the conduct or competency of a state-certified LCP.
Fees
20. Requires the DHS Director, by rule, to establish and collect nonrefundable fees for certification of LCPs that are consistent with fees for hearing aid dispensers, audiologists and language pathologists.
21. Requires DHS to deposit all fees collected for state-certification of LCPs in a segregated account in the Health Services Licensing Fund.
Advisory Committee
22. Establishes Advisory Committee consisting of at least nine LCPs, no more than four of whom hold the same approved certification, who are appointed by the DHS Director.
23. Sets the term for each Advisory Committee member at two years.
24. Requires the DHS Director to consult with the Advisory Committee regarding implementing the state-certified LCP statutes and the rules adopted.
25. Requires the Advisory Committee to:
a) assist in the development of the scope of practice and core competencies for state-certified LCPs with different approved certifications; and
b) review rules and advise the DHS Director of any necessary updates.
Miscellaneous
26. Prohibits
the state and any political subdivision of the state from providing a
preference in awarding a public contract for state-certified LCP services or an
entity that employs
state-certified LCPs.
27. Defines approved certification as one of the following:
a) an international board-certified lactation consultant certification;
b) a certified lactation counselor certification;
c) a certified lactation educator certification;
d) an indigenous lactation counselor certification; or
e) any other LCP certification from a program accredited by a nationally or internationally recognized accrediting agency that is approved by DHS.
28. Defines department as DHS.
29. Defines director as the DHS Director.
30. Defines LCP as a person who provides clinical or nonclinical lactation care, education and support to families.
31. Defines state-certified LCP as an LCP to whom DHS has issued a certificate to practice as a certified LCP in Arizona.
32. Makes technical and conforming changes.
33. Becomes effective on the general effective date.
Amendments Adopted by the Committee on Appropriations, Transportation and Technology
1. Establishes a voluntary state certification for LCPs under DHS.
2. Outlines state-certified LCP application, qualification, fee, rulemaking and disciplinary requirements.
3. Establishes the Advisory Committee consisting of at least nine LCPs, no more than four of whom hold the same approved certification, who are appointed by the DHS Director.
4. Sets the term for each Advisory Committee member at two years.
5. Requires the DHS Director to consult with the Advisory Committee regarding implementing the state-certified LCP statutes and the rules adopted.
6. Requires the Advisory Committee to:
a) assist in the development of the scope of practice and core competencies for state-certified LCPs with different approved certifications; and
b) review rules and advise the DHS Director of any necessary updates.
7.
Prohibits the state and any political subdivision of the state from
providing a preference in awarding a public contract for state-certified LCP
services or an entity that employs
state-certified LCPs.
8. Defines terms.
9. Makes conforming changes.
House Action Senate Action
HHS 1/22/26 DPA 12-0-0-0 RAGE 3/18/26 DP 6-0-1
3rd Read 2/17/26 48-6-6 ATT 3/25/26 DPA 9-0-1
Prepared by Senate Research
March 27, 2026
JT/HD/ci