Liz Brooks, JD, IBCLC, FILCA

about Liz Brooks

Liz Brooks, JD, IBCLC, FILCA, is a lactation consultant in private practice (since 1999) and a lawyer (since 1983). She has worked as a criminal prosecutor, a Congressional lobbyist and a federal litigator. Her legal expertise is in ethics, lobbying, administrative and criminal law. She is familiar by training and experience with the array of challenges faced by lactation consultants each day. As an IBCLC, Liz has worked in:* private practice (offering home visits); * a hospital setting (offering prenatal education, "rounding" on breastfeeding mothers and babies in the full-term and Level II NICU nurseries, and providing in-service education to nurses, doctors and midwives); * a non-profit, community-based breastfeeding clinic (which provides IBCLC service to mothers on a sliding fee scale). Liz currently serves as the Secretary on the Board of Directors of the International Lactation Consultant Association and she remains active in her local ILCA chapter PRO-LC. Being a leader in the professional association for IBCLCs lets Liz share her expertise in corporate governance and policy-development -- but she always keeps an eye on how organizational decisions will trickle down to the day-to-day, working IBCLC. Liz has been a well-received speaker in local, national and international venues. Her topics include legal and ethical matters, and matters of practical administrative interest to the private practitioner.

official bio

Liz Brooks, JD, IBCLC, FILCA, is a lawyer (since 1983) and private practice lactation consultant (since 1997) who brings to life the connection between lactation consultation and the law. IBCLCs face a maze of ethical, moral and legal requirements in their day-to-day practice, no matter what the work setting. With plain language and humor, Liz explains the laws affecting IBCLCs, so the lactation consultant can work ethically and legally. She offers pragmatic tips that can immediately be used in daily practice -- to successfully navigate that maze!

presentations

Liz Brooks is pleased to provide presentations on the following topics to professional and parenting conferences. Presentations on other topics may be available upon request and subject to sufficient development lead-time. (For CERP topics, required paperwork will be provided promptly to meet CERP deadlines)

Staying Above the Law: Legal Issues for the HCP Helping a Breastfeeding Mother
60 - 120 minutes
CERP

Participants will be able to define at least five sources of formal legal authority, and five sources of informal legal authority, over a health care provider (HCP) like an IBCLC.

Participants will be able to define and describe five different scenarios in the workplace where ethical and legal issues arise for the HCP assisting a breastfeeding mother and baby.

Participants will be able to describe five techniques to prepare for an appearance in court as an expert, witness or defendant, in a case involving a breastfeeding mother.

Note: E-CERPs-appropriate material is covered in this session. 90 minutes is the customary session time. Material can be covered in 60 minutes (though evaluations then describe it as "rushed"), and is ideal for 120 minutes (which permits for more Q&A at the end, which participants find very helpful).

Deal or No Deal? A Game Show Approach to IBCLC Ethics
60 - 120 minutes
CERP

Deal or No Deal? What if determining the IBCLC's correct course of action, when faced with a moral, legal or ethical dilemma, was as fun as being a game show contestant? This session will review the ILCA Standards of Practice, and IBLCE Code of Ethics, the IBLCE Scope of Practice for IBCLCs, and other authorities affecting our professional work (i.e. licensing and scope of practice). Look for humor, prizes and even buzzers to make this analysis of IBCLC ethics memorable -- and fun. We'll cover common everyday problems (what if your boss requires you to hand out a formula discharge bag?) and more theoretical ones (can anyone own a patent on human milk components?) An opportunity for audience members to pose hypothetical situations will provide take-home-and-use answers: a prize for everyone!

Objectives: The IBCLC will be able to:
1. describe the differences between the ILCA Standards of Practice, the IBLCE Code of Ethics and the IBLCE Scope of Practice for IBCLCs
2. implement immediate changes in record-keeping to conform with ethical benchmarks for lactation consultation
3. identify (and avoid) real and perceived conflicts of interest in lactation consultation practice
4. describe the influence of marketing of breastmilk substitutes in the workplace, so as to avoid becoming an unwitting salesperson for formula
5. change at least three elements in her day-to-day practice to protect a mother's confidential information
Note:
Optimal time: 90 minutes. This session meets E-CERPs requirements.

The IBCLC in the Courtoom: As Expert, Witness or Defendant
60 - 120 minutes
CERP

Imagine parents in a bitter custody dispute: dad wants overnight visitation; baby is still nursing at night, mom wants you to testify on her behalf. Does the IBCLC represent the Mom? The baby? Or the profession of lactation consultation? What if dad wants you to testify? Is it unethical to be paid to prepare and practice your testimony? Or, imagine the breastfed baby who was born at 37 weeks, left the hospital poorly-feeding, got hyperbilirubinemia, and whose parents have now sued everyone connected with his care (including the IBCLC) for malpractice. Who defends the IBCLC? Who pays the lawyer? Can you continue to work?

As our profession grows, more IBCLCs are finding themselves being called to court – sometimes as a willing expert; sometimes as a reluctant witness. This session will examine the IBCLC’s legal and ethical responsibility if called to court. Liz's expertise is in American law, but many of the concepts are universal, and she can adapt her presentation to suit the intended audience.

Objectives and Content

Describe the process to be qualified as an expert witness on lactation in a courtroom

1. Jurisdiction of family law courts
2. Role of expert vis-à-vis the court, and the parties
3. Preparing your resume and curriculum vitae
4. Describing for the record the international certification to earn IBCLC credential
5. Taking it on the chin: cross-examination

Describe the IBCLC’s responsibilities if sued as part of her work

1. Ethical and legal practices for documentation
2. Professional liability insurance primer
3. Protecting your records during “discovery”
4. Finding allies; avoiding enemies
5. Keeping your focus during the rest of your work

Note:
This presentation is best offered in a 90-minute format, although the topic generates lots of questions which can easily fill another 30 minutes. It qualifies for E-CERPs.

Debating the Issues: A Professional Responsibility
60 - 120 minutes
CERP

The American government is built upon the notion of a balance of power: inherent tensions between the governing authorities in our lives require a system of checks-and-balances. Is the field of lactation consultation any different? As a young allied health care profession, lactation consultation must fit inside (or alongside) pre-existing systems of support and health care for the breastfeeding dayd. This creates tensions between the IBCLC and others serving a mother and baby.

So what is the IBCLC to do when s/he identifies a problem with the advice mom is getting elsewhere? How does s/he professionally, ethically, and legally express a difference of opinion? Do we even put our certification at risk by discussing with mother the non-evidence-based information she has received?

The ILCA Standards of Practice, the IBLCE Code of Ethics and the IBLCE Scope of Practice for IBCLCs do offer guidance on how an IBCLC is to handle conflict and debate ... but this session goes beyond: to describe techniques for discussing your difference of opinion with colleagues, without being ignored or patronized.

Objectives:
Identify sections of the ILCA Standards of Practice, IBLCE Code of Ethics, and IBLCE Scope of Practice for IBCLCs governing an IBCLC's obligations to:
1. act as an advocate for breastfeeding women, providing sufficient information to permit informed decisions
2. base clinical practice on well-designed research
3. work within the legal framework of her/his institution and community
4. share evidence-based information and clinical skills with other health care providers
5. conduct oneself with honesty, integrity and fairness
6. recognize the limits of one's personal competence, making referrals as necessary

Note:
This E-CERPs appropriate session is ideal for a 90-minute format.

Squeaky Clean or Sneaking By? Avoiding Conflicts of Interest as an IBCLC
60 - 120 minutes
CERP

You rent pumps from your home-based business. Can you tell the mothers you see in your second job as a hospital-based lactation consultant?

You've been asked to speak at a local conference about breastfeeding, but the event is being underwritten by a formula manufacturer. Can you do it? How about when the gathering is sponsored by a breastpump manufacturer?

You started out as a La Leche League Leader, and eventually became an IBCLC. You still lead League meetings, where a mother has approached you to discuss her low milk supply. Are you a volunteer, or a lactation consultant?

You sell Brand X Nursing Bras at your clinic, and you've been asked by a customer your opinion on Brand Y. What can you say?

Lactation consultants are often faced with conflicts of interest in their professional lives, and many are confused about "what to worry about." This session is designed to describe conflicts of interest -- in easy-to-understand language. And, we'll review how the competent, ethical IBCLC handles them.

At the end of this session, the participant will be able to:
1. define a conflict of interest for a health care professional
2. describe the difference between a true, and a perceived, conflict of interest.
3. identify three common, everyday situations where true conflicts of interest can arise in lactation clinical practice
4. describe how to disclose a conflict of interest
5. identify when a conflict of interest requires an IBCLC to step back, and refer the mother elsewhere.

Note: This session covers legal and ethical definitions of conflicts of interest for the IBCLC, and is appropriate for E-CERPS. The Q&A session can be quite lively. The presentation is ideal for 90 minutes, but Q&A can easily consume another 30 minutes.

Policy and Procedure Manual for the PPLC: What Ethics and the Law Require
60 - 120 minutes
CERP

ILCA Standard of Practice 2.1 states: "Work within the policies and procedures of the institution where employed, or if self-employed, have identifiable policies and procedures to follow.”

Are you like most private practice IBCLCs, operating alone; maybe starting your business from the kitchen table? Private practice requires more than being a competent clinician -- you need to run a legitimate business. Not only do your professional standards encourage you to use a policy & procedure manual to outline your business practices -- it is a savvy business move.

This session will describe, from the ground up, a working policy & procedure manual for the private practice lactation consultant. The legal and ethical requirements for the P&P Manual will be explained. Extras that will get you motivated to build a busy and rewarding practice will be offered. Participants will leave with an outline that can be immedately used (and adapted) to fit the needs of their private practices.


Objectives:
1. Explain why a private practice lactation consultant should have a policy & procedure manual for her business
2. Describe the legal and ethical requirements underpinning a P&P Manual for the PPLC
3. Implement five (or more) record-keeping changes to enhance private practice
4. Create a strategic plan suited to the immediate and future needs of your private practice
5. Implement five (or more) marketing strategies that will boost your visibility without consuming your time
Note: Suitable for E-CERPs and a 90-minute format, this is a true nuts-and-bolts session that assumes every single participant has never used a policy and procedure manual.

HIPAA and the HCP: Protecting Privacy While Protecting Yourself
60 - 120 minutes
CERP

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law designed to improve access to and continuity of health insurance. Privacy protection is one of HIPAA’s most far-reaching sections. The IBCLC's work with a breastfeeding dyad must be kept confidential.

While lactation consultants have long had the responsibility to respect a mother's privacy, HIPAA imposes new responsibilities. The IBCLC must now:

* tell mother she is entitled to privacy ...
* prove that she has done so ...
* make sure that others she works with also protect mother’s privacy ...
* produce paperwork to meet all of HIPAA’s requirements.

Because HIPAA provides civil and criminal liabilities for failure to comply, it can be frightening to think you don't know your privacy rules. Liz will take the extraordinarily cumbersome and confusing HIPAA regulations, and explain them in plain language: so that the IBCLC understands the law, and can explain it to her clients!

Objectives:
1. Describe the legislative history of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
2. Describe the privacy protections afforded by HIPAA to patients in the health care system
3. Describe five scenarios where an IBCLC may share a mother’s protected health information with others
4. Compare the privacy protections of HIPAA with those of the ILCA Standards of Practice and the IBLCE Code of Ethics
5. Compare HIPAA compliance for the hospital-based IBCLC vs. the private practice IBCLC
Note: E-CERPs may be sought for this session. It can easily be addressed in 60 minutes, although the 90-minute format provides for a longer Q&A session.

Do You Mind If I Use That? Understanding IBLCE Ethics Tenet 25 (Respect Copyrights, Trademarks, Service Marks and Patents)
60 - 120 minutes
CERP

In late 2004 the IBLCE added a new tenet to the Code of Ethics: “Understand, recognize, respect, and acknowledge intellectual property rights, including but not limited to copyrights (which apply to written material, photographs, slides, illustrations, etc.), trademarks, service marks, and patents.”

As an IBCLC, you are required to follow the Code of Ethics. But what if you find the patenting of human milk components objectionable, on legal or moral grounds? Did you know that trademark law for baby food manufacturers "trumps" the protections that the International Code of Marketing of Breast-milk Substitutes is designed to offer?

While these legal issues provide for stimulating discussion, most IBCLCs simply want to know: where can I get my hands on some good, free hand-outs? So we'll cover it all. In addition to a review of the legal issues, the participant will leave with a long list of sources for fabulous materials, that can be immediately used and adapted, in clinical lactation practice.

Objectives:
1. Define the four areas of intellectual property (IP) law that might affect an IBCLC
2. Describe the rationale for IBLCE Code of Ethics Tenet 25, requiring IBCLCs to respect IP laws
3. Describe procedures to obtain permission to use IP materials from others
4. Learn how to protect your own materials from unauthorized use
5. Identify several sources for permission-granted lactation materials, that are immediately available for use
Note: 90 minutes is ideal for this E-CERPS-appropriate program.

Turning Your Clients Into Business Builders
60 - 120 minutes
CERP

You are a private practice lactation consultant. If you're doing your job well, you "get rid of your client": your care plan and follow-up phone calls address the lactation issue at hand, and your client doesn't need to see you again. So how does a lactation consultant stay afloat in this profession? It's not realistic to wait for your satisfied clients to have more children.

This session explores marketing and case management techniques -- all of them ethical and legal -- from which your consult today can draw business to you tomorrow. While your own "best practices" are the best advertisement of your professionalism, every private practitioner can use some fresh ideas to keep her business growing.

After this session the participant will be able to:
(1) Implement five or more changes in paperwork management to enhance marketing of the private practice
(2) Evaluate whether the stressed mother has found the consultation effective
(3) Increase contacts (and referrals) within the local medical community
(4) Explain which sections of the ILCA Standards of Practice, IBLCE Code of Ethics and IBLCE Scope of Practice for IBCLCs cover ethical marketing practices for the IBCLC
(5) Design effective marketing materials targetted for those in contact with the mother
Note: This session includes a review of the ILCA Standards of Practice, IBLCE Code of Ethics and IBLCE Scope of Practice for IBCLCs as they affect a private practitioner seeking to build her client base, and is appropriate for E-CERPs.

Legal and Ethical Challenges Around the World for the Private Practice Lactation Consultant
60 - 90 minutes
CERP

Around the world, private practice lactation consultants (PPLCs) fill a gap: providing skilled lactation care for the mother who has left the hospital or birthing center, but now has issues that go beyond those a peer counselor can address. Lactation problems today are complex: rising C-section rates; babies being born (and discharged) earlier; mothers (with NICU babies) who are exclusively pumping; babies with anatomical variations; short maternity leaves; maternal history of infertility and low-supply. And most PPLCs operate alone. This session will address the professional challenges common to all PPLCs, whatever their work or cultural setting. Legal and ethical issues will be addressed -- and practice tips will be offered that can be implemented immediately.

By the end of the session the participant will be able to:
(1) Describe five sections of the IBLCE Code of Ethics, IBLCE Scope of Practice for IBCLCs, and the ILCA Standards of Practice, addressing “professional conduct” by IBCLCs

(2) Implement at least five record-keeping and business marketing practices which comply with standards for “professional conduct” by IBCLCs

(3) Access three reliable websites providing free materials, of use to the private practice lactation consultant seeking to comply with standards of “professional conduct”Note: This practical session also meets with E-CERPs requirement

Who Wants To Be A Millionaire - And Is That Ethical?
60 - 90 minutes
CERP

Liz's game show approach to IBCLC ethics is so popular that a second version has been added! All new questions -- all new quandries -- but every scenario describes realistic issues an IBCLC might face in day-to-day work. Learn law and ethics the fun way: by earning prizes!Objectives: The IBCLC will be able to:
1. describe the differences between the ILCA Standards of Practice, the IBLCE Code of Ethics and the IBLCE Scope of Practice for IBCLCs
2. implement immediate changes in record-keeping to conform with ethical benchmarks for lactation consultation
3. identify (and avoid) real and perceived conflicts of interest in lactation consultation practice
4. describe the influence of marketing of breastmilk substitutes in the workplace, so as to avoid becoming an unwitting salesperson for formula
5. change at least three elements in her day-to-day practice to protect a mother's confidential information
Note:
Optimal time: 90 minutes. This session meets E-CERPs requirements.

Conflicts are Interesting! Why Are They Bad?
30 - 60 minutes
CERP

Conflicts of interest: Are you a little bit unsure that you'd recognize one? The IBLCE Code of Ethics, IBLCE Scope of Practice for IBCLCs and ILCA Standards of Pracice are all quite clear: IBCLCs should avoid conflicts of interest. This session provides a can't-fail way to remember how to recongize a conflict of interest in your work as an IBCLC -- and how to avoid (or cure) it!
At the end of this session, the participant will be able to:
1. define a conflict of interest for a health care professional
2. describe the difference between a true, and a perceived, conflict of interest.
3. identify three common, everyday situations where true conflicts of interest can arise in lactation clinical practice
4. describe how to disclose a conflict of interest
5. identify when a conflict of interest requires an IBCLC to step back, and refer the mother elsewhere.

Note: This compact session covers legal and ethical definitions of conflicts of interest for the IBCLC -- all in 30-60 minutes. It is appropriate for E-CERPS.

When Worlds Collide: How Ethics Differ for IBCLCs, Peer Counselors, Nurses and Volunteers
60 - 90 minutes
CERP

Lots of people help breastfeeding families: IBCLCs, WIC Peer Counselors, doctors, nurses, dietitians, midwives, mother-to-mother counselors, childbirth educators. Different legal and ethical responsibilities apply to each of these helper groups. And there are responsiblities that everyone must meet, no matter what the job title or work setting. This is a lively session to teach you how to follow the law, and meet high ethical and professional standards, all while serving breastfeeding mothers and children.

Participants will be able to:
(1) Identify differences in the scopes of practice for various professions serving breastfeeding dyads
(2) Describe the difference between a professional “scope of practice” and a work place “conflict of interest”
(3) Identify different ethical expectations for various professions serving a breastfeeding dyad
Note: This session meets requirements for E-CERPs

The WHO Code in Everyday Practice: Real Life Scenarios:
30 - 90 minutes
CERP

There is a lot of confusion about what the International [WHO] Code means, and how to support it, in a world full of marketing. Do you violate the Int'l [WHO] Code if you work for a hospital that distributes formula discharge bags? Can you use glossy handouts from bottle manufacturers? Tenet 24 of the IBLCE Code of Ethics requires IBCLCs to adhere to the WHO Code. This session will use real-life case studies to discuss challenges faced by IBCLCs, asking: a) does the Int’l Code apply; (b) are other options available to curtail marketing influences in the healthcare workplace; and (c) what are the consequences when there is a violation of the Int’l Code?


At the end of this session, the participants will be able to:
1. Describe the legislative history of the International Code of Marketing of Breast-milk Substitutes, and why IBCLCs need to support its principles.
2. Identify geopolitical areas that have enacted enforcement procedures for the International Code, and those that do not have an offical support mechanism for this global initiative.
3. Identify three or more areas of commerce and marketing, not envisioned when the Code was drafted in 1981, that affect today's commercial messages about breastfeeding.
4. Describe the mechanism for reporting International Code violations, and identify reliable means to determine if a marketer is in compliance with the International Code
5. Implement five or more immediate changes in professional practice to show IBCLC support for the International Code.

Note:
This session is another hard-to-find E-CERP offering.

Becoming a Mentor Without Breaking Your Back, Your Bank or Your Ethics
30 - 90 minutes
CERP

IBLCE Pathway 3 is the new and improved process by which IBCLC Candidates can, with careful guidance of teacher-mentors, enter the profession of lactation consultation. By serving as a mentor, an IBCLC can train the next generation while (ethically!) earning money for the time and expertise this program requires. At the end of this presentation, the participant will be able to:
(1) Define required elements of IBLCE Pathway 3 for both candidates, and mentor/teachers;
(2) Describe three differences between informal mentoring, and teaching as part of a training curriculum;
(3) Find sections of IBLCE Scope of Practice, IBLCE Code of Ethics, and ILCA Standards of Practice that address IBCLC compensation; and
(4) Implement Pathway 3 training program elements that allow for compensation as teacher, without a conflict-of-interest as a mentor Note:
This session may earn E-CERPs, along with some very practical do-this-now advice!

Can an IBCLC Fire a Mom?  The Legal and Ethical Roadmap
30 - 90 minutes
CERP

Your client just called at 3 a.m., for the third night in a row, for more "hand-holding" about babies that want to breastfeed at night. The mother you saw in the hospital is threatening to write a nasty letter to the administrators because you urged breastfeeding-on-demand, which is not what she learned in her faith-based parenting class. Your client of a 36-weeker, discharged home at 38 weeks, refuses to pump because she "has no time," but she cut your session short so she could go get a pedicure.

Can an IBCLC ever fire a mom? Sometimes the "chemistry" just isn't there, and you think a mother may be better served by other IBCLCs you can suggest. Sometimes your client/patient is volatile or even dangerous. Sometimes you Just Don't Like this mom. This session will discuss when, and how, an IBCLC may end her professional relationship with a mother.
After this session, the participant will be able to identify:
(1) Sections of the IBLCE Code of Ethics, IBLCE Scope of Practice for IBCLCs, and ILCA Standards of Practice that govern how an IBCLC may end a professional relationship with a mother;
(2) Three annoying habits of mothers that are not grounds to "fire" her as a client/patient;
(3) Three surprising habits by mothers that will permit you to sever your professional ties;
(4) At least six verbal and written steps needed to ethically and legally terminate the professional lactation consultation relationship.
Note:
This session earns E-CERPs, and you'll hear lots of hair-raising case studies that will make you happy for your dull days.