I am a contract employee at a community hospital.  I wrote a proposal to the
hospital board and submitted it through the Head Nurse Manager on Maternity,
who was very supportive of the program.  Originally, I worked there 10 hours
a week doing inservice training for nurses and seeing anyone who was
breastfeeding on the floor.  Now that we have gone to 24 hour discharge in
NY,  I do mostly follow ups.  I call everyone who has delivered at the
facility who is breastfeeding and check on how things are going.  If things
don't sound right, they can come in and see me.  There is no charge for one
visit.  At this point in time we have no mechanism for charging a woman for
a follow up visit so I usually don't tell anyone and see her anyway.  (Don't
tell anyone-this is our little secret.  You, me and the hundreds of others
who read this).  I also see anyone in the hospital who is having problems
that the nurses can't help with-or if the nurses are just overwhelmed and
don't have the time.  Another service I provide is a breastfeeding support
group which, as of yet, has not taken off.
        The original proposal explained to the "powers that be" that it is
far less expensive to pay me than to deal with a lawsuit.  This came on the
heels of the you-know-what newspaper scandal and following TV program using
the same scare tactics.  So they aggreed and I work there as a consultant 12
hours a week.  I work for WIC the other 18 hours a week.  This has it's
drawbacks (few supplies, follow-up difficulties, no taxes taken out of my
pay, and no benefit-to name a few) and it's benefits (I have a change of
scenery every day, I work enough regular hours for my liking and I do
eventually get paid), but it's ok for now.
        If you'd like to discuss this more, email me privately.  I'd be
happy to help you in any way I can.
Lacnettingly-
Barbara Leshin-Zucker, IBCLC
Highland Mills, NY  (WHERE???)