316 Ga. 383
Ga.2023Background
- Plaintiffs Mary Jackson (a Certified Lactation Counselor, CLC) and ROSE (a nonprofit that trains and employs lactation supporters) challenged the Georgia Lactation Consultant Practice Act, which licenses lactation consultants and permits licensure only to International Board Certified Lactation Consultants (IBCLCs).
- The Act defines "lactation care and services" broadly (assessment, care planning, implementation, education, outcome evaluation, assistive devices) and generally prohibits compensated practice of those services without a license, subject to enumerated exemptions (healthcare professionals, volunteers, students under supervision, etc.).
- Jackson (a hospital employee) and ROSE (which trains and sometimes pays non-IBCLC providers) presented undisputed evidence that their work involves direct, clinical lactation services that fall within the Act’s definition.
- Procedural history: initial dismissal was reversed by this Court in Jackson I; on remand parties filed cross-motions for summary judgment; the trial court granted the Secretary summary judgment on due process and granted Plaintiffs summary judgment on equal protection; the Secretary appealed and Plaintiffs cross-appealed.
- The Georgia Supreme Court (this opinion) reviewed de novo, applied a state-due-process framework for occupational licensing, and concluded the Act violates Plaintiffs’ due process rights by unreasonably restricting compensated lactation care to IBCLCs.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Act infringes the right to pursue a lawful occupation | Jackson: Act bars Plaintiffs from performing their lawful work (direct clinical lactation services) unless IBCLC-certified | Secretary: Act does not bar Plaintiffs because non-IBCLC peer/education work is non-"clinical"; licensing is rationally related to public health/quality | Held: The Act does burden Plaintiffs — their paid work falls within the Act’s "clinical" definition and enumerated services |
| Whether the State articulated a legitimate interest sufficient to justify the restriction | Jackson: State interest (quality) is generic/speculative and not tied to evidence of harm from non-IBCLC providers | Secretary: Protecting public health and promoting access to quality care justifies restricting compensated practice to IBCLCs | Held: The asserted interest (quality) is insufficient here — no evidence of harm and quality alone, untethered to a specific health/safety risk, cannot justify the categorical bar |
| Whether the licensing restriction is reasonably necessary (non-arbitrary) | Jackson: The restriction is arbitrary and unnecessary given CLC/ROSE training and lack of harm evidence | Secretary: Legislature may set standards; IBCLC requirement is rationally related to health/safety goals | Held: Not reasonably necessary — record shows CLCs and ROSE-trained providers provide safe, competent services and no evidence of public harm; speculation cannot sustain the restriction |
| Remedy / scope of decision | Jackson: Seek invalidation of Act as applied to Plaintiffs (and similar providers) | Secretary: Defend Act’s validity and scope | Held: The Act violates Georgia due process; trial court’s grant to Secretary on due process reversed; equal protection not reached on appeal |
Key Cases Cited
- Jackson v. Raffensperger, 308 Ga. 736 (2020) (this Court’s prior decision reversing dismissal and framing due-process claim)
- Bramley v. State, 187 Ga. 826 (1939) (occupational licensing invalid where restrictions are arbitrary and not tied to health, safety, or morals)
- Jenkins v. Manry, 216 Ga. 538 (1961) (disparate licensing treatment can show unreasonable interference with lawful occupation)
- Cooper v. Rollins, 152 Ga. 588 (1922) (upholding licensing where linked to preventing spread of disease; illustrates when regulation is necessary)
- Odell v. City of Atlanta, 97 Ga. 670 (1896) (early articulation of right to pursue lawful occupations)
- Bazemore v. State, 121 Ga. 619 (1905) (recognition that some trades may be specially regulated when peculiarly susceptible to public harm)
- Richardson v. Coker, 188 Ga. 170 (1939) (limits on regulation not grounded in specific public-safety risks)
- Southeastern Elec. Co. v. City of Atlanta, 179 Ga. 514 (1934) (invalidating arbitrary regulation distinguishing similar work by formalistic categories)
- City of Lilburn v. Sanchez, 268 Ga. 520 (1997) (example of upholding regulation where direct evidence showed discrete public-welfare harms)