1-1 By: Berlanga (Senate Sponsor - Zaffirini) H.B. No. 1193
1-2 (In the Senate - Received from the House May 1, 1995;
1-3 May 3, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 23, 1995, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 6, Nays
1-6 0; May 23, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1193 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of orthotists and prosthetists;
1-11 providing a civil penalty.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Title 132, Revised Statutes, is amended by adding
1-14 Article 8920 to read as follows:
1-15 Art. 8920. REGULATION OF ORTHOTISTS AND PROSTHETISTS
1-16 Sec. 1. SHORT TITLE. This article may be cited as the
1-17 Orthotics and Prosthetics Act.
1-18 Sec. 2. DEFINITIONS. In this Act:
1-19 (1) "Board" means the Texas Board of Orthotics and
1-20 Prosthetics.
1-21 (2) "Commissioner" means the commissioner of public
1-22 health.
1-23 (3) "Custom-fabricated" means an orthosis or
1-24 prosthesis has been designed, prescribed, fabricated, fitted, and
1-25 aligned specifically for an individual in accordance with sound
1-26 biomechanical principles.
1-27 (4) "Custom-fitted" means an orthosis or prosthesis
1-28 that has been adjusted, prescribed, fitted, and aligned for a
1-29 specific individual according to sound biomechanical principles.
1-30 (5) "Department" means the Texas Department of Health.
1-31 (6) "License" includes a license, registration,
1-32 certificate, accreditation, or other authorization issued under
1-33 this Act to engage in an activity regulated under this Act.
1-34 (7) "Licensed orthotist" means a person licensed under
1-35 this Act who practices orthotics and represents the person to the
1-36 public by a title or description of services that includes the term
1-37 "orthotics," "orthotists," "brace," "orthoses," "orthotic," or a
1-38 similar title or description of services.
1-39 (8) "Licensed orthotist assistant" means a person
1-40 licensed under this Act who assists and is under the supervision at
1-41 an orthotic or prosthetic facility of a licensed orthotist
1-42 responsible for the acts of the assistant.
1-43 (9) "Licensed prosthetist" means a person licensed
1-44 under this Act who practices prosthetics and represents the person
1-45 to the public by a title or description of services that includes
1-46 the term "prosthetics," "prosthetist," "prosthetic," "artificial
1-47 limb," or a similar title or description of services.
1-48 (10) "Licensed prosthetist assistant" means a person
1-49 licensed under this Act who assists and is under the supervision at
1-50 an orthotic or prosthetic facility of a licensed prosthetist
1-51 responsible for the acts of the assistant.
1-52 (11) "Licensed prosthetist orthotist" means a person
1-53 licensed under this Act who practices both prosthetics and
1-54 orthotics and represents the person to the public by a title or
1-55 description of services that includes the terms "prosthetics
1-56 orthotics," "prosthetist orthotist," "prosthetic orthotic,"
1-57 "artificial limb," "brace," or a similar title or description of
1-58 services.
1-59 (12) "Licensed prosthetist orthotist assistant" means
1-60 a person licensed under this Act who assists and is under the
1-61 supervision at an orthotic or prosthetic facility of a licensed
1-62 prosthetist orthotist responsible for the acts of the assistant.
1-63 (13) "Orthosis" means a custom-fabricated or
1-64 custom-fitted medical device designed to provide for the support,
1-65 alignment, prevention, or correction of neuromuscular or
1-66 musculoskeletal disease, injury, or deformity. The term does not
1-67 include a fabric or elastic support, corset, arch support,
1-68 low-temperature plastic splint, truss, elastic hose, cane, crutch,
2-1 soft cervical collar, an orthosis for diagnostic or evaluation
2-2 purposes, dental appliance, or any other similar device carried in
2-3 stock and sold by a drugstore, department store, or corset shop.
2-4 (14) "Orthotic or prosthetic facility" means a
2-5 physical site, including a building or office, where the profession
2-6 and practice of orthotics or prosthetics takes place.
2-7 (15) "Orthotics" means the science and practice of
2-8 measuring, designing, fabricating, assembling, fitting, adjusting,
2-9 or servicing an orthosis under an order from a licensed physician,
2-10 chiropractor, or podiatrist for the correction or alleviation of
2-11 neuromuscular or musculoskeletal dysfunction, disease, injury, or
2-12 deformity.
2-13 (16) "Person" means an individual, corporation,
2-14 partnership, association, or other organization.
2-15 (17) "Profession of orthotics or prosthetics" means
2-16 allied health care medical services used to identify, prevent,
2-17 correct, or alleviate acute or chronic neuromuscular or
2-18 musculoskeletal dysfunctions of the human body that support and
2-19 provide rehabilitative health care services concerned with the
2-20 restoration of function, prevention, or progression of disabilities
2-21 resulting from disease, injury, or congenital anomalies. Orthotic
2-22 and prosthetic services include direct patient care, including
2-23 consultation, evaluation, treatment, education, and advice to
2-24 maximize the rehabilitation potential of disabled individuals.
2-25 (18) "Prosthesis" means a custom-fabricated or fitted
2-26 medical device that is not surgically implanted and is used to
2-27 replace a missing limb, appendage, or other external human body
2-28 part, including an artificial limb, hand, or foot. The term does
2-29 not include an artificial eye, ear, finger, or toe, a dental
2-30 appliance, a cosmetic device, including an artificial breast,
2-31 eyelash, or wig, or other device that does not have a significant
2-32 impact on the musculoskeletal functions of the body.
2-33 (19) "Prosthetics" means the science and practice of
2-34 measuring, designing, fabricating, assembling, fitting, adjusting,
2-35 or servicing a prosthesis under an order from a licensed physician,
2-36 chiropractor, or podiatrist.
2-37 (20) "Registered orthotic technician" means a person
2-38 registered under this Act who fabricates, assembles, and services
2-39 orthoses under the direction of a licensed orthotist or licensed
2-40 orthotist assistant responsible for the acts of the technician.
2-41 (21) "Registered prosthetic orthotic technician" means
2-42 a person registered under this Act who fabricates, assembles, or
2-43 services prostheses and orthoses under the direction of a licensed
2-44 orthotist and licensed prosthetist, a licensed prosthetist
2-45 orthotist, or a licensed orthotist assistant, licensed prosthetist
2-46 assistant, or licensed prosthetist orthotist assistant responsible
2-47 for the acts of the technician.
2-48 (22) "Registered prosthetic technician" means a person
2-49 registered under this Act who fabricates, assembles, or services
2-50 prostheses under the direction of a licensed prosthetist or
2-51 licensed prosthetist assistant responsible for the acts of the
2-52 technician.
2-53 Sec. 3. BOARD. (a) The Texas Board of Orthotics and
2-54 Prosthetics is established as a part of the department and shall
2-55 perform its duties as a board with the department.
2-56 (b) The board consists of six members appointed by the
2-57 governor with the advice and consent of the senate. Appointments
2-58 to the board shall be made without regard to the race, color,
2-59 disability, sex, religion, age, or national origin of the
2-60 appointees.
2-61 (c) Members of the board are appointed for staggered
2-62 six-year terms, with two members' terms expiring on February 1 of
2-63 each odd-numbered year.
2-64 (d) One member of the board must be a licensed orthotist, be
2-65 a resident of this state, and have practiced orthotics for the five
2-66 years preceding the date of appointment. One member of the board
2-67 must be a licensed prosthetist, be a resident of this state, and
2-68 have practiced prosthetics for the five years preceding the date of
2-69 appointment. One member of the board must be a licensed
2-70 prosthetist orthotist, be a resident of this state, and have
3-1 practiced prosthetics and orthotics for the five years preceding
3-2 the date of appointment. One member of the board must be a
3-3 representative of the public who uses an orthosis. One member of
3-4 the board must be a representative of the public who uses a
3-5 prosthesis. One member of the board must be a representative of
3-6 the public who does not use an orthosis or prosthesis.
3-7 (e) A vacancy on the board shall be filled by appointment by
3-8 the governor of an individual who has the appropriate
3-9 qualifications. The appointed person serves for the remainder of
3-10 the term.
3-11 (f) A member of the board is not liable for damages in a
3-12 civil action for any act performed in good faith in the execution
3-13 of the member's duties.
3-14 (g) The board is subject to Chapter 325, Government Code
3-15 (Texas Sunset Act). Unless continued in existence as provided by
3-16 that chapter, the board is abolished and this Act expires September
3-17 1, 2007.
3-18 Sec. 4. REMOVAL FROM BOARD. (a) It is ground for removal
3-19 from the board if a member:
3-20 (1) does not have at the time of appointment the
3-21 qualifications required for appointment to the board;
3-22 (2) does not maintain during service on the board the
3-23 qualifications required for appointment to the board;
3-24 (3) violates a prohibition established by this Act;
3-25 (4) cannot discharge the member's duties for a
3-26 substantial part of the term for which the member is appointed
3-27 because of illness or disability; or
3-28 (5) is absent from more than half of the regularly
3-29 scheduled board meetings that the member is eligible to attend
3-30 during a calendar year unless the absence is excused by majority
3-31 vote of the board.
3-32 (b) The validity of an action of the board is not affected
3-33 by the fact that the action was taken when a ground for removal of
3-34 a member of the board existed.
3-35 (c) If the executive director has knowledge that a potential
3-36 ground for removal exists, the executive director shall notify the
3-37 presiding officer of the board of the ground. The presiding
3-38 officer shall then notify the governor that a potential ground for
3-39 removal exists.
3-40 Sec. 5. BOARD POWERS AND DUTIES. (a) The board shall
3-41 review applications for a license at least once each year at
3-42 reasonable times and places designated by the board.
3-43 (b) The board may collect license application fees, renewal
3-44 fees, examination fees, and other fees for other administrative
3-45 expenses. If the General Appropriations Act does not set the
3-46 amount of those fees, the board shall set the fees in amounts
3-47 reasonable and necessary for the administration and implementation
3-48 of this Act.
3-49 (c) The board shall approve any examination required for a
3-50 license under this Act. Each examination shall be offered at least
3-51 once each year.
3-52 (d) The board may:
3-53 (1) investigate complaints;
3-54 (2) issue, suspend, deny, and revoke licenses;
3-55 (3) reprimand license holders and place license
3-56 holders on probation;
3-57 (4) issue subpoenas; and
3-58 (5) hold hearings.
3-59 (e) The board shall keep an information file about each
3-60 complaint that is filed with the board relating to a person or
3-61 entity regulated by the board. If a written complaint that the
3-62 board has authority to resolve is filed with the board, the board,
3-63 at least as frequently as quarterly and until the final disposition
3-64 of the complaint, shall notify the parties to the complaint of the
3-65 status of the complaint unless the notice would jeopardize an
3-66 undercover investigation.
3-67 (f) The board shall propose rules consistent with this Act
3-68 to carry out its duties in administering this Act and submit the
3-69 proposed rules to the attorney general for review. The board shall
3-70 adopt rules consistent with the advice of the attorney general. In
4-1 adopting rules, the board shall consider the applicable policies
4-2 and procedures of the department.
4-3 (g) The commissioner, with the advice of the board, shall
4-4 appoint an executive director to administer this Act. The board
4-5 may use personnel, facilities, furniture, equipment, and other
4-6 items supplied by the department to administer this Act.
4-7 (h) The executive director or the executive director's
4-8 designee shall develop an intra-agency career ladder program. The
4-9 program shall require intra-agency posting of all nonentry level
4-10 positions concurrently with any public posting.
4-11 (i) The executive director or the executive director's
4-12 designee shall develop a system of annual performance evaluation
4-13 based on measurable job tasks. All merit pay for board employees
4-14 shall be based on the system established under this subsection.
4-15 (j) The board shall prepare information of consumer interest
4-16 describing the regulatory functions of the board and legal rights
4-17 of consumers as provided by this Act.
4-18 (k) The board shall assist legal authorities in the
4-19 prosecution of any person violating this Act.
4-20 (l) The board shall prepare or approve continuing education
4-21 programs for license holders and shall adopt rules that require a
4-22 license holder to participate in an approved continuing education
4-23 program to renew a license issued under this Act.
4-24 (m) The board shall develop and implement policies that
4-25 clearly define the respective responsibilities of the governing
4-26 body of the board and the staff of the board.
4-27 Sec. 6. PUBLIC INFORMATION. (a) The board shall prepare
4-28 information of public interest describing the functions of the
4-29 board and describing the procedures by which complaints are filed
4-30 with and resolved by the board. The board shall make the
4-31 information available to the general public and appropriate state
4-32 agencies.
4-33 (b) The board by rule shall establish methods by which
4-34 consumers and service recipients are notified of the name, mailing
4-35 address, and telephone number of the board for the purpose of
4-36 directing complaints to the board. The board may provide for that
4-37 notification:
4-38 (1) on each registration form, application, or written
4-39 contract for services of an individual or entity regulated by the
4-40 board;
4-41 (2) on a sign prominently displayed in the place of
4-42 business of each individual or entity regulated by the board; or
4-43 (3) in a bill for service provided by an individual or
4-44 entity regulated by the board.
4-45 (c) The board shall list along with its regular telephone
4-46 number the toll-free telephone number that may be called to present
4-47 a complaint about a person regulated or required to be regulated
4-48 under this Act if the toll-free number is established under other
4-49 state law.
4-50 Sec. 7. PUBLIC PARTICIPATION IN BOARD MEETINGS. The board
4-51 shall develop and implement policies that provide the public with a
4-52 reasonable opportunity to appear before the board and to speak on
4-53 any issue under the jurisdiction of the board.
4-54 Sec. 8. PROGRAM ACCESSIBILITY. The board shall prepare and
4-55 maintain a written plan that describes how a person who does not
4-56 speak English can be provided reasonable access to the board's
4-57 programs. The board shall also comply with federal and state laws
4-58 for program and facility accessibility.
4-59 Sec. 9. TRAINING; STANDARDS OF CONDUCT INFORMATION. Each
4-60 board member shall comply with the board member training
4-61 requirements established by any other state agency that is given
4-62 authority to establish the requirements for the board.
4-63 Sec. 10. OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE
4-64 REQUIREMENTS. The board is subject to Chapters 551 and 2001,
4-65 Government Code.
4-66 Sec. 11. ORGANIZATION OF BOARD. (a) The members of the
4-67 board shall elect from the membership of the board a presiding
4-68 officer, secretary, and other officers required for the conduct of
4-69 business. Special meetings of the board shall be called by the
4-70 presiding officer or on the written request of any three members.
5-1 The board may adopt rules necessary to govern its proceedings.
5-2 (b) The executive director shall keep a record of each
5-3 meeting of the board and maintain a register containing the names
5-4 of all persons holding a license under this Act. The record and
5-5 register shall be open at all times to public inspection. On March
5-6 1 of each year, the executive director shall send an official copy
5-7 of the register of license holders to the secretary of state for
5-8 permanent record. A certified copy of the register is admissible
5-9 as evidence in any court of this state.
5-10 Sec. 12. COMPENSATION. A member of the board is entitled to
5-11 compensation and reimbursement of the member's travel expenses as
5-12 provided by the General Appropriations Act.
5-13 Sec. 13. EFFECT OF LOBBYING ACTIVITY. A person may not
5-14 serve as a member of the board or act as the general counsel to the
5-15 board if the person is required to register as a lobbyist under
5-16 Chapter 305, Government Code, because of the person's activities
5-17 for compensation on behalf of a profession related to the operation
5-18 of the board.
5-19 Sec. 14. PUBLIC MEMBERSHIP RESTRICTION. A person is not
5-20 eligible for appointment by the governor as a public member of the
5-21 board if the person or person's spouse:
5-22 (1) is registered, certified, or licensed by an
5-23 occupational regulatory agency in the field of health care;
5-24 (2) is employed by or participates in the management
5-25 of a business entity or other organization regulated by the board
5-26 or receiving funds from the board;
5-27 (3) owns or controls, directly or indirectly, more
5-28 than a 10 percent interest in a business entity or other
5-29 organization regulated by the board or receiving funds from the
5-30 board; or
5-31 (4) uses or receives a substantial amount of tangible
5-32 goods, services, or funds from the board, other than compensation
5-33 or reimbursement authorized by law for board membership,
5-34 attendance, or expenses.
5-35 Sec. 15. CONFLICT OF INTEREST RESTRICTIONS. (a) An
5-36 officer, employee, or paid consultant of a Texas trade association
5-37 in the field of health care may not be a member or employee of the
5-38 board who is exempt from the state's position classification plan
5-39 or is compensated at or above the amount prescribed by the General
5-40 Appropriations Act for step 1, salary group 17, of the position
5-41 classification salary schedule.
5-42 (b) A person who is the spouse of an officer, manager, or
5-43 paid consultant of a Texas trade association in the field of health
5-44 care may not be a member of the board and may not be an employee of
5-45 the board who is exempt from the state's position classification
5-46 plan or is compensated at or above the amount prescribed by the
5-47 General Appropriations Act for step 1, salary group 17, of the
5-48 position classification salary schedule.
5-49 (c) For the purposes of this section, a Texas trade
5-50 association is a nonprofit, cooperative, and voluntarily joined
5-51 association of business or professional competitors in this state
5-52 designed to assist its members and its industry or profession in
5-53 dealing with mutual business or professional problems and in
5-54 promoting their common interest.
5-55 Sec. 16. AUDIT. The financial transactions of the board are
5-56 subject to audit by the state auditor in accordance with Chapter
5-57 321, Government Code.
5-58 Sec. 17. REPORT TO GOVERNOR AND LEGISLATURE. During January
5-59 of each year, the board shall file with the governor and the
5-60 presiding officer of each house of the legislature a complete and
5-61 detailed written report accounting for all funds received and
5-62 disbursed by the board during the preceding year.
5-63 Sec. 18. EQUAL EMPLOYMENT OPPORTUNITY POLICIES. (a) The
5-64 executive director or the executive director's designee shall
5-65 prepare and maintain a written policy statement to ensure
5-66 implementation of a program of equal employment opportunity under
5-67 which all personnel transactions are made without regard to race,
5-68 color, disability, sex, religion, age, or national origin. The
5-69 policy statement must include:
5-70 (1) personnel policies, including policies relating to
6-1 recruitment, evaluation, selection, application, training, and
6-2 promotion of personnel that are in compliance with Chapter 21,
6-3 Labor Code;
6-4 (2) a comprehensive analysis of the board workforce
6-5 that meets federal and state guidelines;
6-6 (3) procedures by which a determination can be made of
6-7 significant underutilization in the board workforce of all persons
6-8 for whom federal or state guidelines encourage a more equitable
6-9 balance; and
6-10 (4) reasonable methods to appropriately address those
6-11 areas of underutilization.
6-12 (b) A policy statement prepared under Subsection (a) of this
6-13 section must cover an annual period, be updated annually, be
6-14 reviewed by the Commission on Human Rights for compliance with
6-15 Subsection (a)(1) of this section, and be filed with the governor's
6-16 office.
6-17 (c) The governor's office shall deliver a biennial report to
6-18 the legislature based on the information received under Subsection
6-19 (b) of this section. The report may be made separately or as part
6-20 of other biennial reports to the legislature.
6-21 Sec. 19. NOTICE OF STANDARDS OF CONDUCT. The board shall
6-22 provide to its members and employees, as often as necessary,
6-23 information regarding their qualifications for office or employment
6-24 under this Act and their responsibilities under applicable laws
6-25 relating to standards of conduct for state officers or employees.
6-26 Sec. 20. APPROPRIATIONS TO TEXAS DEPARTMENT OF HEALTH. The
6-27 department shall receive and account for funds derived under this
6-28 Act. The department shall deposit all funds collected under this
6-29 Act to the credit of the general revenue fund.
6-30 Sec. 21. EXEMPTIONS. (a) This Act does not restrict a
6-31 license holder of another state agency from performing health care
6-32 services within the scope of the license holder's applicable
6-33 licensing act if:
6-34 (1) the license holder:
6-35 (A) does not represent to others that the
6-36 license holder practices the profession of orthotics or
6-37 prosthetics;
6-38 (B) is an orthotist, prosthetist, prosthetist
6-39 orthotist or an assistant to a person in one of those professions;
6-40 or
6-41 (C) uses the terms "prosthetist," "prosthesis,"
6-42 "prosthetic," "artificial limb," "orthotist," "orthosis,"
6-43 "orthotic," "brace" or uses the letters "LP," "LPA," "LO," "LOA,"
6-44 "LPO," "LPOA" or any derivative of those terms or letters in
6-45 connection with the license holder's name or practice; and
6-46 (2) the license holder practices in conformance with
6-47 the applicable laws and rules relating to the person's license and
6-48 does not violate Section 22 of this Act.
6-49 (b) This Act does not apply to the activities and services
6-50 of a person acting as a student in orthotics or prosthetics
6-51 pursuing a course of study in a prosthetic or orthotic program at a
6-52 college or university recognized by the American Medical
6-53 Association and accredited by the Commission on Accreditation of
6-54 Allied Health Education Programs or working in a recognized
6-55 training center or research facility if those activities and
6-56 services constitute a part of the person's course of study in the
6-57 discipline in which the person's supervisor is licensed under this
6-58 Act.
6-59 (c) This Act does not apply to a podiatrist practicing under
6-60 the law regulating podiatry (Article 4567 et seq., Revised
6-61 Statutes).
6-62 (d) This Act does not apply to a pedorthist certified by the
6-63 Board for Certification in Pedorthics. For the purposes of this
6-64 subsection, a certified pedorthist is a person certified by the
6-65 Board for Certification in Pedorthics, or its successor entity, in
6-66 the design, manufacture, fit, and modification of shoes and related
6-67 foot orthoses below the ankle as prescribed by a licensed doctor of
6-68 medicine or a doctor of podiatry for the amelioration of a painful
6-69 or disabling condition of the foot. "Foot orthosis" includes
6-70 prosthetic toe fillers or orthosis for use below the ankle.
7-1 (e) This Act does not apply to a certified fitter or
7-2 certified master orthotist who holds a credential issued by the
7-3 National Association of Retail Druggists if the fitter or master
7-4 orthotist is working within that person's scope of practice as
7-5 defined by the maximum allowable payment schedule of the Texas
7-6 Rehabilitation Commission.
7-7 (f) This Act does not apply to a doctor of chiropratic
7-8 practicing under the law regulating chiropractic (Article 4512b,
7-9 Revised Statutes).
7-10 Sec. 22. PROHIBITED ACTS. (a) A person may not practice,
7-11 attempt to practice, or offer to practice prosthetics or orthotics,
7-12 act as an assistant to a person who practices prosthetics or
7-13 orthotics, or in any way hold the person out as being able to
7-14 practice prosthetics or orthotics unless the person holds a license
7-15 issued by the board under this Act.
7-16 (b) A person or the person's employees, agents, or
7-17 representatives may not use in connection with the person's name or
7-18 business activities the terms or a combination of the terms or
7-19 letters described in Section 21(a)(1), indicate orally or in
7-20 writing, directly or by implication, that a prosthetic or orthotic
7-21 service is provided or supplied, or extend or provide prosthetic or
7-22 orthotic services unless the person is a prosthetist or orthotist
7-23 or an assistant to a prosthetist or orthotist licensed under this
7-24 Act.
7-25 (c) A person licensed under this Act violates this Act if
7-26 the person violates Section 161.091, Health and Safety Code.
7-27 Sec. 23. PROSTHETIST AND ORTHOTIST LICENSE REQUIREMENTS.
7-28 (a) To obtain a license to practice prosthetics or orthotics in
7-29 this state, an individual must file a written application with the
7-30 board on the form provided by the board, pay the nonrefundable
7-31 application fee prescribed by the board, and have:
7-32 (1) completed the formal training, including the
7-33 required hours of classroom education and clinical practice, in an
7-34 area of study the board by rule determines to be necessary and
7-35 appropriate;
7-36 (2) completed a clinical residency in the professional
7-37 area for which licensure is sought that complies with the
7-38 standards, guidelines, or procedures established by the board for a
7-39 clinical residency offered in this state or in another state; and
7-40 (3) passed all written and practical examinations
7-41 approved and required by the board.
7-42 (b) The requirements for a license established by board rule
7-43 must include:
7-44 (1) either:
7-45 (A) a bachelor's degree in orthotics and
7-46 prosthetics from a college or university educational program
7-47 recognized by the American Medical Association and the Commission
7-48 on Accreditation of Allied Health Education Programs; or
7-49 (B) a bachelor's degree and a prosthetic or
7-50 orthotic certificate from a practitioner educational program
7-51 recognized by the American Medical Association and the Commission
7-52 on Accreditation of Allied Health Education Programs; and
7-53 (2) not less than 1,900 hours of professional clinical
7-54 residency completed under the direct supervision of a licensed
7-55 orthotist, licensed prosthetist, or a licensed prosthetist
7-56 orthotist in the discipline for which licensure is sought.
7-57 (c) A person may apply for an exemption from the license
7-58 requirements adopted by the board under this section if the person
7-59 applies not later than the 181st day after the date the board's
7-60 initial rules under this Act are finally adopted and published and
7-61 the person is a resident of this state who must have provided
7-62 comprehensive orthotic, prosthetic, or orthotic and prosthetic care
7-63 in this state for the three years preceding the date of the
7-64 application.
7-65 (d) A person may apply for an exemption from the license
7-66 requirements adopted by the board under this section if the person
7-67 applies not later than the 181st day after the date the board's
7-68 initial rules under this Act are finally adopted and published and
7-69 the person is a resident of this state who must have provided
7-70 comprehensive orthotic, prosthetic, or orthotic and prosthetic care
8-1 outside this state for not less than the 15 years preceding the
8-2 date of the person's application.
8-3 (d) A person who has provided comprehensive orthotic,
8-4 prosthetic, or orthotic and prosthetic care in this state for less
8-5 than the three years required by Subsection (c) of this section may
8-6 obtain a license to practice in this state by completing and
8-7 passing all written and practical examinations approved and
8-8 required by the board.
8-9 (f) The board shall issue a license to a person who is
8-10 determined to be exempt from the license requirements under
8-11 Subsection (c) and (d) of this section or who obtains a license
8-12 under Subsection (e) of this section. Such a license holder is
8-13 entitled to the same license privileges as if the person met the
8-14 educational and vocational requirements under Subsection (a) or (b)
8-15 of this section. The person is subject to the license renewal
8-16 requirements adopted by the board, except for the academic,
8-17 clinical training, and examination requirements, which may not be
8-18 imposed as a condition of the person's license.
8-19 Sec. 24. PROSTHETIST OR ORTHOTIST ASSISTANT LICENSE. (a)
8-20 An applicant for a license as a prosthetist assistant or orthotist
8-21 assistant must file a written application with the board on a form
8-22 provided by the board and pay the nonrefundable application fee
8-23 prescribed by the board.
8-24 (b) An applicant under this section must present evidence
8-25 satisfactory to the board that the applicant has completed an
8-26 educational program, including courses in the anatomical,
8-27 biological, and physical sciences, and clinical residency as
8-28 prescribed and adopted by the board.
8-29 (c) An assistant licensed under this section may provide
8-30 only ancillary patient care services, as defined by the board, in
8-31 the discipline in which the assistant's supervisor is licensed
8-32 under this Act.
8-33 (d) A person may apply for an exemption from the license
8-34 requirements adopted by the board under this section if the person
8-35 applies not later than the 181st day after the date the board's
8-36 initial rules under this Act are finally adopted and published and
8-37 if the person is a resident of this state who has practiced within
8-38 the scope of practice of an assistant, as defined by the board, for
8-39 five consecutive years in this state.
8-40 Sec. 25. PROSTHETIC OR ORTHOTIC TECHNICIAN REGISTRATION.
8-41 (a) An applicant for registration as a registered prosthetic
8-42 technician or registered orthotic technician must file a written
8-43 application with the board on a form provided by the board and pay
8-44 the nonrefundable application fee prescribed by the board.
8-45 (b) An applicant under this section must present evidence
8-46 satisfactory to the board that the applicant has completed an
8-47 educational program and laboratory experience as prescribed and
8-48 adopted by the board.
8-49 (c) A person may apply for an exemption from the
8-50 registration requirements adopted by the board under this section
8-51 if the person applies not later than the 181st day after the date
8-52 the board's initial rules under this Act are finally adopted and
8-53 published and if the person is a resident of this state who has
8-54 practiced as an orthotic or prosthetic technician for five
8-55 consecutive years in this state.
8-56 Sec. 26. ACCREDITATION OF FACILITIES. (a) The board by
8-57 rule shall adopt requirements for the accreditation and the renewal
8-58 of an accreditation of an orthotic or prosthetic facility in which
8-59 the profession and practice of orthotics or prosthetics is
8-60 conducted. A facility licensed under Subtitle B, Title 4, Health
8-61 and Safety Code, is exempt from the requirements for accreditation
8-62 in this section.
8-63 (b) If one or more facilities are owned by a person, the
8-64 board may require only one application for the accreditation of all
8-65 the person's facilities. Each orthotic or prosthetic facility must
8-66 meet the requirements prescribed by the board.
8-67 (c) An orthotic or prosthetic facility must be under the
8-68 on-site direction of an orthotist or prosthetist licensed by the
8-69 board in the discipline for which accreditation is sought.
8-70 (d) The rules adopted under this section may not prohibit a
9-1 licensed individual from practicing in an orthotic or prosthetic
9-2 facility within the scope of the individual's license.
9-3 Sec. 27. ISSUANCE OF LICENSE. (a) The board shall issue a
9-4 license in prosthetics or orthotics to an applicant who meets the
9-5 qualifications established under this Act and the requirements
9-6 adopted by the board as provided by this Act. A license is valid
9-7 for two years from the date issued and may be renewed before
9-8 expiration.
9-9 (b) The board may issue a license or registration under this
9-10 Act only to an individual. The board may issue an accreditation
9-11 only to an orthotic or prosthetic facility.
9-12 (c) A license may be granted in either orthotics or
9-13 prosthetics, or in both fields, if the person meets the
9-14 requirements established by the board.
9-15 Sec. 28. PROVISIONAL LICENSE. (a) A person practicing
9-16 comprehensive prosthetic or orthotic patient management who does
9-17 not meet the requirements of this Act for licensing as a
9-18 prosthetist or orthotist by October 1, 1996, and is not exempt
9-19 under this Act, must comply with the requirements of Sections
9-20 23(a) and (b) of this Act on or before October 1, 2002.
9-21 (b) A person subject to this section may apply for a
9-22 prosthetist or orthotist provisional license by filing a written
9-23 application with the board on a form provided by the board and
9-24 paying a nonrefundable application fee prescribed by the board.
9-25 (c) A provisional license may only be issued to an
9-26 individual who is actively engaged in complying with the
9-27 educational and clinical licensing requirements of Sections 23(a)
9-28 and (b) of this Act. A provisional license may be revoked by the
9-29 board if the board determines that the provisional license holder
9-30 is not in compliance with this section.
9-31 (d) A provisional license is valid for two years from the
9-32 date issued and may be renewed with documentation as required by
9-33 board rule.
9-34 (e) This section expires January 1, 2003.
9-35 Sec. 29. TEMPORARY LICENSE. (a) The board may issue a
9-36 temporary license to an individual who:
9-37 (1) has recently become a resident of this state;
9-38 (2) has applied for licensing as an orthotist,
9-39 prosthetist, or both; and
9-40 (3) has been licensed by the state in which the person
9-41 formerly resided that has licensing requirements that are equal to
9-42 or exceed the requirements of this Act.
9-43 (b) A temporary license is valid for one year from the date
9-44 issued. A temporary license may be renewed for not more than one
9-45 additional year if the applicant presents to the board sufficient
9-46 evidence of good cause for renewal.
9-47 Sec. 30. STUDENT REGISTRATION. (a) The board may issue a
9-48 student registration certificate to an individual who:
9-49 (1) holds either:
9-50 (A) a bachelor's degree in orthotics and
9-51 prosthetics conferred by a college or university recognized by the
9-52 American Medical Association and accredited by the Commission on
9-53 Accreditation of Allied Health Education Programs; or
9-54 (B) a bachelor's degree and an orthotic or
9-55 prosthetic certificate from an educational program recognized by
9-56 the American Medical Association and accredited by the Commission
9-57 on Accreditation of Allied Health Education Programs; and
9-58 (2) is working toward fulfillment of the requirements
9-59 for licensing as a prosthetist, orthotist, or prosthetist
9-60 orthotist.
9-61 (b) A student registrant may work only under the direct
9-62 supervision of a licensed orthotist, licensed prosthetist, or
9-63 licensed prosthetist orthotist who is responsible for the acts of
9-64 the student registrant and is licensed in the discipline of the
9-65 clinical residency.
9-66 (c) A student registration certificate is valid for two
9-67 years from the date issued and may be renewed once for an
9-68 additional two years.
9-69 Sec. 31. EXAMINATION EXEMPTION. The board may accept as a
9-70 substitute for the examination requirement proof that the applicant
10-1 for the exemption holds a current license in a state that has
10-2 licensing requirements that are equal to or exceed the requirements
10-3 of this Act.
10-4 Sec. 32. CONTINUING EDUCATION. (a) An applicant for
10-5 renewal of a license shall submit to the board evidence of
10-6 satisfactory completion of the continuing education requirements
10-7 required by the board.
10-8 (b) The board shall notify each license holder of the
10-9 holder's failure to comply with the board's continuing education
10-10 requirements and shall notify the license holder that if the holder
10-11 does not obtain the required continuing education before the
10-12 expiration of three months after the date the notice was given, the
10-13 board may take any action authorized by this Act concerning the
10-14 suspension or revocation of the holder's license.
10-15 Sec. 33. DISCIPLINARY PROVISIONS. (a) After notice and
10-16 opportunity for a hearing, the board may revoke, suspend, or refuse
10-17 to renew a license issued under this Act on a finding that:
10-18 (1) the license was obtained by fraud,
10-19 misrepresentation, or concealment of a material fact;
10-20 (2) the person engaged in fraud or deceit in
10-21 connection with services provided by the person;
10-22 (3) the person engaged in unprofessional or unethical
10-23 conduct;
10-24 (4) the person engaged in gross negligence or
10-25 malpractice; or
10-26 (5) the person violated this Act or a rule adopted
10-27 under this Act.
10-28 (b) A license revoked under Subsection (a) of this section
10-29 may be reinstated after the first anniversary of the date of the
10-30 revocation by the board on terms the board determines to be
10-31 necessary.
10-32 Sec. 34. CIVIL PENALTY. (a) A person who violates this Act
10-33 is subject to a civil penalty of $200 for the first violation and
10-34 $500 for each subsequent violation. At the request of the board,
10-35 the attorney general shall bring an action in the name of the state
10-36 to collect a civil penalty under this section.
10-37 (b) Each day a violation of Section 22 of this Act continues
10-38 is a separate violation for the purpose of this section.
10-39 SECTION 2. (a) In making the initial appointments to the
10-40 Texas Board of Orthotics and Prosthetics, the governor shall, not
10-41 later than October 1, 1995, appoint:
10-42 (1) two members for terms expiring February 1, 1997;
10-43 (2) two members for terms expiring February 1, 1999;
10-44 and
10-45 (3) two members for terms expiring February 1, 2001.
10-46 (b) The initial members of the board appointed under
10-47 Subsection (a) of this section shall have the qualifications
10-48 required by this subsection. One member must be an orthotist
10-49 certified by the American Board for Certification in Orthotics and
10-50 Prosthetics, Inc., be a resident of this state, and have practiced
10-51 orthotics for the five years preceding the date of appointment.
10-52 Two members must be orthotists who hold a credential issued by the
10-53 Board of Orthotist Certification, are residents of this state, and
10-54 have practiced orthotics for the five years preceding the date of
10-55 appointment. One member must be a prosthetist orthotist certified
10-56 by the American Board for Certification in Orthotics and
10-57 Prosthetics, Inc., be a resident of this state, and have practiced
10-58 prosthetics and orthotics for the five years preceding the date of
10-59 appointment. One member must be a representative of the public who
10-60 uses an orthosis. One member must be a representative of the
10-61 public who uses a prosthesis.
10-62 (c) A member appointed under this section to a place on the
10-63 board required to be held by a person licensed under Article 8920,
10-64 Revised Statutes, as added by this Act, may continue to serve
10-65 without having the appropriate license until February 1, 1997, by
10-66 which date the person must obtain the required license.
10-67 (d) The board shall adopt rules under Article 8920, Revised
10-68 Statutes, as added by this Act, not later than October 1, 1996.
10-69 SECTION 3. (a) Except as provided by Subsection (b) of this
10-70 section, this Act takes effect September 1, 1995.
11-1 (b) Sections 22 and 34, Article 8920, Revised Statutes, as
11-2 added by this Act, take effect October 1, 1996.
11-3 SECTION 4. The importance of this legislation and the
11-4 crowded condition of the calendars in both houses create an
11-5 emergency and an imperative public necessity that the
11-6 constitutional rule requiring bills to be read on three several
11-7 days in each house be suspended, and this rule is hereby suspended.
11-8 * * * * *