By: Patterson S.B. No. 291
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the regulation of orthotists and prosthetists;
1-2 providing a civil penalty.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Title 132, Revised Statutes, is amended by adding
1-5 Article 8920 to read as follows:
1-6 Art. 8920. REGULATION OF ORTHOTISTS AND PROSTHETISTS
1-7 Sec. 1. SHORT TITLE. This article may be cited as the
1-8 Orthotics and Prosthetics Act.
1-9 Sec. 2. DEFINITIONS. In this Act:
1-10 (1) "Board" means the Texas Board of Orthotics and
1-11 Prosthetics.
1-12 (2) "Commissioner" means the commissioner of public
1-13 health.
1-14 (3) "Custom-fabricated" means an orthosis or
1-15 prosthesis has been designed, prescribed, fabricated, fitted, and
1-16 aligned specifically for an individual in accordance with sound
1-17 biomechanical principles.
1-18 (4) "Custom-fitted" means an orthosis or prosthesis
1-19 that has been adjusted, prescribed, fitted, and aligned for a
1-20 specific individual according to sound biomechanical principles.
1-21 (5) "Department" means the Texas Department of Health.
1-22 (6) "License" includes a license, registration,
1-23 certificate, accreditation, or other authorization issued under
2-1 this Act to engage in an activity regulated under this Act.
2-2 (7) "Licensed orthotist" or "LO" means a person
2-3 licensed under this Act who practices orthotics and represents the
2-4 person to the public by a title or description of services that
2-5 includes the term "orthotics," "orthotist," "brace," "orthoses,"
2-6 "orthotic," or a similar title or description of services.
2-7 (8) "Licensed orthotist assistant" or "LOA" means a
2-8 person licensed under this Act who assists and is under the
2-9 supervision at an orthotic or prosthetic facility of a licensed
2-10 orthotist responsible for the acts of the assistant.
2-11 (9) "Licensed prosthetist" or "LP" means a person
2-12 licensed under this Act who practices prosthetics and represents
2-13 the person to the public by a title or description of services that
2-14 includes the term "prosthetics," "prosthetist," "prostheses,"
2-15 "prosthetic," "artificial limb," or a similar title or description
2-16 of services.
2-17 (10) "Licensed prosthetist assistant" or "LPA" means a
2-18 person licensed under this Act who assists and is under the
2-19 supervision at an orthotic or prosthetic facility of a licensed
2-20 prosthetist responsible for the acts of the assistant.
2-21 (11) "Licensed prosthetist orthotist" or "LPO" means a
2-22 person licensed under this Act who practices both prosthetics and
2-23 orthotics and represents the person to the public by a title or
2-24 description of services that includes the terms "prosthetics
2-25 orthotics," "prosthetist orthotist," "prosthetic orthotic,"
3-1 "artificial limb," "brace," or a similar title or description of
3-2 services.
3-3 (12) "Licensed prosthetist orthotist assistant" or
3-4 "LPOA" means a person licensed under this Act who assists and is
3-5 under the supervision at an orthotic or prosthetic facility of a
3-6 licensed prosthetist orthotist or a licensed prosthetist and
3-7 licensed orthotist responsible for the acts of the assistant.
3-8 (13) "Orthosis" means a custom-fabricated or
3-9 custom-fitted medical device designed to provide for the support,
3-10 alignment, prevention, or correction of neuromuscular or
3-11 musculoskeletal disease, injury, or deformity. The term does not
3-12 include a fabric or elastic support, corset, arch support,
3-13 low-temperature plastic splint, truss, elastic hose, cane, crutch,
3-14 soft cervical collar, orthosis for diagnostic or evaluation
3-15 purposes, dental appliance, or any other similar device carried in
3-16 stock and sold by a drugstore, department store, or corset shop.
3-17 (14) "Orthotic or prosthetic facility" means a
3-18 physical site, including a building or office, where the profession
3-19 and practice of orthotics or prosthetics normally takes place.
3-20 (15) "Orthotics" means the science and practice of
3-21 measuring, designing, fabricating, assembling, fitting, adjusting,
3-22 or servicing an orthosis under an order from a licensed physician,
3-23 chiropractor, or podiatrist for the correction or alleviation of
3-24 neuromuscular or musculoskeletal dysfunction, disease, injury, or
3-25 deformity.
4-1 (16) "Person" means an individual, corporation,
4-2 partnership, association, or other organization.
4-3 (17) "Profession of orthotics or prosthetics" means
4-4 allied health care medical services used to identify, prevent,
4-5 correct, or alleviate acute or chronic neuromuscular or
4-6 musculoskeletal dysfunctions of the human body that support and
4-7 provide rehabilitative health care services concerned with the
4-8 restoration of function, prevention, or progression of disabilities
4-9 resulting from disease, injury, or congenital anomalies. Orthotic
4-10 and prosthetic services include direct patient care, including
4-11 consultation, evaluation, treatment, education, and advice to
4-12 maximize the rehabilitation potential of disabled individuals.
4-13 (18) "Prosthesis" means a custom-fabricated or fitted
4-14 medical device that is not surgically implanted and is used to
4-15 replace a missing limb, appendage, or other external human body
4-16 part, including an artificial limb, hand, or foot. The term does
4-17 not include an artificial eye, ear, finger, or toe, a dental
4-18 appliance, a cosmetic device, including an artificial breast,
4-19 eyelash, or wig, or other device that does not have a significant
4-20 impact on the musculoskeletal functions of the body.
4-21 (19) "Prosthetics" means the science and practice of
4-22 measuring, designing, fabricating, assembling, fitting, adjusting,
4-23 or servicing a prosthesis under an order from a licensed physician,
4-24 chiropractor, or podiatrist.
4-25 (20) "Registered orthotic technician" means a person
5-1 registered under this Act who fabricates, assembles, and services
5-2 orthoses under the direction of a licensed orthotist or licensed
5-3 orthotist assistant responsible for the acts of the technician.
5-4 (21) "Registered prosthetic orthotic technician" means
5-5 a person registered under this Act who fabricates, assembles, or
5-6 services prostheses and orthoses under the direction of a licensed
5-7 orthotist and licensed prosthetist, a licensed prosthetist
5-8 orthotist, or a licensed orthotist assistant, licensed prosthetist
5-9 assistant, or licensed prosthetist orthotist assistant responsible
5-10 for the acts of the technician.
5-11 (22) "Registered prosthetic technician" means a person
5-12 registered under this Act who fabricates, assembles, or services
5-13 prostheses under the direction of a licensed prosthetist or
5-14 licensed prosthetist assistant responsible for the acts of the
5-15 technician.
5-16 Sec. 3. BOARD. (a) The Texas Board of Orthotics and
5-17 Prosthetics is established as a part of the department and shall
5-18 perform its duties as a board with the department.
5-19 (b) The board consists of six members appointed by the
5-20 governor with the advice and consent of the senate. Appointments
5-21 to the board shall be made without regard to the race, color,
5-22 disability, sex, religion, age, or national origin of the
5-23 appointees.
5-24 (c) Members of the board are appointed for staggered
5-25 six-year terms, with two members' terms expiring on February 1 of
6-1 each odd-numbered year.
6-2 (d) One member of the board must be a licensed orthotist, be
6-3 a resident of this state, and have practiced orthotics for the five
6-4 years preceding the date of appointment. One member of the board
6-5 must be a licensed prosthetist, be a resident of this state, and
6-6 have practiced prosthetics for the five years preceding the date of
6-7 appointment. One member of the board must be a licensed
6-8 prosthetist orthotist, be a resident of this state, and have
6-9 practiced prosthetics and orthotics for the five years preceding
6-10 the date of appointment. One member of the board must be a
6-11 representative of the public who uses an orthosis. One member of
6-12 the board must be a representative of the public who uses a
6-13 prosthesis. One member of the board must be a representative of
6-14 the public who does not use an orthosis or prosthesis.
6-15 (e) A vacancy on the board shall be filled by appointment by
6-16 the governor of an individual who has the appropriate
6-17 qualifications. The appointed person serves for the remainder of
6-18 the term.
6-19 (f) A member of the board is not liable for damages in a
6-20 civil action for any act performed in good faith in the execution
6-21 of the member's duties.
6-22 (g) The board is subject to Chapter 325, Government Code
6-23 (Texas Sunset Act). Unless continued in existence as provided by
6-24 that chapter, the board is abolished and this Act expires September
6-25 1, 2009.
7-1 Sec. 4. REMOVAL FROM BOARD. (a) It is a ground for removal
7-2 from the board if a member:
7-3 (1) does not have at the time of appointment the
7-4 qualifications required for appointment to the board;
7-5 (2) does not maintain during service on the board the
7-6 qualifications required for appointment to the board;
7-7 (3) violates a prohibition established by this Act;
7-8 (4) cannot discharge the member's duties for a
7-9 substantial part of the term for which the member is appointed
7-10 because of illness or disability; or
7-11 (5) is absent from more than half of the regularly
7-12 scheduled board meetings that the member is eligible to attend
7-13 during a calendar year unless the absence is excused by majority
7-14 vote of the board.
7-15 (b) The validity of an action of the board is not affected
7-16 by the fact that the action was taken when a ground for removal of
7-17 a member of the board existed.
7-18 (c) If the executive director has knowledge that a potential
7-19 ground for removal exists, the executive director shall notify the
7-20 presiding officer of the board of the ground. The presiding
7-21 officer shall then notify the governor that a potential ground for
7-22 removal exists.
7-23 Sec. 5. BOARD POWERS AND DUTIES. (a) The board shall
7-24 review applications for a license at least once each year at
7-25 reasonable times and places designated by the board.
8-1 (b) The board may collect license application fees, renewal
8-2 fees, examination fees, and other fees for other administrative
8-3 expenses. If the General Appropriations Act does not set the
8-4 amount of those fees, the board shall set the fees in amounts
8-5 reasonable and necessary for the administration and implementation
8-6 of this Act.
8-7 (c) The board shall approve any examination required for a
8-8 license under this Act. Each examination shall be offered at least
8-9 once each year.
8-10 (d) The board may:
8-11 (1) investigate complaints;
8-12 (2) issue, suspend, deny, and revoke licenses;
8-13 (3) reprimand license holders and place license
8-14 holders on probation;
8-15 (4) issue subpoenas; and
8-16 (5) hold hearings.
8-17 (e) The board shall keep an information file about each
8-18 complaint that is filed with the board relating to a person or
8-19 entity regulated by the board. If a written complaint that the
8-20 board has authority to resolve is filed with the board, the board,
8-21 at least as frequently as quarterly and until the final disposition
8-22 of the complaint, shall notify the parties to the complaint of the
8-23 status of the complaint unless the notice would jeopardize an
8-24 undercover investigation.
8-25 (f) The board shall propose rules consistent with this Act
9-1 to carry out its duties in administering this Act and submit the
9-2 proposed rules to the attorney general for review. The board shall
9-3 adopt rules consistent with the advice of the attorney general. In
9-4 adopting rules, the board shall consider the applicable policies
9-5 and procedures of the department.
9-6 (g) The commissioner, with the advice of the board, shall
9-7 appoint an executive director to administer this Act. The board
9-8 may use personnel, facilities, furniture, equipment, and other
9-9 items supplied by the department to administer this Act.
9-10 (h) The executive director or the executive director's
9-11 designee shall develop an intra-agency career ladder program. The
9-12 program shall require intra-agency posting of all nonentry level
9-13 positions concurrently with any public posting.
9-14 (i) The executive director or the executive director's
9-15 designee shall develop a system of annual performance evaluations
9-16 based on measurable job tasks. All merit pay for board employees
9-17 shall be based on the system established under this subsection.
9-18 (j) The board shall prepare information of consumer interest
9-19 describing the regulatory functions of the board and legal rights
9-20 of consumers as provided by this Act.
9-21 (k) The board shall assist legal authorities in the
9-22 prosecution of any person violating this Act.
9-23 (l) The board shall prepare or approve continuing education
9-24 programs for license holders and shall adopt rules that require a
9-25 license holder to participate in an approved continuing education
10-1 program to renew a license issued under this Act.
10-2 (m) The board shall develop and implement policies that
10-3 clearly define the respective responsibilities of the governing
10-4 body of the board and the staff of the board.
10-5 Sec. 6. PUBLIC INFORMATION. (a) The board shall prepare
10-6 information of public interest describing the functions of the
10-7 board and describing the procedures by which complaints are filed
10-8 with and resolved by the board. The board shall make the
10-9 information available to the general public and appropriate state
10-10 agencies.
10-11 (b) The board by rule shall establish methods by which
10-12 consumers and service recipients are notified of the name, mailing
10-13 address, and telephone number of the board for the purpose of
10-14 directing complaints to the board. The board may provide for that
10-15 notification:
10-16 (1) on each registration form, application, or written
10-17 contract for services of an individual or entity regulated by the
10-18 board;
10-19 (2) on a sign prominently displayed in the place of
10-20 business of each individual or entity regulated by the board; or
10-21 (3) in a bill for service provided by an individual or
10-22 entity regulated by the board.
10-23 (c) The board shall list along with its regular telephone
10-24 number the toll-free telephone number that may be called to present
10-25 a complaint about a person regulated or required to be regulated
11-1 under this Act if the toll-free number is established under other
11-2 state law.
11-3 Sec. 7. PUBLIC PARTICIPATION IN BOARD MEETINGS. The board
11-4 shall develop and implement policies that provide the public with a
11-5 reasonable opportunity to appear before the board and to speak on
11-6 any issue under the jurisdiction of the board.
11-7 Sec. 8. PROGRAM ACCESSIBILITY. The board shall prepare and
11-8 maintain a written plan that describes how a person who does not
11-9 speak English can be provided reasonable access to the board's
11-10 programs. The board shall also comply with federal and state laws
11-11 for program and facility accessibility.
11-12 Sec. 9. TRAINING; STANDARDS OF CONDUCT INFORMATION. Each
11-13 board member shall comply with the board member training
11-14 requirements established by any other state agency that is given
11-15 authority to establish the requirements for the board.
11-16 Sec. 10. OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE
11-17 REQUIREMENTS. The board is subject to Chapters 551 and 2001,
11-18 Government Code.
11-19 Sec. 11. ORGANIZATION OF BOARD. (a) The members of the
11-20 board shall elect from the membership of the board a presiding
11-21 officer, a secretary, and other officers required for the conduct
11-22 of business. Special meetings of the board shall be called by the
11-23 presiding officer or on the written request of any three members.
11-24 The board may adopt rules necessary to govern its proceedings.
11-25 (b) The executive director shall keep a record of each
12-1 meeting of the board and maintain a register containing the names
12-2 of all persons holding a license under this Act. The record and
12-3 register shall be open at all times to public inspection. On March
12-4 1 of each year, the executive director shall send an official copy
12-5 of the register of license holders to the secretary of state for
12-6 permanent record. A certified copy of the register is admissible
12-7 as evidence in any court of this state.
12-8 Sec. 12. COMPENSATION. A member of the board is entitled to
12-9 compensation and reimbursement of the member's travel expenses as
12-10 provided by the General Appropriations Act.
12-11 Sec. 13. EFFECT OF LOBBYING ACTIVITY. A person may not
12-12 serve as a member of the board or act as the general counsel to the
12-13 board if the person is required to register as a lobbyist under
12-14 Chapter 305, Government Code, because of the person's activities
12-15 for compensation on behalf of a profession related to the operation
12-16 of the board.
12-17 Sec. 14. PUBLIC MEMBERSHIP RESTRICTION. A person is not
12-18 eligible for appointment by the governor as a public member of the
12-19 board if the person or person's spouse:
12-20 (1) is registered, certified, or licensed by an
12-21 occupational regulatory agency in the field of health care;
12-22 (2) is employed by or participates in the management
12-23 of a business entity or other organization regulated by the board
12-24 or receiving funds from the board;
12-25 (3) owns or controls, directly or indirectly, more
13-1 than a 10 percent interest in a business entity or other
13-2 organization regulated by the board or receiving funds from the
13-3 board; or
13-4 (4) uses or receives a substantial amount of tangible
13-5 goods, services, or funds from the board, other than compensation
13-6 or reimbursement authorized by law for board membership,
13-7 attendance, or expenses.
13-8 Sec. 15. CONFLICT OF INTEREST RESTRICTIONS. (a) An
13-9 officer, employee, or paid consultant of a Texas trade association
13-10 in the field of health care may not be a member or employee of the
13-11 board who is exempt from the state's position classification plan
13-12 or is compensated at or above the amount prescribed by the General
13-13 Appropriations Act for step 1, salary group 17, of the position
13-14 classification salary schedule.
13-15 (b) A person who is the spouse of an officer, manager, or
13-16 paid consultant of a Texas trade association in the field of health
13-17 care may not be a member of the board and may not be an employee of
13-18 the board who is exempt from the state's position classification
13-19 plan or is compensated at or above the amount prescribed by the
13-20 General Appropriations Act for step 1, salary group 17, of the
13-21 position classification salary schedule.
13-22 (c) For the purposes of this section, a Texas trade
13-23 association is a nonprofit, cooperative, and voluntarily joined
13-24 association of business or professional competitors in this state
13-25 designed to assist its members and its industry or profession in
14-1 dealing with mutual business or professional problems and in
14-2 promoting their common interest.
14-3 Sec. 16. AUDIT. The financial transactions of the board are
14-4 subject to audit by the state auditor in accordance with Chapter
14-5 321, Government Code.
14-6 Sec. 17. REPORT TO GOVERNOR AND LEGISLATURE. During January
14-7 of each year, the board shall file with the governor and the
14-8 presiding officer of each house of the legislature a complete and
14-9 detailed written report accounting for all funds received and
14-10 disbursed by the board during the preceding year.
14-11 Sec. 18. EQUAL EMPLOYMENT OPPORTUNITY POLICIES. (a) The
14-12 executive director or the executive director's designee shall
14-13 prepare and maintain a written policy statement to ensure
14-14 implementation of a program of equal employment opportunity under
14-15 which all personnel transactions are made without regard to race,
14-16 color, disability, sex, religion, age, or national origin. The
14-17 policy statement must include:
14-18 (1) personnel policies, including policies relating to
14-19 recruitment, evaluation, selection, application, training, and
14-20 promotion of personnel, that are in compliance with Chapter 21,
14-21 Labor Code;
14-22 (2) a comprehensive analysis of the board workforce
14-23 that meets federal and state guidelines;
14-24 (3) procedures by which a determination can be made of
14-25 significant underutilization in the board workforce of all persons
15-1 for whom federal or state guidelines encourage a more equitable
15-2 balance; and
15-3 (4) reasonable methods to appropriately address those
15-4 areas of underutilization.
15-5 (b) A policy statement prepared under Subsection (a) of this
15-6 section must cover an annual period, be updated annually, be
15-7 reviewed by the Commission on Human Rights for compliance with
15-8 Subsection (a)(1) of this section, and be filed with the governor's
15-9 office.
15-10 (c) The governor's office shall deliver a biennial report to
15-11 the legislature based on the information received under Subsection
15-12 (b) of this section. The report may be made separately or as part
15-13 of other biennial reports to the legislature.
15-14 Sec. 19. NOTICE OF STANDARDS OF CONDUCT. The board shall
15-15 provide to its members and employees, as often as necessary,
15-16 information regarding their qualifications for office or employment
15-17 under this Act and their responsibilities under applicable laws
15-18 relating to standards of conduct for state officers or employees.
15-19 Sec. 20. APPROPRIATIONS TO TEXAS DEPARTMENT OF HEALTH. The
15-20 department shall receive and account for funds derived under this
15-21 Act. The department shall deposit all funds collected under this
15-22 Act to the credit of the general revenue fund.
15-23 Sec. 21. EXEMPTIONS. (a) This Act does not restrict a
15-24 license holder of another state agency from performing health care
15-25 services within the scope of the license holder's applicable
16-1 licensing act if:
16-2 (1) the license holder:
16-3 (A) does not represent to others that the
16-4 license holder practices the profession of orthotics or
16-5 prosthetics; or
16-6 (B) does not use the terms "prosthetist,"
16-7 "prosthesis," "prosthetic," "artificial limb," "orthotist,"
16-8 "orthosis," "orthotic," or "brace" or the letters "LP," "LPA,"
16-9 "LO," "LOA," "LPO," or "LPOA" or any derivative of those terms or
16-10 letters in connection with the license holder's name or practice;
16-11 and
16-12 (2) the license holder practices in conformance with
16-13 the applicable laws and rules relating to the person's license and
16-14 does not violate Section 22 of this Act.
16-15 (b) This Act does not apply to the activities and services
16-16 of a person acting as a student in orthotics or prosthetics who is
16-17 pursuing a course of study in a prosthetic or orthotic program at a
16-18 college or university recognized and accredited by the Commission
16-19 on Accreditation of Allied Health Education Programs or an orthotic
16-20 or prosthetic educational program having educational standards that
16-21 are equivalent to or exceed the standards adopted by the Commission
16-22 on Accreditation of Allied Health Education Programs or who is
16-23 working in a recognized training center or research facility, if
16-24 those activities and services constitute a part of the person's
16-25 course of study in the discipline in which the person's supervisor
17-1 is licensed under this Act.
17-2 (c) This Act does not apply to a:
17-3 (1) podiatrist practicing under the law regulating
17-4 podiatry (Article 4567 et seq., Revised Statutes); or
17-5 (2) doctor of chiropractic practicing under the law
17-6 regulating chiropractic (Chapter 94, Acts of the 51st Legislature,
17-7 Regular Session, 1949 (Article 4512b, Vernon's Texas Civil
17-8 Statutes)).
17-9 (d) This Act does not apply to a pedorthist certified by the
17-10 Board for Certification in Pedorthics. For the purposes of this
17-11 subsection, a certified pedorthist is a person certified by the
17-12 Board for Certification in Pedorthics, or its successor entity, in
17-13 the design, manufacture, fit, and modification of shoes and related
17-14 foot orthoses below the anatomical ankle joint as prescribed by a
17-15 licensed doctor of medicine or a doctor of podiatry for the
17-16 amelioration of a painful or disabling condition of the foot.
17-17 "Foot orthosis" includes prosthetic toe fillers or orthoses for use
17-18 below the ankle.
17-19 (e) This Act does not apply to a certified fitter or
17-20 certified master orthotist who holds a credential issued by the
17-21 National Community Pharmacists Association if the fitter or master
17-22 orthotist:
17-23 (1) is working within the person's scope of practice
17-24 as defined by the board; or
17-25 (2) provides the following services or devices
18-1 described by the Health Care Financing Administration's Common
18-2 Procedure Coding System:
18-3 (A) foam cervical collar;
18-4 (B) thermoplastic foam cervical collar;
18-5 (C) plastic cervical collar;
18-6 (D) rib belt;
18-7 (E) thoracic-lumbar support;
18-8 (F) lumbar-sacral support;
18-9 (G) sacroiliac support;
18-10 (H) ptosis support;
18-11 (I) pendulous abdomen support;
18-12 (J) torso support;
18-13 (K) knee orthosis;
18-14 (L) knee orthosis with stays;
18-15 (M) knee orthosis with joints;
18-16 (N) knee orthosis with condylar pads;
18-17 (O) knee orthosis with joints and condylar pads;
18-18 (P) knee immobilizer;
18-19 (Q) multiligamentus ankle support;
18-20 (R) figure eight shoulder restrainer;
18-21 (S) acromioclavicular support;
18-22 (T) elbow orthosis with stays;
18-23 (U) elbow orthosis with joints;
18-24 (V) wrist splint;
18-25 (W) pneumatic ankle splint;
19-1 (X) pneumatic walking splint;
19-2 (Y) pneumatic full leg splint;
19-3 (Z) pneumatic knee splint;
19-4 (AA) mastectomy bra;
19-5 (BB) mastectomy sleeve;
19-6 (CC) mastectomy form;
19-7 (DD) silicone breast prosthesis;
19-8 (EE) medium weight calf-length stocking;
19-9 (FF) heavy weight calf-length stocking;
19-10 (GG) surgical weight calf-length stocking;
19-11 (HH) medium weight thigh-length stocking;
19-12 (II) heavy weight thigh-length stocking;
19-13 (JJ) surgical weight thigh-length stocking;
19-14 (KK) medium weight full-length stocking;
19-15 (LL) heavy weight full-length stocking;
19-16 (MM) surgical weight full-length stocking;
19-17 (NN) medium weight leotard;
19-18 (OO) surgical weight leotard;
19-19 (PP) custom made compression stocking;
19-20 (QQ) lymphedema sleeve;
19-21 (RR) garter belt;
19-22 (SS) single truss with standard pad;
19-23 (TT) double truss with standard pad;
19-24 (UU) water pad addition to truss; and
19-25 (VV) scrotal pad addition to truss.
20-1 Sec. 22. PROHIBITED ACTS. (a) A person may not practice,
20-2 attempt to practice, or offer to practice prosthetics or orthotics,
20-3 act as an assistant to a person who practices prosthetics or
20-4 orthotics, or in any way hold the person out as being able to
20-5 practice prosthetics or orthotics unless the person holds a license
20-6 issued by the board under this Act.
20-7 (b) A person or the person's employees, agents, or
20-8 representatives may not use in connection with the person's name or
20-9 business activities the terms or a combination of the terms or
20-10 letters described in Section 21(a)(1), indicate orally or in
20-11 writing, directly or by implication, that a prosthetic or orthotic
20-12 service is provided or supplied, or extend or provide prosthetic or
20-13 orthotic services unless the person is a prosthetist or orthotist
20-14 or an assistant to a prosthetist or orthotist licensed under this
20-15 Act.
20-16 (c) A person licensed under this Act violates this Act if
20-17 the person violates Section 161.091, Health and Safety Code.
20-18 Sec. 23. PROSTHETIST AND ORTHOTIST LICENSE REQUIREMENTS.
20-19 (a) To obtain a license to practice prosthetics or orthotics in
20-20 this state, an individual must file a written application with the
20-21 board on the form provided by the board, pay the nonrefundable
20-22 application fee prescribed by the board, and:
20-23 (1) be a resident of this state;
20-24 (2) have completed the formal training, including the
20-25 required hours of classroom education and clinical practice, in an
21-1 area of study the board by rule determines to be necessary and
21-2 appropriate;
21-3 (3) have completed a clinical residency in the
21-4 professional area for which licensure is sought that complies with
21-5 the standards, guidelines, or procedures established by the board
21-6 for a clinical residency offered in this state or in another state;
21-7 and
21-8 (4) have completed and passed all written and
21-9 practical examinations approved and required by the board.
21-10 (b) The requirements for a license established by board rule
21-11 must include:
21-12 (1) either:
21-13 (A) a bachelor's degree in orthotics and
21-14 prosthetics from a college or university educational program
21-15 recognized and accredited by the Commission on Accreditation of
21-16 Allied Health Education Programs or from a practitioner educational
21-17 program having educational standards that are equivalent to or
21-18 exceed the standards adopted by the Commission on Accreditation of
21-19 Allied Health Education Programs; or
21-20 (B) a bachelor's degree and a prosthetic or
21-21 orthotic certificate from a practitioner educational program
21-22 recognized and accredited by the Commission on Accreditation of
21-23 Allied Health Education Programs or from a practitioner educational
21-24 program having educational standards that are equivalent to or
21-25 exceed the standards adopted by the Commission on Accreditation of
22-1 Allied Health Education Programs; and
22-2 (2) not less than 1,900 hours of professional clinical
22-3 residency completed under the direct supervision of a licensed
22-4 orthotist, licensed prosthetist, or a licensed prosthetist
22-5 orthotist in the discipline for which licensure is sought.
22-6 (c) The board's rules providing requirements for a license
22-7 must include as an alternative to the requirement under Subsection
22-8 (b) of this section that an applicant have an associate's degree,
22-9 including courses in the anatomical, biological, and physical
22-10 sciences and not less than 4,500 hours of postgraduate clinical
22-11 experience under the direct supervision of a licensed orthotist,
22-12 licensed prosthetist, or licensed prosthetist orthotist in the
22-13 discipline for which licensure is sought. This subsection expires
22-14 January 1, 2005.
22-15 (d) A person may apply for an exemption from the license
22-16 requirements adopted by the board under this section if the person
22-17 applies not later than the 181st day after the date the board's
22-18 initial rules under this Act are finally adopted and published and
22-19 the person:
22-20 (1) is a resident of this state; and
22-21 (2) preceding the date of the application:
22-22 (A) provided comprehensive prosthetic or
22-23 orthotic care for not less than three years, including practicing
22-24 orthotics or prosthetics in this state for the one-year period
22-25 preceding the application date; or
23-1 (B) provided comprehensive prosthetic and
23-2 orthotic care for not less than six years, including practicing
23-3 orthotics and prosthetics in this state for the one-year period
23-4 preceding the application date.
23-5 (e) A person may apply for an exemption from the license
23-6 requirements adopted by the board under this section if the person
23-7 is a resident of this state who presents evidence satisfactory to
23-8 the board that the person possesses unique qualifications to
23-9 practice orthotics, prosthetics, or orthotics and prosthetics.
23-10 (f) A person may obtain a license to practice in this state
23-11 by completing and passing all written and practical examinations
23-12 approved and required by the board if the person:
23-13 (1) applies for the examinations on a form provided by
23-14 the board not later than the 181st day after the date the board's
23-15 initial rules under this Act are finally adopted and published;
23-16 (2) pays the nonrefundable application fee prescribed
23-17 by the board; and
23-18 (3) provided comprehensive orthotic, prosthetic, or
23-19 orthotic and prosthetic care in this state for less than the number
23-20 of years required by Subsection (d) of this section.
23-21 (g) The board shall issue a license to a person who is
23-22 determined to be exempt from the license requirements under
23-23 Subsection (d) or (e) of this section or who obtains a license
23-24 under Subsection (f) of this section. Such a license holder is
23-25 entitled to the same license privileges as if the person met the
24-1 educational and vocational requirements under Subsection (a) or (b)
24-2 of this section. The person is subject to the license renewal
24-3 requirements adopted by the board, except for the academic,
24-4 clinical training, and examination requirements, which may not be
24-5 imposed as a condition of the person's license.
24-6 Sec. 24. PHARMACISTS. The board shall issue a license to a
24-7 person who applies for a license and is licensed or regulated by
24-8 the State Board of Pharmacy and is certified by the National
24-9 Community Pharmacists Association as a certified fitter or master
24-10 orthotist. The board shall assess a licensing fee of no more than
24-11 $50 to a person licensed under this section.
24-12 Sec. 25. PROSTHETIST OR ORTHOTIST ASSISTANT LICENSE.
24-13 (a) An applicant for a license as a prosthetist assistant or
24-14 orthotist assistant must file a written application with the board
24-15 on a form provided by the board and pay the nonrefundable
24-16 application fee prescribed by the board.
24-17 (b) An applicant under this section must present evidence
24-18 satisfactory to the board that the applicant has completed an
24-19 educational program, including courses in the anatomical,
24-20 biological, and physical sciences, and a clinical residency as
24-21 prescribed and adopted by the board.
24-22 (c) An assistant licensed under this section may provide
24-23 only ancillary patient care services, as defined by the board, in
24-24 the discipline in which the assistant's supervisor is licensed
24-25 under this Act.
25-1 (d) A person may apply for an exemption from the license
25-2 requirements adopted by the board under this section if the person
25-3 applies not later than the 181st day after the date the board's
25-4 initial rules under this Act are finally adopted and published and
25-5 if the person is a resident of this state who has practiced within
25-6 the scope of practice of an assistant, as defined by the board, for
25-7 five consecutive years in this state.
25-8 Sec. 26. PROSTHETIC OR ORTHOTIC TECHNICIAN REGISTRATION.
25-9 (a) An applicant for registration as a registered prosthetic
25-10 technician or registered orthotic technician must file a written
25-11 application with the board on a form provided by the board and pay
25-12 the nonrefundable application fee prescribed by the board.
25-13 (b) An applicant under this section must present evidence
25-14 satisfactory to the board that the applicant has completed an
25-15 educational program and laboratory experience as prescribed and
25-16 adopted by the board.
25-17 (c) A person may apply for an exemption from the
25-18 registration requirements adopted by the board under this section
25-19 if the person applies not later than the 181st day after the date
25-20 the board's initial rules under this Act are finally adopted and
25-21 published and if the person is a resident of this state who has
25-22 practiced as an orthotic or prosthetic technician for five
25-23 consecutive years in this state.
25-24 Sec. 27. ACCREDITATION OF FACILITIES. (a) The board by
25-25 rule shall adopt requirements for the accreditation and the renewal
26-1 of an accreditation of an orthotic or prosthetic facility in which
26-2 the profession and practice of orthotics or prosthetics is
26-3 conducted.
26-4 (b) If one or more facilities are owned by a person, the
26-5 board may require only one application for the accreditation of all
26-6 the person's facilities. Each orthotic or prosthetic facility must
26-7 meet the requirements prescribed by the board.
26-8 (c) An orthotic or prosthetic facility must be under the
26-9 on-site direction of an orthotist or prosthetist licensed by the
26-10 board in the discipline for which accreditation is sought.
26-11 (d) The rules adopted under this section may not prohibit a
26-12 licensed individual from practicing in an orthotic or prosthetic
26-13 facility within the scope of the individual's license.
26-14 (e) This section does not apply to a facility licensed under
26-15 Subtitle B, Title 4, Health and Safety Code.
26-16 Sec. 28. ISSUANCE OF LICENSE. (a) The board shall issue a
26-17 license in prosthetics or orthotics to an applicant who meets the
26-18 qualifications established under this Act and the requirements
26-19 adopted by the board as provided by this Act. A license is valid
26-20 for two years from the date issued and may be renewed before
26-21 expiration.
26-22 (b) The board may issue a license or registration under this
26-23 Act only to an individual. The board may issue an accreditation
26-24 only to an orthotic or prosthetic facility.
26-25 (c) A license may be granted in either orthotics or
27-1 prosthetics, or in both, if the person meets the requirements
27-2 established by the board.
27-3 Sec. 29. PROVISIONAL LICENSE. (a) A person practicing
27-4 comprehensive prosthetic or orthotic patient management who does
27-5 not meet the requirements of this Act for licensing as a
27-6 prosthetist or orthotist by October 1, 1998, and is not exempt
27-7 under this Act, must comply with the requirements of Sections 23(a)
27-8 and (b) of this Act on or before January 1, 2005.
27-9 (b) A person subject to this section may apply for a
27-10 prosthetist or orthotist provisional license by filing a written
27-11 application with the board on a form provided by the board and
27-12 paying a nonrefundable application fee prescribed by the board.
27-13 (c) A provisional license may only be issued to an
27-14 individual who is actively engaged in complying with the
27-15 educational and clinical licensing requirements of Sections 23(a)
27-16 and (b) of this Act.
27-17 (d) A provisional license may be revoked by the board if the
27-18 board determines that the provisional license holder is not in
27-19 compliance with this section.
27-20 (e) The educational and clinical training requirements
27-21 established by board rule for a provisional license must include:
27-22 (1) an associate degree, including course work in the
27-23 anatomical, biological, and physical sciences; and
27-24 (2) not less than 4,500 hours of postgraduate clinical
27-25 residency completed under the direct supervision of a licensed
28-1 orthotist or a licensed prosthetist in the discipline for which a
28-2 provisional license is sought.
28-3 (f) A provisional license is valid for two years from the
28-4 date issued and may be renewed with documentation as required by
28-5 board rule.
28-6 (g) This section expires January 1, 2005.
28-7 Sec. 30. TEMPORARY LICENSE. (a) The board may issue a
28-8 temporary license to an individual who:
28-9 (1) has recently become a resident of this state;
28-10 (2) has applied for licensing as an orthotist,
28-11 prosthetist, or both; and
28-12 (3) has:
28-13 (A) practiced the profession of orthotics
28-14 regularly since January 1, 1996; or
28-15 (B) been licensed by the state in which the
28-16 person formerly resided that has licensing requirements that are
28-17 equal to or exceed the requirements of this Act.
28-18 (b) A temporary license is valid for one year from the date
28-19 issued. A temporary license may be renewed for not more than one
28-20 additional year if the applicant presents to the board sufficient
28-21 evidence of good cause for renewal.
28-22 Sec. 31. STUDENT REGISTRATION. (a) The board may issue a
28-23 student registration certificate to an individual who:
28-24 (1) holds either:
28-25 (A) a bachelor's degree in orthotics and
29-1 prosthetics conferred by a college or university educational
29-2 program recognized and accredited by the Commission on
29-3 Accreditation of Allied Health Education Programs or from a
29-4 practitioner educational program having educational standards that
29-5 are equivalent to or exceed the standards adopted by the Commission
29-6 on Accreditation of Allied Health Education Programs; or
29-7 (B) a bachelor's degree and a prosthetic or
29-8 orthotic certificate from a practitioner educational program
29-9 recognized and accredited by the Commission on Accreditation of
29-10 Allied Health Education Programs or from an educational program
29-11 having educational standards that are equivalent to or exceed the
29-12 standards adopted by the Commission on Accreditation of Allied
29-13 Health Education Programs; and
29-14 (2) is working toward fulfillment of the requirements
29-15 for licensing as a prosthetist, orthotist, or prosthetist
29-16 orthotist.
29-17 (b) The board may issue a student registration certificate
29-18 to an individual who holds, as an alternative to the qualifications
29-19 required by Subsection (a)(1)(B) of this section, an associate's
29-20 degree, including course work in the anatomical, biological, and
29-21 physical sciences. This subsection expires January 1, 2005.
29-22 (c) A student registrant may work only under the direct
29-23 supervision of a licensed orthotist, licensed prosthetist, or
29-24 licensed prosthetist orthotist who is responsible for the acts of
29-25 the student registrant and is licensed in the discipline of the
30-1 clinical residency.
30-2 (d) A student registration certificate is valid for two
30-3 years from the date issued and may be renewed once for an
30-4 additional two years.
30-5 Sec. 32. EXAMINATION EXEMPTION. The board may accept as a
30-6 substitute for the examination requirement proof that the applicant
30-7 for the exemption holds a current license in a state that has
30-8 licensing requirements that are equal to or exceed the requirements
30-9 of this Act.
30-10 Sec. 33. CONTINUING EDUCATION. (a) An applicant for
30-11 renewal of a license shall submit to the board evidence of
30-12 satisfactory completion of the continuing education requirements
30-13 required by the board.
30-14 (b) The board shall notify each license holder of the
30-15 holder's failure to comply with the board's continuing education
30-16 requirements and shall notify the license holder that if the holder
30-17 does not obtain the required continuing education before the
30-18 expiration of three months after the date the notice was given, the
30-19 board may take any action authorized by this Act concerning the
30-20 suspension or revocation of the holder's license.
30-21 Sec. 34. DISCIPLINARY PROVISIONS. (a) After notice and
30-22 opportunity for a hearing, the board may revoke, suspend, or refuse
30-23 to renew a license issued under this Act on a finding that:
30-24 (1) the license was obtained by fraud,
30-25 misrepresentation, or concealment of a material fact;
31-1 (2) the person engaged in fraud or deceit in
31-2 connection with services provided by the person;
31-3 (3) the person engaged in unprofessional or unethical
31-4 conduct;
31-5 (4) the person engaged in gross negligence or
31-6 malpractice; or
31-7 (5) the person violated this Act or a rule adopted
31-8 under this Act.
31-9 (b) A license revoked under Subsection (a) of this section
31-10 may be reinstated after the first anniversary of the date of the
31-11 revocation by the board on terms the board determines to be
31-12 necessary.
31-13 Sec. 35. CIVIL PENALTY. (a) A person who violates this Act
31-14 is subject to a civil penalty of $200 for the first violation and
31-15 $500 for each subsequent violation. At the request of the board,
31-16 the attorney general shall bring an action in the name of the state
31-17 to collect a civil penalty under this section.
31-18 (b) Each day a violation of Section 22 of this Act continues
31-19 is a separate violation for the purpose of this section.
31-20 SECTION 2. Section 232.002, Family Code, is amended to read
31-21 as follows:
31-22 Sec. 232.002. Licensing Authorities Subject to Chapter. The
31-23 following state agencies are licensing authorities subject to this
31-24 subchapter:
31-25 (1) Department of Agriculture;
32-1 (2) Texas Commission on Alcohol and Drug Abuse;
32-2 (3) Texas Alcoholic Beverage Commission;
32-3 (4) Texas Appraiser Licensing and Certification Board;
32-4 (5) Texas Board of Architectural Examiners;
32-5 (6) State Board of Barber Examiners;
32-6 (7) Texas Board of Chiropractic Examiners;
32-7 (8) Comptroller of Public Accounts;
32-8 (9) Texas Cosmetology Commission;
32-9 (10) Court Reporters Certification Board;
32-10 (11) State Board of Dental Examiners, if the 74th
32-11 Legislature, at its regular session, enacts legislation that
32-12 becomes law authorizing a state agency to regulate the practice of
32-13 dentistry;
32-14 (12) Texas State Board of Examiners of Dietitians;
32-15 (13) Texas Funeral Service Commission;
32-16 (14) Texas Department of Health;
32-17 (15) Texas Board of Professional Land Surveying;
32-18 (16) Texas Department of Licensing and Regulation;
32-19 (17) Texas State Board of Examiners of Marriage and
32-20 Family Therapists;
32-21 (18) Texas State Board of Medical Examiners;
32-22 (19) Midwifery Board;
32-23 (20) Texas Natural Resource Conservation Commission;
32-24 (21) Board of Nurse Examiners;
32-25 (22) Texas Board of Nursing Facility Administrators;
33-1 (23) Texas Board of Occupational Therapy Examiners;
33-2 (24) Texas Optometry Board;
33-3 (25) Parks and Wildlife Department;
33-4 (26) Texas State Board of Examiners of Perfusionists;
33-5 (27) Texas State Board of Pharmacy;
33-6 (28) Texas Board of Physical Therapy Examiners;
33-7 (29) Texas State Board of Plumbing Examiners;
33-8 (30) Texas State Board of Podiatry Examiners;
33-9 (31) Polygraph Examiners Board;
33-10 (32) Texas Board of Private Investigators and Private
33-11 Security Agencies;
33-12 (33) Texas State Board of Examiners of Professional
33-13 Counselors;
33-14 (34) State Board of Registration for Professional
33-15 Engineers;
33-16 (35) Department of Protective and Regulatory Services;
33-17 (36) Texas State Board of Examiners of Psychologists;
33-18 (37) Texas State Board of Public Accountancy;
33-19 (38) Department of Public Safety of the State of
33-20 Texas;
33-21 (39) Public Utility Commission of Texas;
33-22 (40) Railroad Commission of Texas;
33-23 (41) Texas Real Estate Commission;
33-24 (42) State Bar of Texas;
33-25 (43) Texas State Board of Social Worker Examiners;
34-1 (44) State Board of Examiners for Speech-Language
34-2 Pathology and Audiology;
34-3 (45) Texas Structural Pest Control Board;
34-4 (46) Board of Tax Professional Examiners;
34-5 (47) Secretary of State;
34-6 (48) Supreme Court of Texas;
34-7 (49) Texas Transportation Commission;
34-8 (50) State Board of Veterinary Medical Examiners;
34-9 (51) Board of Vocational Nurse Examiners;
34-10 (52) Texas Ethics Commission;
34-11 (53) Advisory Board of Athletic Trainers;
34-12 (54) State Committee of Examiners in the Fitting and
34-13 Dispensing of Hearing Instruments;
34-14 (55) Texas Board of Licensure for Professional Medical
34-15 Physicists; [and]
34-16 (56) Texas Department of Insurance; and
34-17 (57) Texas Board of Orthotics and Prosthetics.
34-18 SECTION 3. (a) In making the initial appointments to the
34-19 Texas Board of Orthotics and Prosthetics, the governor shall, not
34-20 later than October 1, 1997, appoint:
34-21 (1) two members for terms expiring February 1, 1999;
34-22 (2) two members for terms expiring February 1, 2001;
34-23 and
34-24 (3) two members for terms expiring February 1, 2003.
34-25 (b) The initial members of the board appointed under
35-1 Subsection (a) of this section shall have the qualifications
35-2 required by this subsection. One member must be an orthotist
35-3 certified by the American Board for Certification in Orthotics and
35-4 Prosthetics, Inc., be a resident of this state, and have practiced
35-5 orthotics for the five years preceding the date of appointment.
35-6 Two members must be orthotists who hold a credential issued by the
35-7 Board for Orthotist Certification, are residents of this state, and
35-8 have practiced orthotics for the five years preceding the date of
35-9 appointment. One member must be a prosthetist orthotist or
35-10 prosthetist certified by the American Board for Certification in
35-11 Orthotics and Prosthetics, Inc., be a resident of this state, and
35-12 have practiced prosthetics or orthotics for the five years
35-13 preceding the date of appointment. One member must be a
35-14 representative of the public who uses an orthosis. One member must
35-15 be a representative of the public who uses a prosthesis.
35-16 (c) A member appointed under this section to a place on the
35-17 board required to be held by a person licensed under Article 8920,
35-18 Revised Statutes, as added by this Act, may continue to serve
35-19 without having the appropriate license until February 1, 1999, by
35-20 which date the person must obtain the required license.
35-21 (d) The board shall adopt rules under Article 8920, Revised
35-22 Statutes, as added by this Act, not later than October 1, 1998.
35-23 SECTION 4. (a) Except as provided by Subsection (b) of this
35-24 section, this Act takes effect September 1, 1997.
35-25 (b) Sections 22 and 35, Article 8920, Revised Statutes, as
36-1 added by this Act, take effect October 1, 1998.
36-2 SECTION 5. The importance of this legislation and the
36-3 crowded condition of the calendars in both houses create an
36-4 emergency and an imperative public necessity that the
36-5 constitutional rule requiring bills to be read on three several
36-6 days in each house be suspended, and this rule is hereby suspended.