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.

7-14           (b)  The validity of an action of the board is not affected

7-15     by the fact that the action was taken when a ground for removal of

7-16     a member of the board existed.

7-17           (c)  If the executive director has knowledge that a potential

7-18     ground for removal exists, the executive director shall notify the

7-19     presiding officer of the board of the ground.  The presiding

7-20     officer shall then notify the governor that a potential ground for

7-21     removal exists.

7-22           Sec. 5.  BOARD POWERS AND DUTIES.  (a)  The board shall

7-23     review applications for a license at least once each year at

7-24     reasonable times and places designated by the board.

7-25           (b)  The board may collect license application fees, renewal

 8-1     fees, examination fees, and other fees for other administrative

 8-2     expenses.  If the General Appropriations Act does not set the

 8-3     amount of those fees, the board shall set the fees in amounts

 8-4     reasonable and necessary for the administration and implementation

 8-5     of this Act.

 8-6           (c)  The board shall approve any examination required for a

 8-7     license under this Act.  Each examination shall be offered at least

 8-8     once each year.

 8-9           (d)  The board may:

8-10                 (1)  investigate complaints;

8-11                 (2)  issue, suspend, deny, and revoke licenses;

8-12                 (3)  reprimand license holders and place license

8-13     holders on probation;

8-14                 (4)  issue subpoenas; and

8-15                 (5)  hold hearings.

8-16           (e)  The board shall keep an information file about each

8-17     complaint that is filed with the board relating to a person or

8-18     entity regulated by the board.  If a written complaint that the

8-19     board has authority to resolve is filed with the board, the board,

8-20     at least as frequently as quarterly and until the final disposition

8-21     of the complaint, shall notify the parties to the complaint of the

8-22     status of the complaint unless the notice would jeopardize an

8-23     undercover investigation.

8-24           (f)  The board shall propose rules consistent with this Act

8-25     to carry out its duties in administering this Act and submit the

 9-1     proposed rules to the attorney general for review.  The board shall

 9-2     adopt rules consistent with the advice of the attorney general.  In

 9-3     adopting rules, the board shall consider the applicable policies

 9-4     and procedures of the department.

 9-5           (g)  The commissioner, with the advice of the board, shall

 9-6     appoint an executive director to administer this Act.  The board

 9-7     may use personnel, facilities, furniture, equipment, and other

 9-8     items supplied by the department to administer this Act.

 9-9           (h)  The executive director or the executive director's

9-10     designee shall develop an intra-agency career ladder program.  The

9-11     program shall require intra-agency posting of all nonentry level

9-12     positions concurrently with any public posting.

9-13           (i)  The executive director or the executive director's

9-14     designee shall develop a system of annual performance evaluations

9-15     based on measurable job tasks.  All merit pay for board employees

9-16     shall be based on the system established under this subsection.

9-17           (j)  The board shall prepare information of consumer interest

9-18     describing the regulatory functions of the board and legal rights

9-19     of consumers as provided by this Act.

9-20           (k)  The board shall assist legal authorities in the

9-21     prosecution of any person violating this Act.

9-22           (l)  The board shall prepare or approve continuing education

9-23     programs for license holders and shall adopt rules that require a

9-24     license holder to participate in an approved continuing education

9-25     program to renew a license issued under this Act.

 10-1          (m)  The board shall develop and implement policies that

 10-2    clearly define the respective responsibilities of the governing

 10-3    body of the board and the staff of the board.

 10-4          Sec. 6.  PUBLIC INFORMATION.  (a)  The board shall prepare

 10-5    information of public interest describing the functions of the

 10-6    board and describing the procedures by which complaints are filed

 10-7    with and resolved by the board.  The board shall make the

 10-8    information available to the general public and appropriate state

 10-9    agencies.

10-10          (b)  The board by rule shall establish methods by which

10-11    consumers and service recipients are notified of the name, mailing

10-12    address, and telephone number of the board for the purpose of

10-13    directing complaints to the board.  The board may provide for that

10-14    notification:

10-15                (1)  on each registration form, application, or written

10-16    contract for services of an individual or entity regulated by the

10-17    board;

10-18                (2)  on a sign prominently displayed in the place of

10-19    business of each individual or entity regulated by the board; or

10-20                (3)  in a bill for service provided by an individual or

10-21    entity regulated by the board.

10-22          (c)  The board shall list along with its regular telephone

10-23    number the toll-free telephone number that may be called to present

10-24    a complaint about a person regulated or required to be regulated

10-25    under this Act if the toll-free number is established under other

 11-1    state law.

 11-2          Sec. 7.  PUBLIC PARTICIPATION IN BOARD MEETINGS.  The board

 11-3    shall develop and implement policies that provide the public with a

 11-4    reasonable opportunity to appear before the board and to speak on

 11-5    any issue under the jurisdiction of the board.

 11-6          Sec. 8.  PROGRAM ACCESSIBILITY.  The board shall prepare and

 11-7    maintain a written plan that describes how a person who does not

 11-8    speak English can be provided reasonable access to the board's

 11-9    programs.  The board shall also comply with federal and state laws

11-10    for program and facility accessibility.

11-11          Sec. 9.  TRAINING; STANDARDS OF CONDUCT INFORMATION.  Each

11-12    board member shall comply with the board member training

11-13    requirements established by any other state agency that is given

11-14    authority to establish the requirements for the board.

11-15          Sec. 10.  OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE

11-16    REQUIREMENTS.  The board is subject to Chapters 551 and 2001,

11-17    Government Code.

11-18          Sec. 11.  ORGANIZATION OF BOARD.  (a)  The members of the

11-19    board shall elect from the membership of the board a presiding

11-20    officer, a secretary, and other officers required for the conduct

11-21    of business.  Special meetings of the board shall be called by the

11-22    presiding officer or on the written request of any three members.

11-23    The board may adopt rules necessary to govern its proceedings.

11-24          (b)  The executive director shall keep a record of each

11-25    meeting of the board and maintain a register containing the names

 12-1    of all persons holding a license under this Act.  The record and

 12-2    register shall be open at all times to public inspection.  On March

 12-3    1 of each year, the executive director shall send an official copy

 12-4    of the register of license holders to the secretary of state for

 12-5    permanent record.  A certified copy of the register is admissible

 12-6    as evidence in any court of this state.

 12-7          Sec. 12.  COMPENSATION.  A member of the board is entitled to

 12-8    compensation and reimbursement of the member's travel expenses as

 12-9    provided by the General Appropriations Act.

12-10          Sec. 13.  EFFECT OF LOBBYING ACTIVITY.  A person may not

12-11    serve as a member of the board or act as the general counsel to the

12-12    board if the person is required to register as a lobbyist under

12-13    Chapter 305, Government Code, because of the person's activities

12-14    for compensation on behalf of a profession related to the operation

12-15    of the board.

12-16          Sec. 14.  PUBLIC MEMBERSHIP RESTRICTION.  A person is not

12-17    eligible for appointment by the governor as a public member of the

12-18    board if the person or person's spouse:

12-19                (1)  is registered, certified, or licensed by an

12-20    occupational regulatory agency in the field of health care;

12-21                (2)  is employed by or participates in the management

12-22    of a business entity or other organization regulated by the board

12-23    or receiving funds from the board;

12-24                (3)  owns or controls, directly or indirectly, more

12-25    than a 10 percent interest in a business entity or other

 13-1    organization regulated by the board or receiving funds from the

 13-2    board; or

 13-3                (4)  uses or receives a substantial amount of tangible

 13-4    goods, services, or funds from the board, other than compensation

 13-5    or reimbursement authorized by law for board membership,

 13-6    attendance, or expenses.

 13-7          Sec. 15.  CONFLICT OF INTEREST RESTRICTIONS.  (a)  An

 13-8    officer, employee, or paid consultant of a Texas trade association

 13-9    in the field of health care may not be a member or employee of the

13-10    board who is exempt from the state's position classification plan

13-11    or is compensated at or above the amount prescribed by the General

13-12    Appropriations Act for step 1, salary group 17, of the position

13-13    classification salary schedule.

13-14          (b)  A person who is the spouse of an officer, manager, or

13-15    paid consultant of a Texas trade association in the field of health

13-16    care may not be a member of the board and may not be an employee of

13-17    the board who is exempt from the state's position classification

13-18    plan or is compensated at or above the amount prescribed by the

13-19    General Appropriations Act for step 1, salary group 17, of the

13-20    position classification salary schedule.

13-21          (c)  For the purposes of this section, a Texas trade

13-22    association is a nonprofit, cooperative, and voluntarily joined

13-23    association of business or professional competitors in this state

13-24    designed to assist its members and its industry or profession in

13-25    dealing with mutual business or professional problems and in

 14-1    promoting their common interest.

 14-2          Sec. 16.  AUDIT.  The financial transactions of the board are

 14-3    subject to audit by the state auditor in accordance with Chapter

 14-4    321, Government Code.

 14-5          Sec. 17.  REPORT TO GOVERNOR AND LEGISLATURE.  During January

 14-6    of each year, the board shall file with the governor and the

 14-7    presiding officer of each house of the legislature a complete and

 14-8    detailed written report accounting for all funds received and

 14-9    disbursed by the board during the preceding year.

14-10          Sec. 18.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The

14-11    executive director or the executive director's designee shall

14-12    prepare and maintain a written policy statement to ensure

14-13    implementation of a program of equal employment opportunity under

14-14    which all personnel transactions are made without regard to race,

14-15    color, disability, sex, religion, age, or national origin.  The

14-16    policy statement must include:

14-17                (1)  personnel policies, including policies relating to

14-18    recruitment, evaluation, selection, application, training, and

14-19    promotion of personnel, that are in compliance with Chapter 21,

14-20    Labor Code;

14-21                (2)  a comprehensive analysis of the board workforce

14-22    that meets federal and state laws, rules, and regulations and

14-23    instructions promulgated directly from those laws, rules, and

14-24    regulations;

14-25                (3)  procedures by which a determination can be made of

 15-1    significant underutilization in the board workforce of all persons

 15-2    for whom federal or state laws, rules, and regulations and

 15-3    instructions promulgated directly from those laws, rules, and

 15-4    regulations encourage a more equitable balance; and

 15-5                (4)  reasonable methods to appropriately address those

 15-6    areas of underutilization.

 15-7          (b)  A policy statement prepared under Subsection (a) of this

 15-8    section must cover an annual period, be updated annually, be

 15-9    reviewed by the Commission on Human Rights for compliance with

15-10    Subsection (a)(1) of this section, and be filed with the governor's

15-11    office.

15-12          (c)  The governor's office shall deliver a biennial report to

15-13    the legislature based on the information received under Subsection

15-14    (b) of this section.  The report may be made separately or as part

15-15    of other biennial reports to the legislature.

15-16          Sec. 19.  NOTICE OF STANDARDS OF CONDUCT.  The board shall

15-17    provide to its members and employees, as often as necessary,

15-18    information regarding their qualifications for office or employment

15-19    under this Act and their responsibilities under applicable laws

15-20    relating to standards of conduct for state officers or employees.

15-21          Sec. 20.  APPROPRIATIONS TO TEXAS DEPARTMENT OF HEALTH.  The

15-22    department shall receive and account for funds derived under this

15-23    Act.  The department shall deposit all funds collected under this

15-24    Act to the credit of the general revenue fund.

15-25          Sec. 21.  EXEMPTIONS.  (a)  This Act does not restrict a

 16-1    license holder of another state agency from performing health care

 16-2    services within the scope of the license holder's applicable

 16-3    licensing act if:

 16-4                (1)  the license holder:

 16-5                      (A)  does not represent to others that the

 16-6    license holder practices the profession of orthotics or

 16-7    prosthetics; or

 16-8                      (B)  does not use the terms "prosthetist,"

 16-9    "prosthesis," "prosthetic," "artificial limb," "orthotist,"

16-10    "orthosis," "orthotic," or "brace" or the letters "LP," "LPA,"

16-11    "LO," "LOA," "LPO," or "LPOA" or any derivative of those terms or

16-12    letters in connection with the license holder's name or practice;

16-13    and

16-14                (2)  the license holder practices in conformance with

16-15    the applicable laws and rules relating to the person's license and

16-16    does not violate Section 22 of this Act.

16-17          (b)  This Act does not apply to the activities and services

16-18    of a person acting as a student in orthotics or prosthetics who is

16-19    pursuing a course of study in a prosthetic or orthotic program at a

16-20    college or university recognized and accredited by the Commission

16-21    on Accreditation of Allied Health Education Programs or an orthotic

16-22    or prosthetic educational program having educational standards that

16-23    are equivalent to or exceed the standards adopted by the Commission

16-24    on Accreditation of Allied Health Education Programs or who is

16-25    working in a recognized training center or research facility, if

 17-1    those activities and services constitute a part of the person's

 17-2    course of study in the discipline in which the person's supervisor

 17-3    is licensed under this Act.

 17-4          (c)  This Act does not apply to:

 17-5                (1)  a podiatrist practicing under the law regulating

 17-6    podiatry (Article 4567 et seq., Revised Statutes);

 17-7                (2)  a doctor of chiropractic practicing under the law

 17-8    regulating chiropractic (Chapter 94, Acts of the 51st Legislature,

 17-9    Regular Session, 1949 (Article 4512b, Vernon's Texas Civil

17-10    Statutes));

17-11                (3)  an occupational therapist practicing under the law

17-12    regulating occupational therapy (Occupational Therapy Practice Act

17-13    (Article 8851, Vernon's Texas Civil Statutes)); or

17-14                (4)  a physical therapist practicing under the law

17-15    regulating physical therapy (Chapter 836, Acts of the 62nd

17-16    Legislature, Regular Session, 1971 (Article 4512e, Vernon's Texas

17-17    Civil Statutes)).

17-18          (d)  This Act does not apply to a pedorthist certified by the

17-19    Board for Certification in Pedorthics.  For the purposes of this

17-20    subsection, a certified pedorthist is a person certified by the

17-21    Board for Certification in Pedorthics, or its successor entity, in

17-22    the design, manufacture, fit, and modification of shoes and related

17-23    foot orthoses below the anatomical ankle joint as prescribed by a

17-24    licensed doctor of medicine or a doctor of podiatry for the

17-25    amelioration of a painful or disabling condition of the foot.

 18-1    "Foot orthosis" includes prosthetic toe fillers or orthoses for use

 18-2    below the ankle.

 18-3          (e)  A pharmacist licensed by the Texas State Board of

 18-4    Pharmacy or a person who is working under the direct supervision of

 18-5    a pharmacist may practice orthotics.  Nothing in this Act shall

 18-6    preclude a pharmacist from being reimbursed by a state-funded

 18-7    program for providing these services.

 18-8          Sec. 22.  PROHIBITED ACTS.  (a)  A person may not practice,

 18-9    attempt to practice, or offer to practice prosthetics or orthotics,

18-10    act as an assistant to a person who practices prosthetics or

18-11    orthotics, or in any way hold the person out as being able to

18-12    practice prosthetics or orthotics unless the person holds a license

18-13    issued by the board under this Act.

18-14          (b)  A person or the person's employees, agents, or

18-15    representatives may not use in connection with the person's name or

18-16    business activities the terms or a combination of the terms or

18-17    letters described in Section 21(a)(1) of this Act, indicate orally

18-18    or in writing, directly or by implication, that a prosthetic or

18-19    orthotic service is provided or supplied, or extend or provide

18-20    prosthetic or orthotic services unless the person is a prosthetist

18-21    or orthotist or an assistant to a prosthetist or orthotist licensed

18-22    under this Act.

18-23          (c)  A person licensed under this Act violates this Act if

18-24    the person violates Section 161.091, Health and Safety Code.

18-25          Sec. 23.  PROSTHETIST AND ORTHOTIST LICENSE REQUIREMENTS.

 19-1    (a)  To obtain a license to practice prosthetics or orthotics in

 19-2    this state, an individual must file a written application with the

 19-3    board on the form provided by the board, pay the nonrefundable

 19-4    application fee prescribed by the board, and:

 19-5                (1)  be a resident of this state;

 19-6                (2)  have completed the formal training, including the

 19-7    required hours of classroom education and clinical practice, in an

 19-8    area of study the board by rule determines to be necessary and

 19-9    appropriate;

19-10                (3)  have completed a clinical residency in the

19-11    professional area for which licensure is sought that complies with

19-12    the standards, guidelines, or procedures established by the board

19-13    for a clinical residency offered in this state or in another state;

19-14    and

19-15                (4)  have completed and passed all written and

19-16    practical examinations approved and required by the board.

19-17          (b)  The requirements for a license established by board rule

19-18    must include:

19-19                (1)  either:

19-20                      (A)  a bachelor's degree in orthotics and

19-21    prosthetics from a college or university educational program

19-22    recognized and accredited by the Commission on Accreditation of

19-23    Allied Health Education Programs or from a practitioner educational

19-24    program having educational standards that are equivalent to or

19-25    exceed the standards adopted by the Commission on Accreditation of

 20-1    Allied Health Education Programs; or

 20-2                      (B)  a bachelor's degree and a prosthetic or

 20-3    orthotic certificate from a practitioner educational program

 20-4    recognized and accredited by the Commission on Accreditation of

 20-5    Allied Health Education Programs or from a practitioner educational

 20-6    program having educational standards that are equivalent to or

 20-7    exceed the standards adopted by the Commission on Accreditation of

 20-8    Allied Health Education Programs; and

 20-9                (2)  not less than 1,900 hours of professional clinical

20-10    residency completed under the direct supervision of a licensed

20-11    orthotist, licensed prosthetist, or a licensed prosthetist

20-12    orthotist in the discipline for which licensure is sought.

20-13          (c)  The board's rules providing requirements for a license

20-14    must include as an alternative to the requirement under Subsection

20-15    (b) of this section that an applicant have an associate's degree,

20-16    including courses in the anatomical, biological, and physical

20-17    sciences and not less than 4,500 hours of postgraduate clinical

20-18    experience under the direct supervision of a licensed orthotist,

20-19    licensed prosthetist, or licensed prosthetist orthotist in the

20-20    discipline for which licensure is sought.  This subsection expires

20-21    January 1, 2005.

20-22          (d)  A person may apply for an exemption from the license

20-23    requirements adopted by the board under this section if the person

20-24    applies not later than the 181st day after the date the board's

20-25    initial rules under this Act are finally adopted and published and

 21-1    the person:

 21-2                (1)  is a resident of this state; and

 21-3                (2)  preceding the date of the application:

 21-4                      (A)  provided comprehensive prosthetic or

 21-5    orthotic care for not less than three years, including practicing

 21-6    orthotics or prosthetics in this state for the one-year period

 21-7    preceding the application date; or

 21-8                      (B)  provided comprehensive prosthetic and

 21-9    orthotic care for not less than six years, including practicing

21-10    orthotics and prosthetics in this state for the one-year period

21-11    preceding the application date.

21-12          (e)  A person may apply for an exemption from the license

21-13    requirements adopted by the board under this section if the person

21-14    is a resident of this state who presents evidence satisfactory to

21-15    the board that the person possesses unique qualifications to

21-16    practice orthotics, prosthetics, or orthotics and prosthetics.

21-17          (f)  A person may obtain a license to practice in this state

21-18    by completing and passing all written and practical examinations

21-19    approved and required by the board if the person:

21-20                (1)  applies for the examinations on a form provided by

21-21    the board not later than the 181st day after the date the board's

21-22    initial rules under this Act are finally adopted and published;

21-23                (2)  pays the nonrefundable application fee prescribed

21-24    by the board; and

21-25                (3)  provided comprehensive orthotic, prosthetic, or

 22-1    orthotic and prosthetic care in this state for less than the number

 22-2    of years required by Subsection (d) of this section.

 22-3          (g)  The board shall issue a license to a person who is

 22-4    determined to be exempt from the license requirements under

 22-5    Subsection (d) or (e) of this section or who obtains a license

 22-6    under Subsection (f) of this section.  Such a license holder is

 22-7    entitled to the same license privileges as if the person met the

 22-8    educational and vocational requirements under Subsection (a) or (b)

 22-9    of this section.  The person is subject to the license renewal

22-10    requirements adopted by the board, except for the academic,

22-11    clinical training, and examination requirements, which may not be

22-12    imposed as a condition of the person's license.

22-13          Sec. 24.  PROSTHETIST OR ORTHOTIST ASSISTANT LICENSE.

22-14    (a)  An applicant for a license as a prosthetist assistant or

22-15    orthotist assistant must file a written application with the board

22-16    on a form provided by the board and pay the nonrefundable

22-17    application fee prescribed by the board.

22-18          (b)  An applicant under this section must present evidence

22-19    satisfactory to the board that the applicant has completed an

22-20    educational program, including courses in the anatomical,

22-21    biological, and physical sciences, and a clinical residency as

22-22    prescribed and adopted by the board.

22-23          (c)  An assistant licensed under this section may provide

22-24    only ancillary patient care services, as defined by the board, in

22-25    the discipline in which the assistant's supervisor is licensed

 23-1    under this Act.

 23-2          (d)  A person may apply for an exemption from the license

 23-3    requirements adopted by the board under this section if the person

 23-4    applies not later than the 181st day after the date the board's

 23-5    initial rules under this Act are finally adopted and published and

 23-6    if the person is a resident of this state who has practiced within

 23-7    the scope of practice of an assistant, as defined by the board, for

 23-8    three consecutive years in this state.

 23-9          Sec. 25.  PROSTHETIC OR ORTHOTIC TECHNICIAN REGISTRATION.

23-10    (a)  An applicant for registration as a registered prosthetic

23-11    technician or registered orthotic technician must file a written

23-12    application with the board on a form provided by the board and pay

23-13    the nonrefundable application fee prescribed by the board.

23-14          (b)  An applicant under this section must present evidence

23-15    satisfactory to the board that the applicant has completed an

23-16    educational program and laboratory experience as prescribed and

23-17    adopted by the board.

23-18          (c)  A person may apply for an exemption from the

23-19    registration requirements adopted by the board under this section

23-20    if the person applies not later than the 181st day after the date

23-21    the board's initial rules under this Act are finally adopted and

23-22    published and if the person is a resident of this state who has

23-23    practiced as an orthotic or prosthetic technician for three

23-24    consecutive years in this state.

23-25          Sec. 26.  ACCREDITATION OF FACILITIES.  (a)  The board by

 24-1    rule shall adopt requirements for the accreditation and the renewal

 24-2    of an accreditation of an orthotic or prosthetic facility in which

 24-3    the profession and practice of orthotics or prosthetics is

 24-4    conducted.

 24-5          (b)  If one or more facilities are owned by a person, the

 24-6    board may require only one application for the accreditation of all

 24-7    the person's facilities.  Each orthotic or prosthetic facility must

 24-8    meet the requirements prescribed by the board.

 24-9          (c)  An orthotic or prosthetic facility must be under the

24-10    on-site direction of an orthotist or prosthetist licensed by the

24-11    board in the discipline for which accreditation is sought.

24-12          (d)  The rules adopted under this section may not prohibit a

24-13    licensed individual from practicing in an orthotic or prosthetic

24-14    facility within the scope of the individual's license.

24-15          (e)  This section does not apply to a facility licensed under

24-16    Subtitle B, Title 4, Health and Safety Code.

24-17          Sec. 27.  ISSUANCE OF LICENSE.  (a)  The board shall issue a

24-18    license in prosthetics or orthotics to an applicant who meets the

24-19    qualifications established under this Act and the requirements

24-20    adopted by the board as provided by this Act.  A license is valid

24-21    for two years from the date issued and may be renewed before

24-22    expiration.

24-23          (b)  The board may issue a license or registration under this

24-24    Act only to an individual.  The board may issue an accreditation

24-25    only to an orthotic or prosthetic facility.

 25-1          (c)  A license may be granted in either orthotics or

 25-2    prosthetics, or in both, if the person meets the requirements

 25-3    established by the board.

 25-4          Sec. 28.  PROVISIONAL LICENSE.  (a)  A person practicing

 25-5    comprehensive prosthetic or orthotic patient management who does

 25-6    not meet the requirements of this Act for licensing as a

 25-7    prosthetist or orthotist by October 1, 1998, and is not exempt

 25-8    under this Act, must comply with the requirements of Sections 23(a)

 25-9    and (b) of this Act on or before January 1, 2005.

25-10          (b)  A person subject to this section may apply for a

25-11    prosthetist or orthotist provisional license by filing a written

25-12    application with the board on a form provided by the board and

25-13    paying a nonrefundable application fee prescribed by the board.

25-14          (c)  A provisional license may only be issued to an

25-15    individual who is actively engaged in complying with the

25-16    educational and clinical licensing requirements of Sections 23(a)

25-17    and (b) of this Act.

25-18          (d)  A provisional license may be revoked by the board if the

25-19    board determines that the provisional license holder is not in

25-20    compliance with this section.

25-21          (e)  The educational and clinical training requirements

25-22    established by board rule for a provisional license must include:

25-23                (1)  an associate degree, including course work in the

25-24    anatomical, biological, and physical sciences; and

25-25                (2)  not less than 4,500 hours of postgraduate clinical

 26-1    residency completed under the direct supervision of a licensed

 26-2    orthotist or a licensed prosthetist in the discipline for which a

 26-3    provisional license is sought.

 26-4          (f)  A provisional license is valid for two years from the

 26-5    date issued and may be renewed with documentation as required by

 26-6    board rule.

 26-7          (g)  This section expires January 1, 2005.

 26-8          Sec. 29.  TEMPORARY LICENSE.  (a)  The board may issue a

 26-9    temporary license to an individual who:

26-10                (1)  has recently become a resident of this state;

26-11                (2)  has applied for licensing as an orthotist,

26-12    prosthetist, or both; and

26-13                (3)  has:

26-14                      (A)  practiced the profession of orthotics

26-15    regularly since January 1, 1996; or

26-16                      (B)  been licensed by the state in which the

26-17    person formerly resided that has licensing requirements that are

26-18    equal to or exceed the requirements of this Act.

26-19          (b)  A temporary license is valid for one year from the date

26-20    issued.  A temporary license may be renewed for not more than one

26-21    additional year if the applicant presents to the board sufficient

26-22    evidence of good cause for renewal.

26-23          Sec. 30.  STUDENT REGISTRATION.  (a)  The board may issue a

26-24    student registration certificate to an individual who:

26-25                (1)  holds either:

 27-1                      (A)  a bachelor's degree in orthotics and

 27-2    prosthetics conferred by a college or university educational

 27-3    program recognized and accredited by the Commission on

 27-4    Accreditation of Allied Health Education Programs or from a

 27-5    practitioner educational program having educational standards that

 27-6    are equivalent to or exceed the standards adopted by the Commission

 27-7    on Accreditation of Allied Health Education Programs; or

 27-8                      (B)  a bachelor's degree and a prosthetic or

 27-9    orthotic certificate from a practitioner educational program

27-10    recognized and accredited by the Commission on Accreditation of

27-11    Allied Health Education Programs or from an educational program

27-12    having educational standards that are equivalent to or exceed the

27-13    standards adopted by the Commission on Accreditation of Allied

27-14    Health Education Programs; and

27-15                (2)  is working toward fulfillment of the requirements

27-16    for licensing as a prosthetist, orthotist, or prosthetist

27-17    orthotist.

27-18          (b)  The board may issue a student registration certificate

27-19    to an individual who holds, as an alternative to the qualifications

27-20    required by Subsection (a)(1)(B) of this section, an associate's

27-21    degree, including course work in the anatomical, biological, and

27-22    physical sciences.  This subsection expires January 1, 2005.

27-23          (c)  A student registrant may work only under the direct

27-24    supervision of a licensed orthotist, licensed prosthetist, or

27-25    licensed prosthetist orthotist who is responsible for the acts of

 28-1    the student registrant and is licensed in the discipline of the

 28-2    clinical residency.

 28-3          (d)  A student registration certificate is valid for two

 28-4    years from the date issued and may be renewed once for an

 28-5    additional two years.

 28-6          Sec. 31.  EXAMINATION EXEMPTION.  The board may accept as a

 28-7    substitute for the examination requirement proof that the applicant

 28-8    for the exemption holds a current license in a state that has

 28-9    licensing requirements that are equal to or exceed the requirements

28-10    of this Act.

28-11          Sec. 32.  CONTINUING EDUCATION.  (a)  An applicant for

28-12    renewal of a license shall submit to the board evidence of

28-13    satisfactory completion of the continuing education requirements

28-14    required by the board.

28-15          (b)  The board shall notify each license holder of the

28-16    holder's failure to comply with the board's continuing education

28-17    requirements and shall notify the license holder that if the holder

28-18    does not obtain the required continuing education before the

28-19    expiration of three months after the date the notice was given, the

28-20    board may take any action authorized by this Act concerning the

28-21    suspension or revocation of the holder's license.

28-22          Sec. 33.  DISCIPLINARY PROVISIONS.  (a)  After notice and

28-23    opportunity for a hearing, the board may revoke, suspend, or refuse

28-24    to renew a license issued under this Act on a finding that:

28-25                (1)  the license was obtained by fraud,

 29-1    misrepresentation, or concealment of a material fact;

 29-2                (2)  the person engaged in fraud or deceit in

 29-3    connection with services provided by the person;

 29-4                (3)  the person engaged in unprofessional or unethical

 29-5    conduct;

 29-6                (4)  the person engaged in gross negligence or

 29-7    malpractice; or

 29-8                (5)  the person violated this Act or a rule adopted

 29-9    under this Act.

29-10          (b)  A license revoked under Subsection (a) of this section

29-11    may be reinstated after the first anniversary of the date of the

29-12    revocation by the board on terms the board determines to be

29-13    necessary.

29-14          Sec. 34.  CIVIL PENALTY.  (a)  A person who violates this Act

29-15    is subject to a civil penalty of $200 for the first violation and

29-16    $500 for each subsequent violation.  At the request of the board,

29-17    the attorney general shall bring an action in the name of the state

29-18    to collect a civil penalty under this section.

29-19          (b)  Each day a violation of Section 22 of this Act continues

29-20    is a separate violation for the purpose of this section.

29-21          SECTION 2.  Section 232.002, Family Code, is amended to read

29-22    as follows:

29-23          Sec. 232.002.  Licensing Authorities Subject to Chapter.  The

29-24    following state agencies are licensing authorities subject to this

29-25    subchapter:

 30-1                (1)  Department of Agriculture;

 30-2                (2)  Texas Commission on Alcohol and Drug Abuse;

 30-3                (3)  Texas Alcoholic Beverage Commission;

 30-4                (4)  Texas Appraiser Licensing and Certification Board;

 30-5                (5)  Texas Board of Architectural Examiners;

 30-6                (6)  State Board of Barber Examiners;

 30-7                (7)  Texas Board of Chiropractic Examiners;

 30-8                (8)  Comptroller of Public Accounts;

 30-9                (9)  Texas Cosmetology Commission;

30-10                (10)  Court Reporters Certification Board;

30-11                (11)  State Board of Dental Examiners, if the 74th

30-12    Legislature, at its regular session, enacts legislation that

30-13    becomes law authorizing a state agency to regulate the practice of

30-14    dentistry;

30-15                (12)  Texas State Board of Examiners of Dietitians;

30-16                (13)  Texas Funeral Service Commission;

30-17                (14)  Texas Department of Health;

30-18                (15)  Texas Board of Professional Land Surveying;

30-19                (16)  Texas Department of Licensing and Regulation;

30-20                (17)  Texas State Board of Examiners of Marriage and

30-21    Family Therapists;

30-22                (18)  Texas State Board of Medical Examiners;

30-23                (19)  Midwifery Board;

30-24                (20)  Texas Natural Resource Conservation Commission;

30-25                (21)  Board of Nurse Examiners;

 31-1                (22)  Texas Board of Nursing Facility Administrators;

 31-2                (23)  Texas Board of Occupational Therapy Examiners;

 31-3                (24)  Texas Optometry Board;

 31-4                (25)  Parks and Wildlife Department;

 31-5                (26)  Texas State Board of Examiners of Perfusionists;

 31-6                (27)  Texas State Board of Pharmacy;

 31-7                (28)  Texas Board of Physical Therapy Examiners;

 31-8                (29)  Texas State Board of Plumbing Examiners;

 31-9                (30)  Texas State Board of Podiatry Examiners;

31-10                (31)  Polygraph Examiners Board;

31-11                (32)  Texas Board of Private Investigators and Private

31-12    Security Agencies;

31-13                (33)  Texas State Board of Examiners of Professional

31-14    Counselors;

31-15                (34)  State Board of Registration for Professional

31-16    Engineers;

31-17                (35)  Department of Protective and Regulatory Services;

31-18                (36)  Texas State Board of Examiners of Psychologists;

31-19                (37)  Texas State Board of Public Accountancy;

31-20                (38)  Department of Public Safety of the State of

31-21    Texas;

31-22                (39)  Public Utility Commission of Texas;

31-23                (40)  Railroad Commission of Texas;

31-24                (41)  Texas Real Estate Commission;

31-25                (42)  State Bar of Texas;

 32-1                (43)  Texas State Board of Social Worker Examiners;

 32-2                (44)  State Board of Examiners for Speech-Language

 32-3    Pathology and Audiology;

 32-4                (45)  Texas Structural Pest Control Board;

 32-5                (46)  Board of Tax Professional Examiners;

 32-6                (47)  Secretary of State;

 32-7                (48)  Supreme Court of Texas;

 32-8                (49)  Texas Transportation Commission;

 32-9                (50)  State Board of Veterinary Medical Examiners;

32-10                (51)  Board of Vocational Nurse Examiners;

32-11                (52)  Texas Ethics Commission;

32-12                (53)  Advisory Board of Athletic Trainers;

32-13                (54)  State Committee of Examiners in the Fitting and

32-14    Dispensing of Hearing Instruments;

32-15                (55)  Texas Board of Licensure for Professional Medical

32-16    Physicists; [and]

32-17                (56)  Texas Department of Insurance; and

32-18                (57)  Texas Board of Orthotics and Prosthetics.

32-19          SECTION 3.  (a)  In making the initial appointments to the

32-20    Texas Board of Orthotics and Prosthetics, the governor shall, not

32-21    later than October 1, 1997, appoint:

32-22                (1)  two members for terms expiring February 1, 1999;

32-23                (2)  two members for terms expiring February 1, 2001;

32-24    and

32-25                (3)  two members for terms expiring February 1, 2003.

 33-1          (b)  The initial members of the board appointed under

 33-2    Subsection (a) of this section shall have the qualifications

 33-3    required by this subsection.  One member must be an orthotist

 33-4    certified by the American Board for Certification in Orthotics and

 33-5    Prosthetics, Inc., be a resident of this state, and have practiced

 33-6    orthotics for the five years preceding the date of appointment.

 33-7    Two members must be orthotists who hold a credential issued by the

 33-8    Board for Orthotist Certification, are residents of this state, and

 33-9    have practiced orthotics for the five years preceding the date of

33-10    appointment.  One member must be a prosthetist orthotist or

33-11    prosthetist certified by the American Board for Certification in

33-12    Orthotics and Prosthetics, Inc., be a resident of this state, and

33-13    have practiced prosthetics or orthotics for the five years

33-14    preceding the date of appointment.  One member must be a

33-15    representative of the public who uses an orthosis.  One member must

33-16    be a representative of the public who uses a prosthesis.

33-17          (c)  A member appointed under this section to a place on the

33-18    board required to be held by a person licensed under Article 8920,

33-19    Revised Statutes, as added by this Act, may continue to serve

33-20    without having the appropriate license until February 1, 1999, by

33-21    which date the person must obtain the required license.

33-22          (d)  The board shall adopt rules under Article 8920, Revised

33-23    Statutes, as added by this Act, not later than October 1, 1998.

33-24          SECTION 4.  (a)  Except as provided by Subsection (b) of this

33-25    section, this Act takes effect September 1, 1997.

 34-1          (b)  Sections 22 and 34, Article 8920, Revised Statutes, as

 34-2    added by this Act, take effect October 1, 1998.

 34-3          SECTION 5.  The importance of this legislation and the

 34-4    crowded condition of the calendars in both houses create an

 34-5    emergency and an imperative public necessity that the

 34-6    constitutional rule requiring bills to be read on three several

 34-7    days in each house be suspended, and this rule is hereby suspended.

         _______________________________     _______________________________

             President of the Senate              Speaker of the House

               I hereby certify that S.B. No. 291 passed the Senate on

         March 4, 1997, by a viva-voce vote; and that the Senate concurred

         in House amendments on May 23, 1997, by a viva-voce vote.

                                             _______________________________

                                                 Secretary of the Senate

               I hereby certify that S.B. No. 291 passed the House, with

         amendments, on May 21, 1997, by a non-record vote.

                                             _______________________________

                                                 Chief Clerk of the House

         Approved:

         _______________________________

                     Date

         _______________________________

                   Governor