75R11984 JMM-F
By Patterson S.B. No. 291
Substitute the following for S.B. No. 291:
By Berlanga C.S.S.B. No. 291
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of orthotists and prosthetists;
1-3 providing a civil penalty.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Title 132, Revised Statutes, is amended by adding
1-6 Article 8920 to read as follows:
1-7 Art. 8920. REGULATION OF ORTHOTISTS AND PROSTHETISTS
1-8 Sec. 1. SHORT TITLE. This article may be cited as the
1-9 Orthotics and Prosthetics Act.
1-10 Sec. 2. DEFINITIONS. In this Act:
1-11 (1) "Board" means the Texas Board of Orthotics and
1-12 Prosthetics.
1-13 (2) "Commissioner" means the commissioner of public
1-14 health.
1-15 (3) "Custom-fabricated" means an orthosis or
1-16 prosthesis has been designed, prescribed, fabricated, fitted, and
1-17 aligned specifically for an individual in accordance with sound
1-18 biomechanical principles.
1-19 (4) "Custom-fitted" means an orthosis or prosthesis
1-20 that has been adjusted, prescribed, fitted, and aligned for a
1-21 specific individual according to sound biomechanical principles.
1-22 (5) "Department" means the Texas Department of Health.
1-23 (6) "License" includes a license, registration,
1-24 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,"
2-26 "artificial limb," "brace," or a similar title or description of
2-27 services.
3-1 (12) "Licensed prosthetist orthotist assistant" or
3-2 "LPOA" means a person licensed under this Act who assists and is
3-3 under the supervision at an orthotic or prosthetic facility of a
3-4 licensed prosthetist orthotist or a licensed prosthetist and
3-5 licensed orthotist responsible for the acts of the assistant.
3-6 (13) "Orthosis" means a custom-fabricated or
3-7 custom-fitted medical device designed to provide for the support,
3-8 alignment, prevention, or correction of neuromuscular or
3-9 musculoskeletal disease, injury, or deformity. The term does not
3-10 include a fabric or elastic support, corset, arch support,
3-11 low-temperature plastic splint, truss, elastic hose, cane, crutch,
3-12 soft cervical collar, orthosis for diagnostic or evaluation
3-13 purposes, dental appliance, or any other similar device carried in
3-14 stock and sold by a drugstore, department store, or corset shop.
3-15 (14) "Orthotic or prosthetic facility" means a
3-16 physical site, including a building or office, where the profession
3-17 and practice of orthotics or prosthetics normally takes place.
3-18 (15) "Orthotics" means the science and practice of
3-19 measuring, designing, fabricating, assembling, fitting, adjusting,
3-20 or servicing an orthosis under an order from a licensed physician,
3-21 chiropractor, or podiatrist for the correction or alleviation of
3-22 neuromuscular or musculoskeletal dysfunction, disease, injury, or
3-23 deformity.
3-24 (16) "Person" means an individual, corporation,
3-25 partnership, association, or other organization.
3-26 (17) "Profession of orthotics or prosthetics" means
3-27 allied health care medical services used to identify, prevent,
4-1 correct, or alleviate acute or chronic neuromuscular or
4-2 musculoskeletal dysfunctions of the human body that support and
4-3 provide rehabilitative health care services concerned with the
4-4 restoration of function, prevention, or progression of disabilities
4-5 resulting from disease, injury, or congenital anomalies. Orthotic
4-6 and prosthetic services include direct patient care, including
4-7 consultation, evaluation, treatment, education, and advice to
4-8 maximize the rehabilitation potential of disabled individuals.
4-9 (18) "Prosthesis" means a custom-fabricated or fitted
4-10 medical device that is not surgically implanted and is used to
4-11 replace a missing limb, appendage, or other external human body
4-12 part, including an artificial limb, hand, or foot. The term does
4-13 not include an artificial eye, ear, finger, or toe, a dental
4-14 appliance, a cosmetic device, including an artificial breast,
4-15 eyelash, or wig, or other device that does not have a significant
4-16 impact on the musculoskeletal functions of the body.
4-17 (19) "Prosthetics" means the science and practice of
4-18 measuring, designing, fabricating, assembling, fitting, adjusting,
4-19 or servicing a prosthesis under an order from a licensed physician,
4-20 chiropractor, or podiatrist.
4-21 (20) "Registered orthotic technician" means a person
4-22 registered under this Act who fabricates, assembles, and services
4-23 orthoses under the direction of a licensed orthotist or licensed
4-24 orthotist assistant responsible for the acts of the technician.
4-25 (21) "Registered prosthetic orthotic technician" means
4-26 a person registered under this Act who fabricates, assembles, or
4-27 services prostheses and orthoses under the direction of a licensed
5-1 orthotist and licensed prosthetist, a licensed prosthetist
5-2 orthotist, or a licensed orthotist assistant, licensed prosthetist
5-3 assistant, or licensed prosthetist orthotist assistant responsible
5-4 for the acts of the technician.
5-5 (22) "Registered prosthetic technician" means a person
5-6 registered under this Act who fabricates, assembles, or services
5-7 prostheses under the direction of a licensed prosthetist or
5-8 licensed prosthetist assistant responsible for the acts of the
5-9 technician.
5-10 Sec. 3. BOARD. (a) The Texas Board of Orthotics and
5-11 Prosthetics is established as a part of the department and shall
5-12 perform its duties as a board with the department.
5-13 (b) The board consists of six members appointed by the
5-14 governor with the advice and consent of the senate. Appointments
5-15 to the board shall be made without regard to the race, color,
5-16 disability, sex, religion, age, or national origin of the
5-17 appointees.
5-18 (c) Members of the board are appointed for staggered
5-19 six-year terms, with two members' terms expiring on February 1 of
5-20 each odd-numbered year.
5-21 (d) One member of the board must be a licensed orthotist, be
5-22 a resident of this state, and have practiced orthotics for the five
5-23 years preceding the date of appointment. One member of the board
5-24 must be a licensed prosthetist, be a resident of this state, and
5-25 have practiced prosthetics for the five years preceding the date of
5-26 appointment. One member of the board must be a licensed
5-27 prosthetist orthotist, be a resident of this state, and have
6-1 practiced prosthetics and orthotics for the five years preceding
6-2 the date of appointment. One member of the board must be a
6-3 representative of the public who uses an orthosis. One member of
6-4 the board must be a representative of the public who uses a
6-5 prosthesis. One member of the board must be a representative of
6-6 the public who does not use an orthosis or prosthesis.
6-7 (e) A vacancy on the board shall be filled by appointment by
6-8 the governor of an individual who has the appropriate
6-9 qualifications. The appointed person serves for the remainder of
6-10 the term.
6-11 (f) A member of the board is not liable for damages in a
6-12 civil action for any act performed in good faith in the execution
6-13 of the member's duties.
6-14 (g) The board is subject to Chapter 325, Government Code
6-15 (Texas Sunset Act). Unless continued in existence as provided by
6-16 that chapter, the board is abolished and this Act expires September
6-17 1, 2009.
6-18 Sec. 4. REMOVAL FROM BOARD. (a) It is a ground for removal
6-19 from the board if a member:
6-20 (1) does not have at the time of appointment the
6-21 qualifications required for appointment to the board;
6-22 (2) does not maintain during service on the board the
6-23 qualifications required for appointment to the board;
6-24 (3) violates a prohibition established by this Act;
6-25 (4) cannot discharge the member's duties for a
6-26 substantial part of the term for which the member is appointed
6-27 because of illness or disability; or
7-1 (5) is absent from more than half of the regularly
7-2 scheduled board meetings that the member is eligible to attend
7-3 during a calendar year unless the absence is excused by majority
7-4 vote of the board.
7-5 (b) The validity of an action of the board is not affected
7-6 by the fact that the action was taken when a ground for removal of
7-7 a member of the board existed.
7-8 (c) If the executive director has knowledge that a potential
7-9 ground for removal exists, the executive director shall notify the
7-10 presiding officer of the board of the ground. The presiding
7-11 officer shall then notify the governor that a potential ground for
7-12 removal exists.
7-13 Sec. 5. BOARD POWERS AND DUTIES. (a) The board shall
7-14 review applications for a license at least once each year at
7-15 reasonable times and places designated by the board.
7-16 (b) The board may collect license application fees, renewal
7-17 fees, examination fees, and other fees for other administrative
7-18 expenses. If the General Appropriations Act does not set the
7-19 amount of those fees, the board shall set the fees in amounts
7-20 reasonable and necessary for the administration and implementation
7-21 of this Act.
7-22 (c) The board shall approve any examination required for a
7-23 license under this Act. Each examination shall be offered at least
7-24 once each year.
7-25 (d) The board may:
7-26 (1) investigate complaints;
7-27 (2) issue, suspend, deny, and revoke licenses;
8-1 (3) reprimand license holders and place license
8-2 holders on probation;
8-3 (4) issue subpoenas; and
8-4 (5) hold hearings.
8-5 (e) The board shall keep an information file about each
8-6 complaint that is filed with the board relating to a person or
8-7 entity regulated by the board. If a written complaint that the
8-8 board has authority to resolve is filed with the board, the board,
8-9 at least as frequently as quarterly and until the final disposition
8-10 of the complaint, shall notify the parties to the complaint of the
8-11 status of the complaint unless the notice would jeopardize an
8-12 undercover investigation.
8-13 (f) The board shall propose rules consistent with this Act
8-14 to carry out its duties in administering this Act and submit the
8-15 proposed rules to the attorney general for review. The board shall
8-16 adopt rules consistent with the advice of the attorney general. In
8-17 adopting rules, the board shall consider the applicable policies
8-18 and procedures of the department.
8-19 (g) The commissioner, with the advice of the board, shall
8-20 appoint an executive director to administer this Act. The board
8-21 may use personnel, facilities, furniture, equipment, and other
8-22 items supplied by the department to administer this Act.
8-23 (h) The executive director or the executive director's
8-24 designee shall develop an intra-agency career ladder program. The
8-25 program shall require intra-agency posting of all nonentry level
8-26 positions concurrently with any public posting.
8-27 (i) The executive director or the executive director's
9-1 designee shall develop a system of annual performance evaluations
9-2 based on measurable job tasks. All merit pay for board employees
9-3 shall be based on the system established under this subsection.
9-4 (j) The board shall prepare information of consumer interest
9-5 describing the regulatory functions of the board and legal rights
9-6 of consumers as provided by this Act.
9-7 (k) The board shall assist legal authorities in the
9-8 prosecution of any person violating this Act.
9-9 (l) The board shall prepare or approve continuing education
9-10 programs for license holders and shall adopt rules that require a
9-11 license holder to participate in an approved continuing education
9-12 program to renew a license issued under this Act.
9-13 (m) The board shall develop and implement policies that
9-14 clearly define the respective responsibilities of the governing
9-15 body of the board and the staff of the board.
9-16 Sec. 6. PUBLIC INFORMATION. (a) The board shall prepare
9-17 information of public interest describing the functions of the
9-18 board and describing the procedures by which complaints are filed
9-19 with and resolved by the board. The board shall make the
9-20 information available to the general public and appropriate state
9-21 agencies.
9-22 (b) The board by rule shall establish methods by which
9-23 consumers and service recipients are notified of the name, mailing
9-24 address, and telephone number of the board for the purpose of
9-25 directing complaints to the board. The board may provide for that
9-26 notification:
9-27 (1) on each registration form, application, or written
10-1 contract for services of an individual or entity regulated by the
10-2 board;
10-3 (2) on a sign prominently displayed in the place of
10-4 business of each individual or entity regulated by the board; or
10-5 (3) in a bill for service provided by an individual or
10-6 entity regulated by the board.
10-7 (c) The board shall list along with its regular telephone
10-8 number the toll-free telephone number that may be called to present
10-9 a complaint about a person regulated or required to be regulated
10-10 under this Act if the toll-free number is established under other
10-11 state law.
10-12 Sec. 7. PUBLIC PARTICIPATION IN BOARD MEETINGS. The board
10-13 shall develop and implement policies that provide the public with a
10-14 reasonable opportunity to appear before the board and to speak on
10-15 any issue under the jurisdiction of the board.
10-16 Sec. 8. PROGRAM ACCESSIBILITY. The board shall prepare and
10-17 maintain a written plan that describes how a person who does not
10-18 speak English can be provided reasonable access to the board's
10-19 programs. The board shall also comply with federal and state laws
10-20 for program and facility accessibility.
10-21 Sec. 9. TRAINING; STANDARDS OF CONDUCT INFORMATION. Each
10-22 board member shall comply with the board member training
10-23 requirements established by any other state agency that is given
10-24 authority to establish the requirements for the board.
10-25 Sec. 10. OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE
10-26 REQUIREMENTS. The board is subject to Chapters 551 and 2001,
10-27 Government Code.
11-1 Sec. 11. ORGANIZATION OF BOARD. (a) The members of the
11-2 board shall elect from the membership of the board a presiding
11-3 officer, a secretary, and other officers required for the conduct
11-4 of business. Special meetings of the board shall be called by the
11-5 presiding officer or on the written request of any three members.
11-6 The board may adopt rules necessary to govern its proceedings.
11-7 (b) The executive director shall keep a record of each
11-8 meeting of the board and maintain a register containing the names
11-9 of all persons holding a license under this Act. The record and
11-10 register shall be open at all times to public inspection. On March
11-11 1 of each year, the executive director shall send an official copy
11-12 of the register of license holders to the secretary of state for
11-13 permanent record. A certified copy of the register is admissible
11-14 as evidence in any court of this state.
11-15 Sec. 12. COMPENSATION. A member of the board is entitled to
11-16 compensation and reimbursement of the member's travel expenses as
11-17 provided by the General Appropriations Act.
11-18 Sec. 13. EFFECT OF LOBBYING ACTIVITY. A person may not
11-19 serve as a member of the board or act as the general counsel to the
11-20 board if the person is required to register as a lobbyist under
11-21 Chapter 305, Government Code, because of the person's activities
11-22 for compensation on behalf of a profession related to the operation
11-23 of the board.
11-24 Sec. 14. PUBLIC MEMBERSHIP RESTRICTION. A person is not
11-25 eligible for appointment by the governor as a public member of the
11-26 board if the person or person's spouse:
11-27 (1) is registered, certified, or licensed by an
12-1 occupational regulatory agency in the field of health care;
12-2 (2) is employed by or participates in the management
12-3 of a business entity or other organization regulated by the board
12-4 or receiving funds from the board;
12-5 (3) owns or controls, directly or indirectly, more
12-6 than a 10 percent interest in a business entity or other
12-7 organization regulated by the board or receiving funds from the
12-8 board; or
12-9 (4) uses or receives a substantial amount of tangible
12-10 goods, services, or funds from the board, other than compensation
12-11 or reimbursement authorized by law for board membership,
12-12 attendance, or expenses.
12-13 Sec. 15. CONFLICT OF INTEREST RESTRICTIONS. (a) An
12-14 officer, employee, or paid consultant of a Texas trade association
12-15 in the field of health care may not be a member or employee of the
12-16 board who is exempt from the state's position classification plan
12-17 or is compensated at or above the amount prescribed by the General
12-18 Appropriations Act for step 1, salary group 17, of the position
12-19 classification salary schedule.
12-20 (b) A person who is the spouse of an officer, manager, or
12-21 paid consultant of a Texas trade association in the field of health
12-22 care may not be a member of the board and may not be an employee of
12-23 the board who is exempt from the state's position classification
12-24 plan or is compensated at or above the amount prescribed by the
12-25 General Appropriations Act for step 1, salary group 17, of the
12-26 position classification salary schedule.
12-27 (c) For the purposes of this section, a Texas trade
13-1 association is a nonprofit, cooperative, and voluntarily joined
13-2 association of business or professional competitors in this state
13-3 designed to assist its members and its industry or profession in
13-4 dealing with mutual business or professional problems and in
13-5 promoting their common interest.
13-6 Sec. 16. AUDIT. The financial transactions of the board are
13-7 subject to audit by the state auditor in accordance with Chapter
13-8 321, Government Code.
13-9 Sec. 17. REPORT TO GOVERNOR AND LEGISLATURE. During January
13-10 of each year, the board shall file with the governor and the
13-11 presiding officer of each house of the legislature a complete and
13-12 detailed written report accounting for all funds received and
13-13 disbursed by the board during the preceding year.
13-14 Sec. 18. EQUAL EMPLOYMENT OPPORTUNITY POLICIES. (a) The
13-15 executive director or the executive director's designee shall
13-16 prepare and maintain a written policy statement to ensure
13-17 implementation of a program of equal employment opportunity under
13-18 which all personnel transactions are made without regard to race,
13-19 color, disability, sex, religion, age, or national origin. The
13-20 policy statement must include:
13-21 (1) personnel policies, including policies relating to
13-22 recruitment, evaluation, selection, application, training, and
13-23 promotion of personnel, that are in compliance with Chapter 21,
13-24 Labor Code;
13-25 (2) a comprehensive analysis of the board workforce
13-26 that meets federal and state guidelines;
13-27 (3) procedures by which a determination can be made of
14-1 significant underutilization in the board workforce of all persons
14-2 for whom federal or state guidelines encourage a more equitable
14-3 balance; and
14-4 (4) reasonable methods to appropriately address those
14-5 areas of underutilization.
14-6 (b) A policy statement prepared under Subsection (a) of this
14-7 section must cover an annual period, be updated annually, be
14-8 reviewed by the Commission on Human Rights for compliance with
14-9 Subsection (a)(1) of this section, and be filed with the governor's
14-10 office.
14-11 (c) The governor's office shall deliver a biennial report to
14-12 the legislature based on the information received under Subsection
14-13 (b) of this section. The report may be made separately or as part
14-14 of other biennial reports to the legislature.
14-15 Sec. 19. NOTICE OF STANDARDS OF CONDUCT. The board shall
14-16 provide to its members and employees, as often as necessary,
14-17 information regarding their qualifications for office or employment
14-18 under this Act and their responsibilities under applicable laws
14-19 relating to standards of conduct for state officers or employees.
14-20 Sec. 20. APPROPRIATIONS TO TEXAS DEPARTMENT OF HEALTH. The
14-21 department shall receive and account for funds derived under this
14-22 Act. The department shall deposit all funds collected under this
14-23 Act to the credit of the general revenue fund.
14-24 Sec. 21. EXEMPTIONS. (a) This Act does not restrict a
14-25 license holder of another state agency from performing health care
14-26 services within the scope of the license holder's applicable
14-27 licensing act if:
15-1 (1) the license holder:
15-2 (A) does not represent to others that the
15-3 license holder practices the profession of orthotics or
15-4 prosthetics; or
15-5 (B) does not use the terms "prosthetist,"
15-6 "prosthesis," "prosthetic," "artificial limb," "orthotist,"
15-7 "orthosis," "orthotic," or "brace" or the letters "LP," "LPA,"
15-8 "LO," "LOA," "LPO," or "LPOA" or any derivative of those terms or
15-9 letters in connection with the license holder's name or practice;
15-10 and
15-11 (2) the license holder practices in conformance with
15-12 the applicable laws and rules relating to the person's license and
15-13 does not violate Section 22 of this Act.
15-14 (b) This Act does not apply to the activities and services
15-15 of a person acting as a student in orthotics or prosthetics who is
15-16 pursuing a course of study in a prosthetic or orthotic program at a
15-17 college or university recognized and accredited by the Commission
15-18 on Accreditation of Allied Health Education Programs or an orthotic
15-19 or prosthetic educational program having educational standards that
15-20 are equivalent to or exceed the standards adopted by the Commission
15-21 on Accreditation of Allied Health Education Programs or who is
15-22 working in a recognized training center or research facility, if
15-23 those activities and services constitute a part of the person's
15-24 course of study in the discipline in which the person's supervisor
15-25 is licensed under this Act.
15-26 (c) This Act does not apply to:
15-27 (1) a podiatrist practicing under the law regulating
16-1 podiatry (Article 4567 et seq., Revised Statutes);
16-2 (2) a doctor of chiropractic practicing under the law
16-3 regulating chiropractic (Chapter 94, Acts of the 51st Legislature,
16-4 Regular Session, 1949 (Article 4512b, Vernon's Texas Civil
16-5 Statutes));
16-6 (3) an occupational therapist practicing under the law
16-7 regulating occupational therapy (Occupational Therapy Practice Act
16-8 (Article 8851, Vernon's Texas Civil Statutes)); or
16-9 (4) a physical therapist practicing under the law
16-10 regulating physical therapy (Chapter 836, Acts of the 62nd
16-11 Legislature, Regular Session, 1971 (Article 4512e, Vernon's Texas
16-12 Civil Statutes)).
16-13 (d) This Act does not apply to a pedorthist certified by the
16-14 Board for Certification in Pedorthics. For the purposes of this
16-15 subsection, a certified pedorthist is a person certified by the
16-16 Board for Certification in Pedorthics, or its successor entity, in
16-17 the design, manufacture, fit, and modification of shoes and related
16-18 foot orthoses below the anatomical ankle joint as prescribed by a
16-19 licensed doctor of medicine or a doctor of podiatry for the
16-20 amelioration of a painful or disabling condition of the foot.
16-21 "Foot orthosis" includes prosthetic toe fillers or orthoses for use
16-22 below the ankle.
16-23 (e) This Act does not apply to a certified fitter or
16-24 certified master orthotist who holds a credential issued by the
16-25 National Community Pharmacists Association if the fitter or master
16-26 orthotist:
16-27 (1) is working within the person's scope of practice
17-1 as defined by the board; or
17-2 (2) provides the following services or devices
17-3 described by the Health Care Financing Administration's Common
17-4 Procedure Coding System:
17-5 (A) foam cervical collar;
17-6 (B) thermoplastic foam cervical collar;
17-7 (C) plastic cervical collar;
17-8 (D) rib belt;
17-9 (E) thoracic-lumbar support;
17-10 (F) lumbar-sacral support;
17-11 (G) sacroiliac support;
17-12 (H) ptosis support;
17-13 (I) pendulous abdomen support;
17-14 (J) torso support;
17-15 (K) knee orthosis;
17-16 (L) knee orthosis with stays;
17-17 (M) knee orthosis with joints;
17-18 (N) knee orthosis with condylar pads;
17-19 (O) knee orthosis with joints and condylar pads;
17-20 (P) knee immobilizer;
17-21 (Q) multiligamentus ankle support;
17-22 (R) figure eight shoulder restrainer;
17-23 (S) acromioclavicular support;
17-24 (T) elbow orthosis with stays;
17-25 (U) elbow orthosis with joints;
17-26 (V) wrist splint;
17-27 (W) pneumatic ankle splint;
18-1 (X) pneumatic walking splint;
18-2 (Y) pneumatic full leg splint;
18-3 (Z) pneumatic knee splint;
18-4 (AA) mastectomy bra;
18-5 (BB) mastectomy sleeve;
18-6 (CC) mastectomy form;
18-7 (DD) silicone breast prosthesis;
18-8 (EE) medium weight calf-length stocking;
18-9 (FF) heavy weight calf-length stocking;
18-10 (GG) surgical weight calf-length stocking;
18-11 (HH) medium weight thigh-length stocking;
18-12 (II) heavy weight thigh-length stocking;
18-13 (JJ) surgical weight thigh-length stocking;
18-14 (KK) medium weight full-length stocking;
18-15 (LL) heavy weight full-length stocking;
18-16 (MM) surgical weight full-length stocking;
18-17 (NN) medium weight leotard;
18-18 (OO) surgical weight leotard;
18-19 (PP) custom made compression stocking;
18-20 (QQ) lymphedema sleeve;
18-21 (RR) garter belt;
18-22 (SS) single truss with standard pad;
18-23 (TT) double truss with standard pad;
18-24 (UU) water pad addition to truss; and
18-25 (VV) scrotal pad addition to truss.
18-26 Sec. 22. PROHIBITED ACTS. (a) A person may not practice,
18-27 attempt to practice, or offer to practice prosthetics or orthotics,
19-1 act as an assistant to a person who practices prosthetics or
19-2 orthotics, or in any way hold the person out as being able to
19-3 practice prosthetics or orthotics unless the person holds a license
19-4 issued by the board under this Act.
19-5 (b) A person or the person's employees, agents, or
19-6 representatives may not use in connection with the person's name or
19-7 business activities the terms or a combination of the terms or
19-8 letters described in Section 21(a)(1), indicate orally or in
19-9 writing, directly or by implication, that a prosthetic or orthotic
19-10 service is provided or supplied, or extend or provide prosthetic or
19-11 orthotic services unless the person is a prosthetist or orthotist
19-12 or an assistant to a prosthetist or orthotist licensed under this
19-13 Act.
19-14 (c) A person licensed under this Act violates this Act if
19-15 the person violates Section 161.091, Health and Safety Code.
19-16 Sec. 23. PROSTHETIST AND ORTHOTIST LICENSE REQUIREMENTS.
19-17 (a) To obtain a license to practice prosthetics or orthotics in
19-18 this state, an individual must file a written application with the
19-19 board on the form provided by the board, pay the nonrefundable
19-20 application fee prescribed by the board, and:
19-21 (1) be a resident of this state;
19-22 (2) have completed the formal training, including the
19-23 required hours of classroom education and clinical practice, in an
19-24 area of study the board by rule determines to be necessary and
19-25 appropriate;
19-26 (3) have completed a clinical residency in the
19-27 professional area for which licensure is sought that complies with
20-1 the standards, guidelines, or procedures established by the board
20-2 for a clinical residency offered in this state or in another state;
20-3 and
20-4 (4) have completed and passed all written and
20-5 practical examinations approved and required by the board.
20-6 (b) The requirements for a license established by board rule
20-7 must include:
20-8 (1) either:
20-9 (A) a bachelor's degree in orthotics and
20-10 prosthetics from a college or university educational program
20-11 recognized and accredited by the Commission on Accreditation of
20-12 Allied Health Education Programs or from a practitioner educational
20-13 program having educational standards that are equivalent to or
20-14 exceed the standards adopted by the Commission on Accreditation of
20-15 Allied Health Education Programs; or
20-16 (B) a bachelor's degree and a prosthetic or
20-17 orthotic certificate from a practitioner educational program
20-18 recognized and accredited by the Commission on Accreditation of
20-19 Allied Health Education Programs or from a practitioner educational
20-20 program having educational standards that are equivalent to or
20-21 exceed the standards adopted by the Commission on Accreditation of
20-22 Allied Health Education Programs; and
20-23 (2) not less than 1,900 hours of professional clinical
20-24 residency completed under the direct supervision of a licensed
20-25 orthotist, licensed prosthetist, or a licensed prosthetist
20-26 orthotist in the discipline for which licensure is sought.
20-27 (c) The board's rules providing requirements for a license
21-1 must include as an alternative to the requirement under Subsection
21-2 (b) of this section that an applicant have an associate's degree,
21-3 including courses in the anatomical, biological, and physical
21-4 sciences and not less than 4,500 hours of postgraduate clinical
21-5 experience under the direct supervision of a licensed orthotist,
21-6 licensed prosthetist, or licensed prosthetist orthotist in the
21-7 discipline for which licensure is sought. This subsection expires
21-8 January 1, 2005.
21-9 (d) A person may apply for an exemption from the license
21-10 requirements adopted by the board under this section if the person
21-11 applies not later than the 181st day after the date the board's
21-12 initial rules under this Act are finally adopted and published and
21-13 the person:
21-14 (1) is a resident of this state; and
21-15 (2) preceding the date of the application:
21-16 (A) provided comprehensive prosthetic or
21-17 orthotic care for not less than three years, including practicing
21-18 orthotics or prosthetics in this state for the one-year period
21-19 preceding the application date; or
21-20 (B) provided comprehensive prosthetic and
21-21 orthotic care for not less than six years, including practicing
21-22 orthotics and prosthetics in this state for the one-year period
21-23 preceding the application date.
21-24 (e) A person may apply for an exemption from the license
21-25 requirements adopted by the board under this section if the person
21-26 is a resident of this state who presents evidence satisfactory to
21-27 the board that the person possesses unique qualifications to
22-1 practice orthotics, prosthetics, or orthotics and prosthetics.
22-2 (f) A person may obtain a license to practice in this state
22-3 by completing and passing all written and practical examinations
22-4 approved and required by the board if the person:
22-5 (1) applies for the examinations on a form provided by
22-6 the board not later than the 181st day after the date the board's
22-7 initial rules under this Act are finally adopted and published;
22-8 (2) pays the nonrefundable application fee prescribed
22-9 by the board; and
22-10 (3) provided comprehensive orthotic, prosthetic, or
22-11 orthotic and prosthetic care in this state for less than the number
22-12 of years required by Subsection (d) of this section.
22-13 (g) The board shall issue a license to a person who is
22-14 determined to be exempt from the license requirements under
22-15 Subsection (d) or (e) of this section or who obtains a license
22-16 under Subsection (f) of this section. Such a license holder is
22-17 entitled to the same license privileges as if the person met the
22-18 educational and vocational requirements under Subsection (a) or (b)
22-19 of this section. The person is subject to the license renewal
22-20 requirements adopted by the board, except for the academic,
22-21 clinical training, and examination requirements, which may not be
22-22 imposed as a condition of the person's license.
22-23 Sec. 24. PHARMACISTS. The board shall issue a license to a
22-24 person who applies for a license and is licensed or regulated by
22-25 the State Board of Pharmacy and is certified by the National
22-26 Community Pharmacists Association as a certified fitter or master
22-27 orthotist. The board shall assess a licensing fee of no more than
23-1 $50 to a person licensed under this section.
23-2 Sec. 25. PROSTHETIST OR ORTHOTIST ASSISTANT LICENSE.
23-3 (a) An applicant for a license as a prosthetist assistant or
23-4 orthotist assistant must file a written application with the board
23-5 on a form provided by the board and pay the nonrefundable
23-6 application fee prescribed by the board.
23-7 (b) An applicant under this section must present evidence
23-8 satisfactory to the board that the applicant has completed an
23-9 educational program, including courses in the anatomical,
23-10 biological, and physical sciences, and a clinical residency as
23-11 prescribed and adopted by the board.
23-12 (c) An assistant licensed under this section may provide
23-13 only ancillary patient care services, as defined by the board, in
23-14 the discipline in which the assistant's supervisor is licensed
23-15 under this Act.
23-16 (d) A person may apply for an exemption from the license
23-17 requirements adopted by the board under this section if the person
23-18 applies not later than the 181st day after the date the board's
23-19 initial rules under this Act are finally adopted and published and
23-20 if the person is a resident of this state who has practiced within
23-21 the scope of practice of an assistant, as defined by the board, for
23-22 three consecutive years in this state.
23-23 Sec. 26. PROSTHETIC OR ORTHOTIC TECHNICIAN REGISTRATION.
23-24 (a) An applicant for registration as a registered prosthetic
23-25 technician or registered orthotic technician must file a written
23-26 application with the board on a form provided by the board and pay
23-27 the nonrefundable application fee prescribed by the board.
24-1 (b) An applicant under this section must present evidence
24-2 satisfactory to the board that the applicant has completed an
24-3 educational program and laboratory experience as prescribed and
24-4 adopted by the board.
24-5 (c) A person may apply for an exemption from the
24-6 registration requirements adopted by the board under this section
24-7 if the person applies not later than the 181st day after the date
24-8 the board's initial rules under this Act are finally adopted and
24-9 published and if the person is a resident of this state who has
24-10 practiced as an orthotic or prosthetic technician for three
24-11 consecutive years in this state.
24-12 Sec. 27. ACCREDITATION OF FACILITIES. (a) The board by
24-13 rule shall adopt requirements for the accreditation and the renewal
24-14 of an accreditation of an orthotic or prosthetic facility in which
24-15 the profession and practice of orthotics or prosthetics is
24-16 conducted.
24-17 (b) If one or more facilities are owned by a person, the
24-18 board may require only one application for the accreditation of all
24-19 the person's facilities. Each orthotic or prosthetic facility must
24-20 meet the requirements prescribed by the board.
24-21 (c) An orthotic or prosthetic facility must be under the
24-22 on-site direction of an orthotist or prosthetist licensed by the
24-23 board in the discipline for which accreditation is sought.
24-24 (d) The rules adopted under this section may not prohibit a
24-25 licensed individual from practicing in an orthotic or prosthetic
24-26 facility within the scope of the individual's license.
24-27 (e) This section does not apply to a facility licensed under
25-1 Subtitle B, Title 4, Health and Safety Code.
25-2 Sec. 28. ISSUANCE OF LICENSE. (a) The board shall issue a
25-3 license in prosthetics or orthotics to an applicant who meets the
25-4 qualifications established under this Act and the requirements
25-5 adopted by the board as provided by this Act. A license is valid
25-6 for two years from the date issued and may be renewed before
25-7 expiration.
25-8 (b) The board may issue a license or registration under this
25-9 Act only to an individual. The board may issue an accreditation
25-10 only to an orthotic or prosthetic facility.
25-11 (c) A license may be granted in either orthotics or
25-12 prosthetics, or in both, if the person meets the requirements
25-13 established by the board.
25-14 Sec. 29. PROVISIONAL LICENSE. (a) A person practicing
25-15 comprehensive prosthetic or orthotic patient management who does
25-16 not meet the requirements of this Act for licensing as a
25-17 prosthetist or orthotist by October 1, 1998, and is not exempt
25-18 under this Act, must comply with the requirements of Sections 23(a)
25-19 and (b) of this Act on or before January 1, 2005.
25-20 (b) A person subject to this section may apply for a
25-21 prosthetist or orthotist provisional license by filing a written
25-22 application with the board on a form provided by the board and
25-23 paying a nonrefundable application fee prescribed by the board.
25-24 (c) A provisional license may only be issued to an
25-25 individual who is actively engaged in complying with the
25-26 educational and clinical licensing requirements of Sections 23(a)
25-27 and (b) of this Act.
26-1 (d) A provisional license may be revoked by the board if the
26-2 board determines that the provisional license holder is not in
26-3 compliance with this section.
26-4 (e) The educational and clinical training requirements
26-5 established by board rule for a provisional license must include:
26-6 (1) an associate degree, including course work in the
26-7 anatomical, biological, and physical sciences; and
26-8 (2) not less than 4,500 hours of postgraduate clinical
26-9 residency completed under the direct supervision of a licensed
26-10 orthotist or a licensed prosthetist in the discipline for which a
26-11 provisional license is sought.
26-12 (f) A provisional license is valid for two years from the
26-13 date issued and may be renewed with documentation as required by
26-14 board rule.
26-15 (g) This section expires January 1, 2005.
26-16 Sec. 30. TEMPORARY LICENSE. (a) The board may issue a
26-17 temporary license to an individual who:
26-18 (1) has recently become a resident of this state;
26-19 (2) has applied for licensing as an orthotist,
26-20 prosthetist, or both; and
26-21 (3) has:
26-22 (A) practiced the profession of orthotics
26-23 regularly since January 1, 1996; or
26-24 (B) been licensed by the state in which the
26-25 person formerly resided that has licensing requirements that are
26-26 equal to or exceed the requirements of this Act.
26-27 (b) A temporary license is valid for one year from the date
27-1 issued. A temporary license may be renewed for not more than one
27-2 additional year if the applicant presents to the board sufficient
27-3 evidence of good cause for renewal.
27-4 Sec. 31. STUDENT REGISTRATION. (a) The board may issue a
27-5 student registration certificate to an individual who:
27-6 (1) holds either:
27-7 (A) a bachelor's degree in orthotics and
27-8 prosthetics conferred by a college or university educational
27-9 program recognized and accredited by the Commission on
27-10 Accreditation of Allied Health Education Programs or from a
27-11 practitioner educational program having educational standards that
27-12 are equivalent to or exceed the standards adopted by the Commission
27-13 on Accreditation of Allied Health Education Programs; or
27-14 (B) a bachelor's degree and a prosthetic or
27-15 orthotic certificate from a practitioner educational program
27-16 recognized and accredited by the Commission on Accreditation of
27-17 Allied Health Education Programs or from an educational program
27-18 having educational standards that are equivalent to or exceed the
27-19 standards adopted by the Commission on Accreditation of Allied
27-20 Health Education Programs; and
27-21 (2) is working toward fulfillment of the requirements
27-22 for licensing as a prosthetist, orthotist, or prosthetist
27-23 orthotist.
27-24 (b) The board may issue a student registration certificate
27-25 to an individual who holds, as an alternative to the qualifications
27-26 required by Subsection (a)(1)(B) of this section, an associate's
27-27 degree, including course work in the anatomical, biological, and
28-1 physical sciences. This subsection expires January 1, 2005.
28-2 (c) A student registrant may work only under the direct
28-3 supervision of a licensed orthotist, licensed prosthetist, or
28-4 licensed prosthetist orthotist who is responsible for the acts of
28-5 the student registrant and is licensed in the discipline of the
28-6 clinical residency.
28-7 (d) A student registration certificate is valid for two
28-8 years from the date issued and may be renewed once for an
28-9 additional two years.
28-10 Sec. 32. EXAMINATION EXEMPTION. The board may accept as a
28-11 substitute for the examination requirement proof that the applicant
28-12 for the exemption holds a current license in a state that has
28-13 licensing requirements that are equal to or exceed the requirements
28-14 of this Act.
28-15 Sec. 33. CONTINUING EDUCATION. (a) An applicant for
28-16 renewal of a license shall submit to the board evidence of
28-17 satisfactory completion of the continuing education requirements
28-18 required by the board.
28-19 (b) The board shall notify each license holder of the
28-20 holder's failure to comply with the board's continuing education
28-21 requirements and shall notify the license holder that if the holder
28-22 does not obtain the required continuing education before the
28-23 expiration of three months after the date the notice was given, the
28-24 board may take any action authorized by this Act concerning the
28-25 suspension or revocation of the holder's license.
28-26 Sec. 34. DISCIPLINARY PROVISIONS. (a) After notice and
28-27 opportunity for a hearing, the board may revoke, suspend, or refuse
29-1 to renew a license issued under this Act on a finding that:
29-2 (1) the license was obtained by fraud,
29-3 misrepresentation, or concealment of a material fact;
29-4 (2) the person engaged in fraud or deceit in
29-5 connection with services provided by the person;
29-6 (3) the person engaged in unprofessional or unethical
29-7 conduct;
29-8 (4) the person engaged in gross negligence or
29-9 malpractice; or
29-10 (5) the person violated this Act or a rule adopted
29-11 under this Act.
29-12 (b) A license revoked under Subsection (a) of this section
29-13 may be reinstated after the first anniversary of the date of the
29-14 revocation by the board on terms the board determines to be
29-15 necessary.
29-16 Sec. 35. CIVIL PENALTY. (a) A person who violates this Act
29-17 is subject to a civil penalty of $200 for the first violation and
29-18 $500 for each subsequent violation. At the request of the board,
29-19 the attorney general shall bring an action in the name of the state
29-20 to collect a civil penalty under this section.
29-21 (b) Each day a violation of Section 22 of this Act continues
29-22 is a separate violation for the purpose of this section.
29-23 SECTION 2. Section 232.002, Family Code, is amended to read
29-24 as follows:
29-25 Sec. 232.002. Licensing Authorities Subject to Chapter. The
29-26 following state agencies are licensing authorities subject to this
29-27 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;
30-26 (22) Texas Board of Nursing Facility Administrators;
30-27 (23) Texas Board of Occupational Therapy Examiners;
31-1 (24) Texas Optometry Board;
31-2 (25) Parks and Wildlife Department;
31-3 (26) Texas State Board of Examiners of Perfusionists;
31-4 (27) Texas State Board of Pharmacy;
31-5 (28) Texas Board of Physical Therapy Examiners;
31-6 (29) Texas State Board of Plumbing Examiners;
31-7 (30) Texas State Board of Podiatry Examiners;
31-8 (31) Polygraph Examiners Board;
31-9 (32) Texas Board of Private Investigators and Private
31-10 Security Agencies;
31-11 (33) Texas State Board of Examiners of Professional
31-12 Counselors;
31-13 (34) State Board of Registration for Professional
31-14 Engineers;
31-15 (35) Department of Protective and Regulatory Services;
31-16 (36) Texas State Board of Examiners of Psychologists;
31-17 (37) Texas State Board of Public Accountancy;
31-18 (38) Department of Public Safety of the State of
31-19 Texas;
31-20 (39) Public Utility Commission of Texas;
31-21 (40) Railroad Commission of Texas;
31-22 (41) Texas Real Estate Commission;
31-23 (42) State Bar of Texas;
31-24 (43) Texas State Board of Social Worker Examiners;
31-25 (44) State Board of Examiners for Speech-Language
31-26 Pathology and Audiology;
31-27 (45) Texas Structural Pest Control Board;
32-1 (46) Board of Tax Professional Examiners;
32-2 (47) Secretary of State;
32-3 (48) Supreme Court of Texas;
32-4 (49) Texas Transportation Commission;
32-5 (50) State Board of Veterinary Medical Examiners;
32-6 (51) Board of Vocational Nurse Examiners;
32-7 (52) Texas Ethics Commission;
32-8 (53) Advisory Board of Athletic Trainers;
32-9 (54) State Committee of Examiners in the Fitting and
32-10 Dispensing of Hearing Instruments;
32-11 (55) Texas Board of Licensure for Professional Medical
32-12 Physicists; [and]
32-13 (56) Texas Department of Insurance; and
32-14 (57) Texas Board of Orthotics and Prosthetics.
32-15 SECTION 3. (a) In making the initial appointments to the
32-16 Texas Board of Orthotics and Prosthetics, the governor shall, not
32-17 later than October 1, 1997, appoint:
32-18 (1) two members for terms expiring February 1, 1999;
32-19 (2) two members for terms expiring February 1, 2001;
32-20 and
32-21 (3) two members for terms expiring February 1, 2003.
32-22 (b) The initial members of the board appointed under
32-23 Subsection (a) of this section shall have the qualifications
32-24 required by this subsection. One member must be an orthotist
32-25 certified by the American Board for Certification in Orthotics and
32-26 Prosthetics, Inc., be a resident of this state, and have practiced
32-27 orthotics for the five years preceding the date of appointment.
33-1 Two members must be orthotists who hold a credential issued by the
33-2 Board for Orthotist Certification, are residents of this state, and
33-3 have practiced orthotics for the five years preceding the date of
33-4 appointment. One member must be a prosthetist orthotist or
33-5 prosthetist certified by the American Board for Certification in
33-6 Orthotics and Prosthetics, Inc., be a resident of this state, and
33-7 have practiced prosthetics or orthotics for the five years
33-8 preceding the date of appointment. One member must be a
33-9 representative of the public who uses an orthosis. One member must
33-10 be a representative of the public who uses a prosthesis.
33-11 (c) A member appointed under this section to a place on the
33-12 board required to be held by a person licensed under Article 8920,
33-13 Revised Statutes, as added by this Act, may continue to serve
33-14 without having the appropriate license until February 1, 1999, by
33-15 which date the person must obtain the required license.
33-16 (d) The board shall adopt rules under Article 8920, Revised
33-17 Statutes, as added by this Act, not later than October 1, 1998.
33-18 SECTION 4. (a) Except as provided by Subsection (b) of this
33-19 section, this Act takes effect September 1, 1997.
33-20 (b) Sections 22 and 35, Article 8920, Revised Statutes, as
33-21 added by this Act, take effect October 1, 1998.
33-22 SECTION 5. The importance of this legislation and the
33-23 crowded condition of the calendars in both houses create an
33-24 emergency and an imperative public necessity that the
33-25 constitutional rule requiring bills to be read on three several
33-26 days in each house be suspended, and this rule is hereby suspended.