By Patterson S.B. No. 291
75R2608 JMM-F
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, secretary, and other officers required for the conduct of
11-4 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
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 is working
15-22 in a recognized training center or research facility if those
15-23 activities and services constitute a part of the person's course of
15-24 study in the discipline in which the person's supervisor is
15-25 licensed under this Act.
15-26 (c) This Act does not apply to a:
15-27 (1) podiatrist practicing under the law regulating
16-1 podiatry (Article 4567 et seq., Revised Statutes); or
16-2 (2) 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 (d) This Act does not apply to a pedorthist certified by the
16-7 Board for Certification in Pedorthics. For the purposes of this
16-8 subsection, a certified pedorthist is a person certified by the
16-9 Board for Certification in Pedorthics, or its successor entity, in
16-10 the design, manufacture, fit, and modification of shoes and related
16-11 foot orthoses below the anatomical ankle joint as prescribed by a
16-12 licensed doctor of medicine or a doctor of podiatry for the
16-13 amelioration of a painful or disabling condition of the foot.
16-14 "Foot orthosis" includes prosthetic toe fillers or orthoses for use
16-15 below the ankle.
16-16 (e) This Act does not apply to a certified fitter or
16-17 certified master orthotist who holds a credential issued by the
16-18 National Community Pharmacists Association if the fitter or master
16-19 orthotist:
16-20 (1) is working within the person's scope of practice
16-21 as defined by the board; or
16-22 (2) provides the following services or devices
16-23 described by the Health Care Financing Administration's Common
16-24 Procedure Coding System:
16-25 (A) foam cervical collar;
16-26 (B) thermoplastic foam cervical collar;
16-27 (C) plastic cervical collar;
17-1 (D) rib belt;
17-2 (E) thoracic-lumbar support;
17-3 (F) lumbar-sacral support;
17-4 (G) sacroiliac support;
17-5 (H) ptosis support;
17-6 (I) pendulous abdomen support;
17-7 (J) torso support;
17-8 (K) knee orthosis;
17-9 (L) knee orthosis with stays;
17-10 (M) knee orthosis with joints;
17-11 (N) knee orthosis with condylar pads;
17-12 (O) knee orthosis with joints and condylar pads;
17-13 (P) knee immobilizer;
17-14 (Q) multiligamentus ankle support;
17-15 (R) figure eight shoulder restrainer;
17-16 (S) acromioclavicular support;
17-17 (T) elbow orthosis with stays;
17-18 (U) elbow orthosis with joints;
17-19 (V) wrist splint;
17-20 (W) pneumatic ankle splint;
17-21 (X) pneumatic walking splint;
17-22 (Y) pneumatic full leg splint;
17-23 (Z) pneumatic knee splint;
17-24 (AA) mastectomy bra;
17-25 (BB) mastectomy sleeve;
17-26 (CC) mastectomy form;
17-27 (DD) silicone breast prosthesis;
18-1 (EE) medium weight calf-length stocking;
18-2 (FF) heavy weight calf-length stocking;
18-3 (GG) surgical weight calf-length stocking;
18-4 (HH) medium weight thigh-length stocking;
18-5 (II) heavy weight thigh-length stocking;
18-6 (JJ) surgical weight thigh-length stocking;
18-7 (KK) medium weight full-length stocking;
18-8 (LL) heavy weight full-length stocking;
18-9 (MM) surgical weight full-length stocking;
18-10 (NN) medium weight leotard;
18-11 (OO) surgical weight leotard;
18-12 (PP) custom made compression stocking;
18-13 (QQ) lymphedema sleeve;
18-14 (RR) garter belt;
18-15 (SS) single truss with standard pad;
18-16 (TT) double truss with standard pad;
18-17 (UU) water pad addition to truss; and
18-18 (VV) scrotal pad addition to truss.
18-19 Sec. 22. PROHIBITED ACTS. (a) A person may not practice,
18-20 attempt to practice, or offer to practice prosthetics or orthotics,
18-21 act as an assistant to a person who practices prosthetics or
18-22 orthotics, or in any way hold the person out as being able to
18-23 practice prosthetics or orthotics unless the person holds a license
18-24 issued by the board under this Act.
18-25 (b) A person or the person's employees, agents, or
18-26 representatives may not use in connection with the person's name or
18-27 business activities the terms or a combination of the terms or
19-1 letters described in Section 21(a)(1), indicate orally or in
19-2 writing, directly or by implication, that a prosthetic or orthotic
19-3 service is provided or supplied, or extend or provide prosthetic or
19-4 orthotic services unless the person is a prosthetist or orthotist
19-5 or an assistant to a prosthetist or orthotist licensed under this
19-6 Act.
19-7 (c) A person licensed under this Act violates this Act if
19-8 the person violates Section 161.091, Health and Safety Code.
19-9 Sec. 23. PROSTHETIST AND ORTHOTIST LICENSE REQUIREMENTS.
19-10 (a) To obtain a license to practice prosthetics or orthotics in
19-11 this state, an individual must file a written application with the
19-12 board on the form provided by the board, pay the nonrefundable
19-13 application fee prescribed by the board, and:
19-14 (1) be a resident of this state;
19-15 (2) have completed the formal training, including the
19-16 required hours of classroom education and clinical practice, in an
19-17 area of study the board by rule determines to be necessary and
19-18 appropriate;
19-19 (3) have completed a clinical residency in the
19-20 professional area for which licensure is sought that complies with
19-21 the standards, guidelines, or procedures established by the board
19-22 for a clinical residency offered in this state or in another state;
19-23 and
19-24 (4) have passed all written and practical examinations
19-25 approved and required by the board.
19-26 (b) The requirements for a license established by board rule
19-27 must include:
20-1 (1) either:
20-2 (A) a bachelor's degree in orthotics and
20-3 prosthetics from a college or university 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; or
20-9 (B) a bachelor's degree and a prosthetic or
20-10 orthotic certificate from a practitioner 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; and
20-16 (2) not less than 1,900 hours of professional clinical
20-17 residency completed under the direct supervision of a licensed
20-18 orthotist, licensed prosthetist, or a licensed prosthetist
20-19 orthotist in the discipline for which licensure is sought.
20-20 (c) A person may apply for an exemption from the license
20-21 requirements adopted by the board under this section if the person
20-22 applies not later than the 181st day after the date the board's
20-23 initial rules under this Act are finally adopted and published and
20-24 the person:
20-25 (1) is a resident of this state; and
20-26 (2) preceding the date of the application:
20-27 (A) provided comprehensive orthotic or
21-1 prosthetic care for not less than three years; or
21-2 (B) provided comprehensive orthotic and
21-3 prosthetic care for not less than six years including practicing
21-4 orthotics or prosthetics in this state for the one year period
21-5 preceding the application date.
21-6 (d) A person may apply for an exemption from the license
21-7 requirements adopted by the board under this section if the person
21-8 is a resident of this state who presents evidence to the board that
21-9 the person possesses unique qualifications to practice orthotics or
21-10 prosthetics.
21-11 (e) A person who has provided comprehensive orthotic,
21-12 prosthetic, or orthotic and prosthetic care in this state for less
21-13 than the three years required by Subsection (c) of this section may
21-14 obtain a license to practice in this state by completing and
21-15 passing all written and practical examinations approved and
21-16 required by the board.
21-17 (f) The board shall issue a license to a person who is
21-18 determined to be exempt from the license requirements under
21-19 Subsection (c) of this section or who obtains a license under
21-20 Subsection (d) of this section. Such a license holder is entitled
21-21 to the same license privileges as if the person met the educational
21-22 and vocational requirements under Subsection (a) or (b) of this
21-23 section. The person is subject to the license renewal requirements
21-24 adopted by the board, except for the academic, clinical training,
21-25 and examination requirements, which may not be imposed as a
21-26 condition of the person's license.
21-27 Sec. 24. PROSTHETIST OR ORTHOTIST ASSISTANT LICENSE.
22-1 (a) An applicant for a license as a prosthetist assistant or
22-2 orthotist assistant must file a written application with the board
22-3 on a form provided by the board and pay the nonrefundable
22-4 application fee prescribed by the board.
22-5 (b) An applicant under this section must present evidence
22-6 satisfactory to the board that the applicant has completed an
22-7 educational program, including courses in the anatomical,
22-8 biological, and physical sciences, and clinical residency as
22-9 prescribed and adopted by the board.
22-10 (c) An assistant licensed under this section may provide
22-11 only ancillary patient care services, as defined by the board, in
22-12 the discipline in which the assistant's supervisor is licensed
22-13 under this Act.
22-14 (d) A person may apply for an exemption from the license
22-15 requirements adopted by the board under this section if the person
22-16 applies not later than the 181st day after the date the board's
22-17 initial rules under this Act are finally adopted and published and
22-18 if the person is a resident of this state who has practiced within
22-19 the scope of practice of an assistant, as defined by the board, for
22-20 five consecutive years in this state.
22-21 Sec. 25. PROSTHETIC OR ORTHOTIC TECHNICIAN REGISTRATION.
22-22 (a) An applicant for registration as a registered prosthetic
22-23 technician or registered orthotic technician must file a written
22-24 application with the board on a form provided by the board and pay
22-25 the nonrefundable application fee prescribed by the board.
22-26 (b) An applicant under this section must present evidence
22-27 satisfactory to the board that the applicant has completed an
23-1 educational program and laboratory experience as prescribed and
23-2 adopted by the board.
23-3 (c) A person may apply for an exemption from the
23-4 registration requirements adopted by the board under this section
23-5 if the person applies not later than the 181st day after the date
23-6 the board's initial rules under this Act are finally adopted and
23-7 published and if the person is a resident of this state who has
23-8 practiced as an orthotic or prosthetic technician for five
23-9 consecutive years in this state.
23-10 Sec. 26. ACCREDITATION OF FACILITIES. (a) The board by
23-11 rule shall adopt requirements for the accreditation and the renewal
23-12 of an accreditation of an orthotic or prosthetic facility in which
23-13 the profession and practice of orthotics or prosthetics is
23-14 conducted.
23-15 (b) If one or more facilities are owned by a person, the
23-16 board may require only one application for the accreditation of all
23-17 the person's facilities. Each orthotic or prosthetic facility must
23-18 meet the requirements prescribed by the board.
23-19 (c) An orthotic or prosthetic facility must be under the
23-20 on-site direction of an orthotist or prosthetist licensed by the
23-21 board in the discipline for which accreditation is sought.
23-22 (d) The rules adopted under this section may not prohibit a
23-23 licensed individual from practicing in an orthotic or prosthetic
23-24 facility within the scope of the individual's license.
23-25 (e) This section does not apply to a facility licensed under
23-26 Subtitle B, Title 4, Health and Safety Code.
23-27 Sec. 27. ISSUANCE OF LICENSE. (a) The board shall issue a
24-1 license in prosthetics or orthotics to an applicant who meets the
24-2 qualifications established under this Act and the requirements
24-3 adopted by the board as provided by this Act. A license is valid
24-4 for two years from the date issued and may be renewed before
24-5 expiration.
24-6 (b) The board may issue a license or registration under this
24-7 Act only to an individual. The board may issue an accreditation
24-8 only to an orthotic or prosthetic facility.
24-9 (c) A license may be granted in either orthotics or
24-10 prosthetics, or in both, if the person meets the requirements
24-11 established by the board.
24-12 Sec. 28. PROVISIONAL LICENSE. (a) A person practicing
24-13 comprehensive prosthetic or orthotic patient management who does
24-14 not meet the requirements of this Act for licensing as a
24-15 prosthetist or orthotist by October 1, 1998, and is not exempt
24-16 under this Act, must comply with the requirements of Sections 23(a)
24-17 and (b) of this Act on or before January 1, 2005.
24-18 (b) A person subject to this section may apply for a
24-19 prosthetist or orthotist provisional license by filing a written
24-20 application with the board on a form provided by the board and
24-21 paying a nonrefundable application fee prescribed by the board.
24-22 (c) A provisional license may only be issued to an
24-23 individual who is actively engaged in complying with the
24-24 educational and clinical licensing requirements of Subsection (e)
24-25 of this section or Sections 23(a) and (b) of this Act.
24-26 (d) A provisional license may be revoked by the board if the
24-27 board determines that the provisional license holder is not in
25-1 compliance with this section.
25-2 (e) The board rules providing educational and clinical
25-3 training requirements for a provisional license must include:
25-4 (1) an associate degree in applied health sciences,
25-5 including course work in the anatomical, biological, and physical
25-6 sciences; and
25-7 (2) not less than 4,500 hours of postgraduate clinical
25-8 residency completed under the direct supervision of a licensed
25-9 orthotist or a licensed prosthetist in the discipline for which a
25-10 provisional license is sought.
25-11 (f) A provisional license is valid for two years from the
25-12 date issued and may be renewed with documentation as required by
25-13 board rule.
25-14 (g) This section expires January 1, 2006.
25-15 Sec. 29. TEMPORARY LICENSE. (a) The board may issue a
25-16 temporary license to an individual who:
25-17 (1) has recently become a resident of this state;
25-18 (2) has applied for licensing as an orthotist,
25-19 prosthetist, or both; and
25-20 (3) has:
25-21 (A) practiced the profession of orthotics
25-22 regularly since January 1, 1996; or
25-23 (B) been licensed by the state in which the
25-24 person formerly resided that has licensing requirements that are
25-25 equal to or exceed the requirements of this Act.
25-26 (b) A temporary license is valid for one year from the date
25-27 issued. A temporary license may be renewed for not more than one
26-1 additional year if the applicant presents to the board sufficient
26-2 evidence of good cause for renewal.
26-3 Sec. 30. STUDENT REGISTRATION. (a) The board may issue a
26-4 student registration certificate to an individual who:
26-5 (1) holds either:
26-6 (A) a bachelor's degree in orthotics and
26-7 prosthetics conferred by a college or university recognized and
26-8 accredited by the Commission on Accreditation of Allied Health
26-9 Education Programs or from a practitioner educational program
26-10 having educational standards that are equivalent to or exceed the
26-11 standards adopted by the Commission on Accreditation of Allied
26-12 Health Education Programs; or
26-13 (B) a bachelor's degree and an orthotic or
26-14 prosthetic certificate from a practitioner educational program
26-15 recognized and accredited by the Commission on Accreditation of
26-16 Allied Health Education Programs or from a practitioner educational
26-17 program having educational standards that are equivalent to or
26-18 exceed the standards adopted by the Commission on Accreditation of
26-19 Allied Health Education Programs; and
26-20 (2) is working toward fulfillment of the requirements
26-21 for licensing as a prosthetist, orthotist, or prosthetist
26-22 orthotist.
26-23 (b) A student registrant may work only under the direct
26-24 supervision of a licensed orthotist, licensed prosthetist, or
26-25 licensed prosthetist orthotist who is responsible for the acts of
26-26 the student registrant and is licensed in the discipline of the
26-27 clinical residency.
27-1 (c) A student registration certificate is valid for two
27-2 years from the date issued and may be renewed once for an
27-3 additional two years.
27-4 Sec. 31. EXAMINATION EXEMPTION. The board may accept as a
27-5 substitute for the examination requirement proof that the applicant
27-6 for the exemption holds a current license in a state that has
27-7 licensing requirements that are equal to or exceed the requirements
27-8 of this Act.
27-9 Sec. 32. CONTINUING EDUCATION. (a) An applicant for
27-10 renewal of a license shall submit to the board evidence of
27-11 satisfactory completion of the continuing education requirements
27-12 required by the board.
27-13 (b) The board shall notify each license holder of the
27-14 holder's failure to comply with the board's continuing education
27-15 requirements and shall notify the license holder that if the holder
27-16 does not obtain the required continuing education before the
27-17 expiration of three months after the date the notice was given, the
27-18 board may take any action authorized by this Act concerning the
27-19 suspension or revocation of the holder's license.
27-20 Sec. 33. DISCIPLINARY PROVISIONS. (a) After notice and
27-21 opportunity for a hearing, the board may revoke, suspend, or refuse
27-22 to renew a license issued under this Act on a finding that:
27-23 (1) the license was obtained by fraud,
27-24 misrepresentation, or concealment of a material fact;
27-25 (2) the person engaged in fraud or deceit in
27-26 connection with services provided by the person;
27-27 (3) the person engaged in unprofessional or unethical
28-1 conduct;
28-2 (4) the person engaged in gross negligence or
28-3 malpractice; or
28-4 (5) the person violated this Act or a rule adopted
28-5 under this Act.
28-6 (b) A license revoked under Subsection (a) of this section
28-7 may be reinstated after the first anniversary of the date of the
28-8 revocation by the board on terms the board determines to be
28-9 necessary.
28-10 Sec. 34. CIVIL PENALTY. (a) A person who violates this Act
28-11 is subject to a civil penalty of $200 for the first violation and
28-12 $500 for each subsequent violation. At the request of the board,
28-13 the attorney general shall bring an action in the name of the state
28-14 to collect a civil penalty under this section.
28-15 (b) Each day a violation of Section 22 of this Act continues
28-16 is a separate violation for the purpose of this section.
28-17 SECTION 2. (a) In making the initial appointments to the
28-18 Texas Board of Orthotics and Prosthetics, the governor shall, not
28-19 later than October 1, 1997, appoint:
28-20 (1) two members for terms expiring February 1, 1999;
28-21 (2) two members for terms expiring February 1, 2001;
28-22 and
28-23 (3) two members for terms expiring February 1, 2003.
28-24 (b) The initial members of the board appointed under
28-25 Subsection (a) of this section shall have the qualifications
28-26 required by this subsection. One member must be an orthotist
28-27 certified by the American Board for Certification in Orthotics and
29-1 Prosthetics, Inc., be a resident of this state, and have practiced
29-2 orthotics for the five years preceding the date of appointment.
29-3 Two members must be orthotists who hold a credential issued by the
29-4 Board for Orthotist Certification, are residents of this state, and
29-5 have practiced orthotics for the five years preceding the date of
29-6 appointment. One member must be a prosthetist orthotist or
29-7 prosthetist certified by the American Board for Certification in
29-8 Orthotics and Prosthetics, Inc., be a resident of this state, and
29-9 have practiced prosthetics or orthotics for the five years
29-10 preceding the date of appointment. One member must be a
29-11 representative of the public who uses an orthosis. One member must
29-12 be a representative of the public who uses a prosthesis.
29-13 (c) A member appointed under this section to a place on the
29-14 board required to be held by a person licensed under Article 8920,
29-15 Revised Statutes, as added by this Act, may continue to serve
29-16 without having the appropriate license until February 1, 1999, by
29-17 which date the person must obtain the required license.
29-18 (d) The board shall adopt rules under Article 8920, Revised
29-19 Statutes, as added by this Act, not later than October 1, 1998.
29-20 SECTION 3. (a) Except as provided by Subsection (b) of this
29-21 section, this Act takes effect September 1, 1997.
29-22 (b) Sections 22 and 34, Article 8920, Revised Statutes, as
29-23 added by this Act, take effect October 1, 1998.
29-24 SECTION 4. The importance of this legislation and the
29-25 crowded condition of the calendars in both houses create an
29-26 emergency and an imperative public necessity that the
29-27 constitutional rule requiring bills to be read on three several
30-1 days in each house be suspended, and this rule is hereby suspended.