PRINTER'S NO. 2844
No. 2015 Session of 2007
INTRODUCED BY SCAVELLO, THOMAS, BAKER, BELFANTI, CAPPELLI, CARROLL, COHEN, COSTA, CREIGHTON, DALLY, DePASQUALE, DONATUCCI, EACHUS, J. EVANS, FABRIZIO, GEORGE, GERGELY, GILLESPIE, GRELL, HARHART, HARPER, HELM, HENNESSEY, JAMES, KAUFFMAN, W. KELLER, KORTZ, KOTIK, MACKERETH, MARSICO, McGEEHAN, McILHATTAN, R. MILLER, MOUL, MURT, MUSTIO, NAILOR, OLIVER, O'NEILL, PASHINSKI, PAYNE, PHILLIPS, PICKETT, READSHAW, REICHLEY, SABATINA, SAYLOR, SIPTROTH, SOLOBAY, J. TAYLOR, VEREB, VULAKOVICH, WATERS, WATSON, YOUNGBLOOD AND YUDICHAK, NOVEMBER 14, 2007
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, NOVEMBER 14, 2007
AN ACT 1 Regulating the right to practice prosthetics, orthotics and 2 pedorthics; requiring the licensure of prosthetists, 3 orthotists, orthotic fitters and pedorthists; and providing a 4 penalty. 5 The General Assembly of the Commonwealth of Pennsylvania 6 hereby enacts as follows: 7 Section 1. Short title. 8 This act shall be known and may be cited as the Prosthetist, 9 Orthotist, Orthotic Fitter and Pedorthist Licensure Act. 10 Section 2. Definitions. 11 The following words and phrases when used in this act shall 12 have the meanings given to them in this section unless the 13 context clearly indicates otherwise: 14 "Board." The State Board of Podiatry.
1 "Commissioner." The Commissioner of Professional and 2 Occupational Affairs. 3 "Custom-fabricated device." A prosthesis, orthosis or 4 pedorthic device that is fabricated to original measurements or 5 a mold for use by a patient in accordance with a prescription 6 and which requires substantial clinical and technical judgment 7 in its design and fitting. 8 "Custom-fitted device." A prefabricated prosthesis, orthosis 9 or pedorthic device that is sized or modified for use by the 10 patient in accordance with a prescription and which requires 11 substantial clinical judgment and substantive alteration for 12 appropriate use. 13 "Department." The Department of State of the Commonwealth. 14 "Orthotic fitter." An individual who is licensed to practice 15 orthotics, pursuant to a licensed physician's written 16 prescription, whose scope of practice is limited to fitting 17 prefabricated cervical orthoses not requiring more than minor 18 modification; pressure gradient hose; trusses; custom-molded 19 therapeutic footwear; custom-molded foot orthoses; prefabricated 20 spinal orthoses, except for those used in the treatment of 21 scoliosis, rigid body jackets made of thermoformable materials, 22 and "halo" devices; and prefabricated orthoses of the upper and 23 lower extremities, except for those used in the treatment of 24 bone fractures. 25 "Orthotics." Evaluating, measuring, designing, fabricating, 26 assembling, fitting, adjusting or servicing an orthosis for the 27 correction or alleviation of neuromuscular or musculoskeletal 28 dysfunction, disease, injury or deformity, as provided in this 29 act. 30 "Orthotist." An individual other than an orthotic fitter 20070H2015B2844 - 2 -
1 licensed under this act to practice orthotics. 2 "Over-the-counter." A prefabricated, mass-produced item that 3 is prepackaged and requires no professional advice or judgment 4 in either size selection or use, including fabric or elastic 5 supports, corsets, generic arch supports and elastic hoses. 6 "Pedorthic device." Therapeutic footwear, foot orthoses for 7 use at the ankle or below and modified footwear made for 8 therapeutic purposes. The term does not include nontherapeutic 9 accommodative inlays or nontherapeutic accommodative footwear, 10 regardless of method of manufacture, shoe modifications made for 11 nontherapeutic purposes, unmodified, over-the-counter shoes or 12 prefabricated foot care products. 13 "Pedorthics." Evaluating, measuring, designing, fabricating, 14 assembling, fitting, adjusting or servicing a pedorthic device 15 for the correction or alleviation of neuromuscular or 16 musculoskeletal dysfunction, disease, injury or deformity, as 17 provided in this act. 18 "Pedorthist." An individual licensed under this act to 19 practice pedorthics. 20 "Podiatrist." An individual licensed by the State Board of 21 Podiatry under the act of March 2, 1956 (1955 P.L.1206, No.375), 22 known as the Podiatry Practice Act. 23 "Prefabricated orthosis." A brace or support designed to 24 provide for alignment, correction or prevention of neuromuscular 25 or musculoskeletal dysfunction, disease, injury or deformity. 26 The term does not include fabric or elastic support, corsets, 27 arch supports, low-temperature plastic splints, trusses, elastic 28 hoses, canes, crutches, soft cervical collars, dental appliances 29 or other similar devices carried in stock and sold as over-the- 30 counter items by a drug store, department store, corset shop or 20070H2015B2844 - 3 -
1 surgical supply facility. 2 "Prosthesis." A custom-designed, custom-fabricated, custom- 3 fitted or custom-modified device to replace an absent external 4 limb for purposes of restoring physiological function or 5 cosmesis. The term does not include artificial eyes, ears, 6 fingers or toes, dental appliances, cosmetic devices such as 7 artificial breasts, eyelashes or wigs or other devices that do 8 not have a significant impact on the musculoskeletal functions 9 of the body. 10 "Prosthetics." Evaluating, measuring, designing, 11 fabricating, assembling, fitting, adjusting or servicing a 12 prosthesis. 13 "Prosthetist." An individual licensed under this act to 14 practice prosthetics. 15 Section 3. Regulation of the practices of prosthetics, 16 orthotics, orthotic fitters and pedorthics. 17 (a) License required.--Except as provided in subsection (h), 18 an individual shall be licensed with the board before the 19 individual may practice prosthetics, orthotics, orthotic fitting 20 or pedorthics in this Commonwealth. Individuals shall renew 21 their licenses biennially with the board. 22 (b) Qualifications for licensing as a prosthetist, 23 orthotist, orthotic fitter and pedorthist.--To qualify for 24 licensure to practice prosthetics, orthotics, orthotic fitting 25 or pedorthics, an individual shall: 26 (1) possess a high school diploma or its equivalent; 27 (2) have completed the amount of formal training, 28 including, but not limited to, any hours of classroom 29 education and clinical practice established and approved by a 30 prosthetic, orthotic and pedorthic credentialing organization 20070H2015B2844 - 4 -
1 recognized by the National Organization for Competency 2 Assurance (NOCA) and accredited by the National Commission 3 for Certifying Agencies (NCCA); 4 (3) complete a qualified work experience program or 5 internship in prosthetics, orthotics or pedorthics in 6 accordance with any standards, guidelines or procedures 7 established and approved by the department; 8 (4) pass all examinations that are required for 9 certification by a prosthetic, orthotic or pedorthic 10 credentialing organization recognized by the National 11 Organization for Competency Assurance (NOCA) and accredited 12 by the National Commission for Certifying Agencies (NCCA); 13 and 14 (5) have fulfilled all educational and training 15 requirements consistent with those required for certification 16 by a prosthetic, orthotic and pedorthic credentialing 17 organization recognized by the National Organization for 18 Competency Assurance (NOCA) and accredited by the National 19 Commission for Certifying Agencies (NCCA). 20 (c) Regulations to be promulgated.--The board shall 21 promulgate regulations requiring the proper training of 22 individuals before they may be licensed in the practice of 23 prosthetics, orthotics, orthotics fitter or pedorthics in this 24 Commonwealth. Proper training shall include, to the extent 25 determined by the board, education or demonstrated experience in 26 the practice of prosthetics, orthotics, orthotics fitter or 27 pedorthics. If the board requires successful completion of a 28 written, oral or practical examination in order to qualify for 29 licensure under this act, the examination shall be prepared and 30 administered by a qualified and approved professional testing 20070H2015B2844 - 5 -
1 organization in the manner required for written examinations by 2 section 812.1 of the act of April 9, 1929 (P.L.177, No.175), 3 known as The Administrative Code of 1929. The board may 4 promulgate such other regulations as are deemed proper and 5 necessary regarding the practice of prosthetics, orthotics, 6 orthotics fitter or pedorthics. 7 (d) Practice of certain prosthetists, orthotists, orthotics 8 fitter or pedorthists.--A prosthetist, orthotist, orthotics 9 fitter or pedorthist shall, prior to administering the first 10 treatment, do all of the following: 11 (1) Ensure that the patient has secured a written 12 referral for treatment by prosthetics, orthotics or 13 pedorthics from a physician or podiatrist. A referral under 14 this paragraph shall place conditions and restrictions on the 15 course of treatment if required as a matter of sound medical 16 practice. 17 (2) Ensure that the patient has undergone a medical 18 diagnostic examination or has had the results of a recently 19 performed medical diagnostic examination reviewed by a 20 physician or podiatrist. 21 (3) Keep a copy of the referral and the results of the 22 medical diagnostic examination in the patient's file. 23 (e) Supervision of students in prosthetics, orthotics, 24 orthotics fitter or pedorthics educational programs.--Nothing in 25 this act shall prohibit students enrolled in a prosthetics, 26 orthotics, orthotics fitter or pedorthics educational program 27 from performing prosthetics, orthotics or pedorthics in the 28 course of their instruction, provided that a physician or 29 podiatrist is readily available for consultations and that a 30 prosthetist, orthotist or pedorthist, respectively, is on site 20070H2015B2844 - 6 -
1 and responsible for the direct supervision of students. 2 (f) Faculty in prosthetics, orthotics or pedorthics 3 educational programs.--Nothing in this act shall prohibit 4 faculty teaching in a prosthetic, orthotic, orthotics fitter or 5 pedorthic educational program or visiting guest lecturers from 6 performing prosthetics, orthotics or pedorthics in the course of 7 student instruction or during professional development seminars, 8 provided that such individuals are licensed as a prosthetist, 9 orthotist or pedorthist in this Commonwealth or licensed as a 10 prosthetist, orthotist or pedorthist in another jurisdiction 11 recognized by this Commonwealth and obtain temporary licensure 12 in this Commonwealth. 13 (g) Disciplinary and corrective measures.--Prosthetists, 14 orthotists, orthotic fitters or pedorthists licensed with the 15 board shall be subject to all disciplinary provisions applicable 16 to podiatrists as set forth in the act of March 2, 1956 (1955 17 P.L.1206, No.375), known as the Podiatry Practice Act. 18 (h) Exception.--Nothing in this section shall be construed 19 to prevent: 20 (1) An occupational therapist licensed in this 21 Commonwealth from engaging in the practice in which the 22 occupational therapist is licensed. 23 (2) A physical therapist licensed in this Commonwealth 24 from engaging in the practice in which the physical therapist 25 is licensed. 26 (3) A physician licensed in this Commonwealth from 27 engaging in the practice in which the physician is licensed. 28 (4) A podiatrist licensed in this Commonwealth from 29 engaging in the practice in which the podiatrist is licensed. 30 (5) The practice of prosthetics, orthotics or pedorthics 20070H2015B2844 - 7 -
1 by an individual who is employed by the Federal Government 2 while in the discharge of the employee's official duties. 3 Section 4. Licensure requirement and transition period. 4 (a) Registration required.--Commencing two years after the 5 effective date of this section, no individual shall practice or 6 hold himself or herself out as being able to practice 7 prosthetics, orthotics, orthotics fitter or pedorthics in this 8 Commonwealth unless he or she is licensed in accordance with 9 section 3. 10 (b) Transition period for prosthetist and orthotist 11 registration.--Within two years after the effective date of 12 section 8, an individual certified as a prosthetist, orthotist 13 or a prosthetist/orthotist in accordance with section 3(b) may 14 apply for and shall be granted prosthetic or orthotic licensure 15 under this act upon payment of the required fee. Beginning two 16 years after the effective date of section 8, any applicant for 17 licensure as a prosthetist or an orthotist shall meet the 18 requirements of section 3. 19 (c) Transition period for orthotics fitter licensure.-- 20 Within two years after the effective date of section 8, an 21 individual certified as an orthotics fitter may apply for and 22 shall be granted orthotics fitter licensure under this act upon 23 payment of the required fee. Beginning two years after the 24 effective date of section 8, any applicant for licensure as an 25 orthotics fitter shall meet the requirements of section 3. 26 (d) Transition period for pedorthist licensure.--Within two 27 years after the effective date of section 8, an individual 28 certified as a pedorthist in accordance with section 3(c) may 29 apply for and shall be granted pedorthic licensure under this 30 act upon payment of the required fee. Beginning two years after 20070H2015B2844 - 8 -
1 the effective date of section 8, any applicant for licensure as 2 a pedorthist shall meet the requirements of section 3. 3 (e) Transition period for experienced practitioners.--Within 4 two years of the effective date of section 8, an individual who 5 has practiced full time for at least three years in a 6 prosthetic/orthotic facility as a prosthetist, orthotist, 7 prosthetist/orthotist or orthotic fitter, or in a pedorthic 8 facility as a pedorthist on the effective date of section 8 may 9 file an application with the board to continue to practice 10 prosthetics, orthotics, orthotics fitter or pedorthics at the 11 applicant's identified level of practice. The applicant shall be 12 licensed to practice prosthetics, orthotics, orthotics fitter or 13 pedorthics under this act without examination upon receipt by 14 the board of payment of a licensure fee and after the board has 15 conducted an investigation of the applicant's work history. The 16 board shall complete its investigation within six months of the 17 date of the application. The investigation shall include, but 18 not be limited to, completion by the applicant of a 19 questionnaire regarding the applicant's work history and scope 20 of practice. 21 Section 5. Fee. 22 The board may charge a reasonable fee, fixed by the board by 23 regulation, for all licenses, renewals and examinations 24 authorized by this act or the regulations promulgated under 25 section 3. 26 Section 6. Penalties. 27 (a) Licensure.--Except as provided for in section 3(e), it 28 shall be unlawful for an individual to practice prosthetics, 29 orthotics, orthotics fitter or pedorthics in this Commonwealth 30 unless the individual is licensed as a prosthetist, orthotist, 20070H2015B2844 - 9 -
1 orthotics fitter or pedorthist by the board. An individual 2 willfully violating the provisions of this act commits a 3 misdemeanor of the third degree. 4 (b) Injunction.--The unlawful practice of prosthetics, 5 orthotics, orthotics fitter or pedorthics as defined may be 6 enjoined by the courts on petition of the board or by the 7 commissioner. In any such proceeding, it shall not be necessary 8 to show that any person is individually injured by the actions 9 complained of. If the respondent is found guilty of the unlawful 10 practice of prosthetics, orthotics, orthotics fitter or 11 pedorthics, the court shall enjoin him or her from so practicing 12 unless he or she has been duly licensed. Procedure in such cases 13 shall be the same as in any other injunction suit. The remedy of 14 injunction shall be in addition to criminal prosecution and 15 punishment. 16 Section 7. Disposition of certain moneys. 17 All fees, fines and civil penalties imposed in accordance 18 with this act and subsequently collected shall be for the 19 exclusive use by the board in carrying out the provisions of 20 this act. 21 Section 8. Approval of prosthetics, orthotics, orthotics fitter 22 or pedorthics educational programs. 23 The Department of Education shall approve any prosthetics, 24 orthotics, orthotics fitter or pedorthics educational program 25 that meets the relevant and appropriate requirements of 22 Pa. 26 Code (relating to education) and 24 Pa.C.S. Ch. 65 (relating to 27 private colleges, universities and seminaries) and that meets or 28 exceeds the standards required for prosthetics, orthotics, 29 orthotics fitter or pedorthics programs established by an 30 accrediting agency recognized by the United States Department of 20070H2015B2844 - 10 -
1 Education. 2 Section 20. Effective date. 3 This act shall take effect as follows: 4 (1) The following provisions shall take effect 5 immediately: 6 (i) Section 3(b). 7 (ii) This section. 8 (2) The remainder of this act shall take effect in six 9 months. K5L63JLW/20070H2015B2844 - 11 -