H.F. _____ Section 1. Section 147.1, subsections 3 and 6, Code 2011, 1 are amended to read as follows: 2 3. “Licensed” or “certified” , when applied to a physician 3 and surgeon, podiatric physician, osteopathic physician and 4 surgeon, physician assistant, psychologist, chiropractor, 5 nurse, dentist, dental hygienist, dental assistant, 6 optometrist, speech pathologist, audiologist, pharmacist, 7 physical therapist, physical therapist assistant, occupational 8 therapist, occupational therapy assistant, orthotist, 9 prosthetist, pedorthist, respiratory care practitioner, 10 practitioner of cosmetology arts and sciences, practitioner 11 of barbering, funeral director, dietitian, marital and 12 family therapist, mental health counselor, social worker, 13 massage therapist, athletic trainer, acupuncturist, nursing 14 home administrator, hearing aid dispenser, or sign language 15 interpreter or transliterator means a person licensed under 16 this subtitle. 17 6. “Profession” means medicine and surgery, podiatry, 18 osteopathic medicine and surgery, practice as a physician 19 assistant, psychology, chiropractic, nursing, dentistry, 20 dental hygiene, dental assisting, optometry, speech pathology, 21 audiology, pharmacy, physical therapy, physical therapist 22 assisting, occupational therapy, occupational therapy 23 assisting, respiratory care, cosmetology arts and sciences, 24 barbering, mortuary science, marital and family therapy, mental 25 health counseling, social work, dietetics, massage therapy, 26 athletic training, acupuncture, nursing home administration, 27 hearing aid dispensing, or sign language interpreting or 28 transliterating , orthotics, prosthetics, or pedorthics . 29 Sec. 2. Section 147.2, subsection 1, Code 2011, is amended 30 to read as follows: 31 1. A person shall not engage in the practice of medicine 32 and surgery, podiatry, osteopathic medicine and surgery, 33 psychology, chiropractic, physical therapy, physical 34 therapist assisting, nursing, dentistry, dental hygiene, 35 -1- LSB 1582YC (4) 84 jr/nh 1/ 9

H.F. _____ dental assisting, optometry, speech pathology, audiology, 1 occupational therapy, occupational therapy assisting, 2 orthotics, prosthetics, pedorthics, respiratory care, 3 pharmacy, cosmetology arts and sciences, barbering, social 4 work, dietetics, marital and family therapy or mental health 5 counseling, massage therapy, mortuary science, athletic 6 training, acupuncture, nursing home administration, hearing aid 7 dispensing, or sign language interpreting or transliterating, 8 or shall not practice as a physician assistant, unless the 9 person has obtained a license for that purpose from the board 10 for the profession. 11 Sec. 3. Section 147.13, Code 2011, is amended by adding the 12 following new subsection: 13 NEW SUBSECTION . 24. For orthotics, prosthetics, and 14 pedorthics, the board of orthotics, prosthetics, and 15 pedorthics. 16 Sec. 4. Section 147.14, subsection 1, Code 2011, is amended 17 by adding the following new paragraph: 18 NEW PARAGRAPH . x. For the board of orthotics, prosthetics, 19 and pedorthics, three persons licensed to practice orthotics, 20 prosthetics, or pedorthics who have engaged in the practice 21 of orthotics, prosthetics, or pedorthics in Iowa for at least 22 three years immediately preceding their appointment to the 23 board and two members who are not licensed to practice and who 24 shall represent the general public. 25 Sec. 5. Section 147.74, Code 2011, is amended by adding the 26 following new subsection: 27 NEW SUBSECTION . 24. a. An orthotist licensed under chapter 28 148F may use the words “licensed orthotist” after the person’s 29 name or signify the same by the use of the letters “L.O.” after 30 the person’s name. 31 b. A pedorthist licensed under chapter 148F may use the 32 words “licensed pedorthist” after the person’s name or signify 33 the same by the use of the letters “L.ped.” after the person’s 34 name. 35 -2- LSB 1582YC (4) 84 jr/nh 2/ 9

H.F. _____ c. A prosthetist licensed under chapter 148F may use the 1 words “licensed prosthetist” after the person’s name or signify 2 the same by the use of the letters “L.P.” after the person’s 3 name. 4 Sec. 6. NEW SECTION . 148F.1 Title and purpose. 5 1. This chapter may be cited and referred to as the 6 “Orthotics, Prosthetics, and Pedorthics Practice Act” . 7 2. The purpose of this chapter is to provide for the 8 regulation of persons offering orthotic, prosthetic, and 9 pedorthic services to the public in order to safeguard the 10 public health, safety, and welfare. 11 Sec. 7. NEW SECTION . 148F.2 Definitions. 12 As used in this chapter: 13 1. “Board” means the board of orthotics, prosthetics, and 14 pedorthics. 15 2. “Orthotic and prosthetic scope of practice” means a 16 list of tasks, with relative weight given to such factors 17 as importance, criticality, and frequency, based on 18 internationally accepted standards of orthotic and prosthetic 19 care as outlined by the international society of prosthetics 20 and orthotics’ professional profile for category I and category 21 III orthotic and prosthetic personnel. 22 3. “Orthotics” means the science and practice of evaluating, 23 measuring, designing, fabricating, assembling, fitting, 24 adjusting, or servicing an orthosis under an order from a 25 licensed physician or podiatric physician for the correction or 26 alleviation of neuromuscular or musculoskeletal dysfunction, 27 disease, injury, or deformity. 28 4. “Orthotist” means a health care professional, 29 specifically educated and trained in orthotic patient care, 30 who measures, designs, fabricates, fits, or services orthoses 31 and may assist in the formulation of the order and treatment 32 plan of orthoses for the support or correction of disabilities 33 caused by neuromusculoskeletal diseases, injuries, or 34 deformities. 35 -3- LSB 1582YC (4) 84 jr/nh 3/ 9

H.F. _____ 5. “Pedorthic scope of practice” means a list of tasks 1 with relative weight given to such factors as importance, 2 criticality, and frequency based on nationally accepted 3 standards of pedorthic care as outlined by the national 4 commission on orthotic and prosthetic education comprehensive 5 analysis with an empirical validation study of the profession 6 performed by an independent testing company. 7 6. “Pedorthics” means the science and practice of 8 evaluating, measuring, designing, fabricating, assembling, 9 fitting, adjusting, or servicing a pedorthic device under an 10 order from a licensed physician or podiatric physician for the 11 correction or alleviation of neuromuscular or musculoskeletal 12 dysfunction, disease, injury, or deformity. 13 7. “Pedorthist” means a health care professional, 14 specifically educated and trained in pedorthic patient 15 care, who measures, designs, fabricates, fits, or services 16 pedorthic devices and may assist in the formulation of the 17 order and treatment plan of pedorthic devices for the support 18 or correction of disabilities caused by neuromusculoskeletal 19 diseases, injuries, or deformities. 20 8. “Prosthesis” means an artificial medical device that 21 is not surgically implanted and that is used to replace a 22 missing limb, appendage, or any other external human body part 23 including an artificial limb, hand, or foot. “Prosthesis” 24 does not include artificial eyes, ears, fingers, or toes, 25 dental appliances, cosmetic devices such as artificial breasts, 26 eyelashes, or wigs, or other devices that do not have a 27 significant impact on the musculoskeletal functions of the 28 body. 29 9. “Prosthetics” means the science and practice of 30 evaluating, measuring, designing, fabricating, assembling, 31 fitting, adjusting, or servicing a prosthesis under an order 32 from a licensed physician. 33 10. “Prosthetist” means a health care professional, 34 specifically educated and trained in prosthetic patient care, 35 -4- LSB 1582YC (4) 84 jr/nh 4/ 9

H.F. _____ who measures, designs, fabricates, fits, or services prostheses 1 and may assist in the formulation of the order and treatment 2 plan of prostheses for the replacement of external parts of the 3 human body lost due to amputation or congenital deformities or 4 absences. 5 Sec. 8. NEW SECTION . 148F.3 Duties of the board. 6 The board shall administer this chapter. The board’s duties 7 shall include but are not limited to the following: 8 1. Adoption of rules to administer and interpret this 9 chapter, chapter 147, and chapter 272C with respect to the 10 education and licensing of orthotists, prosthetists, and 11 pedorthists. 12 2. Adoption of rules to establish accepted standards of 13 orthotic and prosthetic scope of practice. 14 3. Adoption of rules relating to professional conduct and 15 licensing and the establishment of ethical and professional 16 standards of practice. 17 4. Acting on matters concerning licensure and the process 18 of applying for, granting, suspending, imposing supervisory 19 or probationary conditions upon, reinstating, revoking, or 20 renewing a license. 21 5. Establishing and collecting licensure fees as provided 22 in section 147.80. 23 6. Developing continuing education requirements as a 24 condition of license renewal. 25 7. Evaluating requirements for licensure in other states to 26 determine if reciprocity may be granted. 27 Sec. 9. NEW SECTION . 148F.4 Persons and practices not 28 affected. 29 This chapter does not prevent or restrict the practice, 30 services, or activities of any of the following: 31 1. A person licensed in this state by any other law from 32 engaging in the profession or occupation for which the person 33 is licensed. 34 2. A person employed as an orthotics, prosthetics, or 35 -5- LSB 1582YC (4) 84 jr/nh 5/ 9

H.F. _____ pedorthics practitioner by the government of the United States 1 if that person practices solely under the direction or control 2 of the organization by which the person is employed. 3 3. A person pursuing a course of study leading to a degree 4 or certificate in recreational therapy in an educational 5 program accredited or approved according to rules adopted by 6 the board, if the activities and services constitute a part of 7 a supervised course of study and the person is designated by a 8 title which clearly indicates the person’s status as a student 9 or trainee. 10 Sec. 10. NEW SECTION . 148F.5 Qualifications for licensure 11 as orthotist, prosthetist, or pedorthist. 12 1. To qualify for a license to practice orthotics or 13 prosthetics, a person shall meet the following requirements: 14 a. Possess a baccalaureate degree from a college or 15 university. 16 b. Have completed the amount of formal training including 17 but not limited to any hours of classroom education and 18 clinical practice established and approved by the board. 19 c. Complete a clinical residency in the professional area 20 for which a license is sought in accordance with standards, 21 guidelines, or procedures for residencies established and 22 approved by the board. The majority of training must be 23 devoted to services performed under the supervision of a 24 licensed practitioner of orthotics or prosthetics or a person 25 certified as a certified orthotist, certified prosthetist, 26 or certified prosthetist orthotist whose practice is located 27 outside the state. 28 d. Pass all written, practical, and oral examinations that 29 are required and approved by the board. 30 e. Be qualified to practice in accordance with accepted 31 standards of orthotic and prosthetic care as established by the 32 board. 33 2. To qualify for a license to practice pedorthics, a person 34 shall meet the following requirements: 35 -6- LSB 1582YC (4) 84 jr/nh 6/ 9

H.F. _____ a. Submit proof of a high school diploma or its equivalent. 1 b. Have completed the amount of formal training including 2 but not limited to any hours of classroom education and 3 clinical practice established and approved by the board. 4 c. Complete a qualified work experience program or 5 internship in pedorthics that has a minimum of one thousand 6 hours of pedorthic patient care experience in accordance 7 with any standards, guidelines, or procedures established 8 and approved by the board. The majority of training must 9 be devoted to services performed under the supervision of a 10 licensed practitioner of pedorthics or a person certified as 11 a certified pedorthist whose practice is located outside the 12 state. 13 d. Pass all examinations that are required and approved by 14 the board. 15 e. Be qualified to practice in accordance with accepted 16 standards of pedorthic care as established by the board. 17 3. The standards and requirements for licensure established 18 by the board shall be substantially equal to or in excess of 19 standards commonly accepted in the professions of orthotics, 20 prosthetics, or pedorthics, as applicable. The board shall 21 adopt rules as necessary to set the standards and requirements. 22 4. A person may be licensed in more than one discipline. 23 Sec. 11. NEW SECTION . 148F.6 Assistants and technicians. 24 1. a. A person shall not work as an assistant to an 25 orthotist or prosthetist or provide patient care services or 26 fabrication of orthoses or prostheses, unless the work is 27 performed under the supervision of a licensed orthotist or 28 prosthetist. 29 b. An assistant may perform orthotic or prosthetic 30 procedures and related tasks in the management of patient care. 31 An assistant may also fabricate, repair, and maintain orthoses 32 and prostheses. 33 2. a. A person shall not work as a technician unless 34 the work is performed under the supervision of a licensed 35 -7- LSB 1582YC (4) 84 jr/nh 7/ 9

H.F. _____ orthotist, prosthetist, or pedorthist. 1 b. A technician may assist a person licensed under this 2 chapter with fabrication of orthoses, prostheses, or pedorthic 3 devices but does not provide direct patient care. 4 Sec. 12. NEW SECTION . 148F.7 Limitation on provision of 5 care and services. 6 A licensed orthotist, prosthetist, or pedorthist may provide 7 care or services only if the care or services are provided 8 pursuant to an order from a licensed physician, a licensed 9 podiatric physician, an advanced registered nurse practitioner 10 who has a written collaborative agreement with a collaborating 11 physician or podiatric physician that specifically authorizes 12 ordering the services of an orthotist, prosthetist, or 13 pedorthist, an advanced registered nurse practitioner who 14 practices in a hospital or ambulatory surgical treatment center 15 and possesses clinical privileges to order services of an 16 orthotist, prosthetist, or pedorthist, or a physician assistant 17 who has been delegated the authority to order the services of 18 an orthotist, prosthetist, or pedorthist by the assistant’s 19 supervising physician. A licensed podiatric physician or an 20 advanced registered nurse practitioner collaborating with a 21 podiatric physician may only order care or services concerning 22 the foot from a licensed prosthetist. 23 Sec. 13. Section 272C.1, subsection 6, Code 2011, is amended 24 by adding the following new paragraph: 25 NEW PARAGRAPH . ag. The board of orthotics, prosthetics, and 26 pedorthics, created pursuant to chapter 147. 27 Sec. 14. INITIAL BOARD. The initial members of the board of 28 orthotics, prosthetics, and pedorthics established pursuant to 29 this Act shall be appointed to the following terms: 30 1. Two professional members eligible for licensure and one 31 public member shall be appointed for a term of two years. 32 2. One professional member eligible for licensure and one 33 public member shall be appointed for a term of one year. 34 EXPLANATION 35 -8- LSB 1582YC (4) 84 jr/nh 8/ 9

H.F. _____ This bill creates new Code chapter 148F that requires 1 the licensure of persons offering orthotic, prosthetic, or 2 pedorthic services. The bill provides for the establishment of 3 a five-member licensing board consisting of three professional 4 members and two members who represent the general public. 5 The bill provides for fees to fund the board and provides 6 penalties for violation of the practice requirement. The 7 penalties, including criminal penalties, are set out for all 8 health-related boards in Code chapters 147 and 272C. The board 9 is similar in composition and responsibilities to the other 10 health-related licensing boards. 11 Orthotics is the science and practice of evaluating, 12 measuring, designing, fabricating, assembling, fitting, 13 adjusting, or servicing a custom-fabricated or custom-fitted 14 brace or support for the correction or alleviation of 15 neuromuscular or musculoskeletal dysfunction, disease, injury, 16 or deformity. 17 Pedorthics is the science and practice of evaluating, 18 measuring, designing, fabricating, assembling, fitting, 19 adjusting, or servicing a specially designed shoe or shoe 20 insert for the correction or alleviation of neuromuscular or 21 musculoskeletal dysfunction, disease, injury, or deformity. 22 Prosthetics is the science and practice of evaluating, 23 measuring, designing, fabricating, assembling, fitting, 24 adjusting, or servicing an artificial medical device that is 25 not surgically implanted and that is used to replace a missing 26 limb, appendage, or any other external human body part. 27 The bill provides qualifications for licensure as an 28 orthotist, prosthetist, or pedorthist and requirements for 29 assistants and technicians to be supervised by such licensees. 30 -9- LSB 1582YC (4) 84 jr/nh 9/ 9