Senate
File
226
-
Introduced
SENATE
FILE
226
BY
DANIELSON
A
BILL
FOR
An
Act
relating
to
the
licensure
of
orthotists,
prosthetists,
1
and
pedorthists
and
providing
for
fees
and
penalties.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
2240SS
(5)
84
jr/nh
S.F.
226
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-
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2240SS
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1/
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226
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
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226
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.
“Orthosis”
means
a
custom-fabricated
or
custom-fitted
16
brace
or
support
designed
to
provide
for
alignment,
correction,
17
or
prevention
of
neuromuscular
or
musculoskeletal
dysfunction,
18
disease,
injury,
or
deformity.
“Orthosis”
does
not
include
19
fabric
or
elastic
supports,
corsets,
arch
supports,
low
20
temperature
plastic
splints,
trusses,
elastic
hoses,
canes,
21
crutches,
soft
cervical
collars,
dental
appliances,
or
other
22
similar
devices
carried
in
stock
and
sold
as
“over-the-counter”
23
items
by
a
drug
store,
department
store,
corset
shop,
or
24
surgical
supply
facility.
25
3.
“Orthotic
and
prosthetic
education
program”
means
a
course
26
of
instruction
accredited
by
the
commission
on
accreditation
27
of
allied
health
education
programs,
consisting
of
both
of
the
28
following:
29
a.
A
basic
curriculum
of
college
level
instruction
in
math,
30
physics,
biology,
chemistry,
and
psychology.
31
b.
A
specific
curriculum
in
orthotic
or
prosthetic
courses,
32
including
but
not
limited
to:
33
(1)
Lectures
covering
pertinent
anatomy,
biomechanics,
34
pathomechanics,
prosthetic-orthotic
components
and
materials,
35
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training
and
functional
capabilities,
prosthetic
or
orthotic
1
performance
evaluation,
prescription
considerations,
etiology
2
of
amputations
and
disease
processes
necessitating
prosthetic
3
or
orthotic
use,
and
medical
management.
4
(2)
Subject
matter
related
to
pediatric
and
geriatric
5
problems.
6
(3)
Instruction
in
acute
care
techniques,
such
as
immediate
7
and
early
post-surgical
prosthetics
and
fracture
bracing
8
techniques.
9
(4)
Lectures,
demonstrations,
and
laboratory
experiences
10
related
to
the
entire
process
of
measuring,
casting,
fitting,
11
fabricating,
aligning,
and
completing
prostheses
or
orthoses.
12
4.
“Orthotic
and
prosthetic
scope
of
practice”
means
a
13
list
of
tasks,
with
relative
weight
given
to
such
factors
14
as
importance,
criticality,
and
frequency,
based
on
15
internationally
accepted
standards
of
orthotic
and
prosthetic
16
care
as
outlined
by
the
international
society
of
prosthetics
17
and
orthotics’
professional
profile
for
category
I
and
category
18
III
orthotic
and
prosthetic
personnel.
19
5.
“Orthotics”
means
the
science
and
practice
of
evaluating,
20
measuring,
designing,
fabricating,
assembling,
fitting,
21
adjusting,
or
servicing
an
orthosis
under
an
order
from
a
22
licensed
physician
or
podiatric
physician
for
the
correction
or
23
alleviation
of
neuromuscular
or
musculoskeletal
dysfunction,
24
disease,
injury,
or
deformity.
25
6.
“Orthotist”
means
a
health
care
professional,
26
specifically
educated
and
trained
in
orthotic
patient
care,
27
who
measures,
designs,
fabricates,
fits,
or
services
orthoses
28
and
may
assist
in
the
formulation
of
the
order
and
treatment
29
plan
of
orthoses
for
the
support
or
correction
of
disabilities
30
caused
by
neuromusculoskeletal
diseases,
injuries,
or
31
deformities.
32
7.
“Pedorthic
device”
means
therapeutic
shoes,
such
as
33
diabetic
shoes
and
inserts,
shoe
modifications
made
for
34
therapeutic
purposes,
below-the-ankle
partial
foot
prostheses,
35
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226
and
foot
orthoses
for
use
at
the
ankle
or
below.
The
term
also
1
includes
subtalar-control
foot
orthoses
designed
to
manage
the
2
function
of
the
anatomy
by
controlling
the
range
of
motion
of
3
the
subtalar
joint.
Excluding
pedorthic
devices
which
are
4
footwear,
the
proximal
height
of
a
custom
pedorthic
device
5
does
not
extend
beyond
the
junction
of
the
gastrocnemius
and
6
the
Achilles
tendon.
“Pedorthic
device”
does
not
include
7
nontherapeutic
inlays
or
footwear
regardless
of
method
of
8
manufacture;
unmodified,
nontherapeutic
over-the-counter
shoes;
9
or
prefabricated
foot
care
products.
10
8.
“Pedorthic
education
program”
means
an
educational
11
program
accredited
by
the
national
commission
on
orthotic
and
12
prosthetic
education
consisting
of
all
of
the
following:
13
a.
A
basic
curriculum
of
instruction
in
foot-related
14
pathology
of
diseases,
anatomy,
and
biomechanics.
15
b.
A
specific
curriculum
in
pedorthic
courses,
including
16
lectures
covering
shoes,
foot
orthoses,
and
shoe
modifications,
17
pedorthic
components
and
materials,
training
and
functional
18
capabilities,
pedorthic
performance
evaluation,
prescription
19
considerations,
etiology
of
disease
processes
necessitating
20
use
of
pedorthic
devices,
medical
management,
subject
matter
21
related
to
pediatric
and
geriatric
problems,
and
lectures,
22
demonstrations,
and
laboratory
experiences
related
to
the
23
entire
process
of
measuring
and
casting,
fitting,
fabricating,
24
aligning,
and
completing
pedorthic
devices.
25
9.
“Pedorthic
scope
of
practice”
means
a
list
of
tasks
26
with
relative
weight
given
to
such
factors
as
importance,
27
criticality,
and
frequency
based
on
nationally
accepted
28
standards
of
pedorthic
care
as
outlined
by
the
national
29
commission
on
orthotic
and
prosthetic
education
comprehensive
30
analysis
with
an
empirical
validation
study
of
the
profession
31
performed
by
an
independent
testing
company.
32
10.
“Pedorthics”
means
the
science
and
practice
of
33
evaluating,
measuring,
designing,
fabricating,
assembling,
34
fitting,
adjusting,
or
servicing
a
pedorthic
device
under
an
35
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order
from
a
licensed
physician
or
podiatric
physician
for
the
1
correction
or
alleviation
of
neuromuscular
or
musculoskeletal
2
dysfunction,
disease,
injury,
or
deformity.
3
11.
“Pedorthist”
means
a
health
care
professional,
4
specifically
educated
and
trained
in
pedorthic
patient
5
care,
who
measures,
designs,
fabricates,
fits,
or
services
6
pedorthic
devices
and
may
assist
in
the
formulation
of
the
7
order
and
treatment
plan
of
pedorthic
devices
for
the
support
8
or
correction
of
disabilities
caused
by
neuromusculoskeletal
9
diseases,
injuries,
or
deformities.
10
12.
“Prosthesis”
means
an
artificial
medical
device
that
11
is
not
surgically
implanted
and
that
is
used
to
replace
a
12
missing
limb,
appendage,
or
any
other
external
human
body
part
13
including
an
artificial
limb,
hand,
or
foot.
14
13.
“Prosthetics”
means
the
science
and
practice
of
15
evaluating,
measuring,
designing,
fabricating,
assembling,
16
fitting,
adjusting,
or
servicing
a
prosthesis
under
an
order
17
from
a
licensed
physician.
18
14.
“Prosthetist”
means
a
health
care
professional,
19
specifically
educated
and
trained
in
prosthetic
patient
care,
20
who
measures,
designs,
fabricates,
fits,
or
services
prostheses
21
and
may
assist
in
the
formulation
of
the
order
and
treatment
22
plan
of
prostheses
for
the
replacement
of
external
parts
of
the
23
human
body
lost
due
to
amputation
or
congenital
deformities
or
24
absences.
25
15.
“Resident”
means
a
person
who
has
completed
an
education
26
program
in
either
orthotics
or
prosthetics
and
is
continuing
27
the
person’s
clinical
education
in
a
residency
accredited
by
28
the
national
commission
on
orthotic
and
prosthetic
education.
29
16.
“Residency”
means
an
approved
supervised
program
of
30
a
minimum
duration
of
one
year
to
acquire
practical
clinical
31
training
in
orthotics
or
prosthetics
in
a
patient
care
setting.
32
Sec.
8.
NEW
SECTION
.
148F.3
Duties
of
the
board.
33
The
board
shall
administer
this
chapter.
The
board’s
duties
34
shall
include
but
are
not
limited
to
the
following:
35
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1.
Adoption
of
rules
to
administer
and
interpret
this
1
chapter,
chapter
147,
and
chapter
272C
with
respect
to
the
2
education
and
licensing
of
orthotists,
prosthetists,
and
3
pedorthists.
4
2.
Adoption
of
rules
to
establish
accepted
standards
of
5
orthotic
and
prosthetic
scope
of
practice,
including
the
6
classification
of
devices.
7
3.
Adoption
of
rules
relating
to
professional
conduct
and
8
licensing
and
the
establishment
of
ethical
and
professional
9
standards
of
practice.
10
4.
Acting
on
matters
concerning
licensure
and
the
process
11
of
applying
for,
granting,
suspending,
imposing
supervisory
12
or
probationary
conditions
upon,
reinstating,
revoking,
or
13
renewing
a
license.
14
5.
Establishing
and
collecting
licensure
fees
as
provided
15
in
section
147.80.
16
6.
Developing
continuing
education
requirements
as
a
17
condition
of
license
renewal.
18
7.
Evaluating
requirements
for
licensure
in
other
states
to
19
determine
if
reciprocity
may
be
granted.
20
8.
Adoption
of
rules
providing
temporary
licensing
for
21
persons
providing
orthotic,
prosthetic,
and
pedorthic
care
22
in
this
state
prior
to
the
effective
date
of
this
Act.
A
23
temporary
license
is
good
for
no
more
than
one
year.
24
Sec.
9.
NEW
SECTION
.
148F.4
Persons
and
practices
not
25
affected.
26
This
chapter
does
not
prevent
or
restrict
the
practice,
27
services,
or
activities
of
any
of
the
following:
28
1.
A
person
licensed
in
this
state
by
any
other
law
from
29
engaging
in
the
profession
or
occupation
for
which
the
person
30
is
licensed.
31
2.
A
person
employed
as
an
orthotics,
prosthetics,
or
32
pedorthics
practitioner
by
the
government
of
the
United
States
33
if
that
person
practices
solely
under
the
direction
or
control
34
of
the
organization
by
which
the
person
is
employed.
35
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3.
A
person
pursuing
a
course
of
study
leading
to
a
degree
1
or
certificate
in
orthotics,
prosthetics,
or
pedorthics
in
an
2
educational
program
accredited
or
approved
according
to
rules
3
adopted
by
the
board,
if
the
activities
and
services
constitute
4
a
part
of
a
supervised
course
of
study
and
the
person
is
5
designated
by
a
title
which
clearly
indicates
the
person’s
6
status
as
a
student,
resident,
or
trainee.
7
Sec.
10.
NEW
SECTION
.
148F.5
Qualifications
for
licensure
8
as
orthotist,
prosthetist,
or
pedorthist.
9
1.
To
qualify
for
a
license
to
practice
orthotics
or
10
prosthetics,
a
person
shall
meet
the
following
requirements:
11
a.
Possess
a
baccalaureate
degree
from
a
college
or
12
university.
13
b.
Have
completed
the
amount
of
formal
training,
including
14
but
not
limited
to
an
orthotic
and
prosthetic
education
15
program,
and
clinical
practice
established
and
approved
by
the
16
board.
17
c.
Complete
a
clinical
residency
in
the
professional
area
18
for
which
a
license
is
sought
in
accordance
with
standards,
19
guidelines,
or
procedures
for
residencies
established
and
20
approved
by
the
board.
The
majority
of
training
must
be
21
devoted
to
services
performed
under
the
supervision
of
a
22
licensed
practitioner
of
orthotics
or
prosthetics
or
a
person
23
certified
as
a
certified
orthotist,
certified
prosthetist,
24
or
certified
prosthetist
orthotist
whose
practice
is
located
25
outside
the
state.
26
d.
Pass
all
written,
practical,
and
oral
examinations
that
27
are
required
and
approved
by
the
board.
28
e.
Be
qualified
to
practice
in
accordance
with
accepted
29
standards
of
orthotic
and
prosthetic
care
as
established
by
the
30
board.
31
2.
To
qualify
for
a
license
to
practice
pedorthics,
a
person
32
shall
meet
the
following
requirements:
33
a.
Submit
proof
of
a
high
school
diploma
or
its
equivalent.
34
b.
Have
completed
the
amount
of
formal
training,
including
35
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but
not
limited
to
a
pedorthic
education
program,
and
clinical
1
practice
established
and
approved
by
the
board.
2
c.
Complete
a
qualified
work
experience
program
or
3
internship
in
pedorthics
that
has
a
minimum
of
one
thousand
4
hours
of
pedorthic
patient
care
experience
in
accordance
5
with
any
standards,
guidelines,
or
procedures
established
6
and
approved
by
the
board.
The
majority
of
training
must
7
be
devoted
to
services
performed
under
the
supervision
of
a
8
licensed
practitioner
of
pedorthics
or
a
person
certified
as
9
a
certified
pedorthist
whose
practice
is
located
outside
the
10
state.
11
d.
Pass
all
examinations
that
are
required
and
approved
by
12
the
board.
13
e.
Be
qualified
to
practice
in
accordance
with
accepted
14
standards
of
pedorthic
care
as
established
by
the
board.
15
3.
The
standards
and
requirements
for
licensure
established
16
by
the
board
shall
be
substantially
equal
to
or
in
excess
of
17
standards
commonly
accepted
in
the
professions
of
orthotics,
18
prosthetics,
or
pedorthics,
as
applicable.
The
board
shall
19
adopt
rules
as
necessary
to
set
the
standards
and
requirements.
20
4.
A
person
may
be
licensed
in
more
than
one
discipline.
21
Sec.
11.
NEW
SECTION
.
148F.6
Assistants
and
technicians.
22
1.
a.
A
person
shall
not
work
as
an
assistant
to
an
23
orthotist
or
prosthetist
or
provide
patient
care
services
or
24
fabrication
of
orthoses
or
prostheses,
unless
the
work
is
25
performed
under
the
supervision
of
a
licensed
orthotist
or
26
prosthetist.
27
b.
An
assistant
may
perform
orthotic
or
prosthetic
28
procedures
and
related
tasks
in
the
management
of
patient
care.
29
An
assistant
may
also
fabricate,
repair,
and
maintain
orthoses
30
and
prostheses.
31
2.
a.
A
person
shall
not
work
as
a
technician
unless
32
the
work
is
performed
under
the
supervision
of
a
licensed
33
orthotist,
prosthetist,
or
pedorthist.
34
b.
A
technician
may
assist
a
person
licensed
under
this
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chapter
with
fabrication
of
orthoses,
prostheses,
or
pedorthic
1
devices
but
shall
not
provide
direct
patient
care.
2
Sec.
12.
NEW
SECTION
.
148F.7
Limitation
on
provision
of
3
care
and
services.
4
A
licensed
orthotist,
prosthetist,
or
pedorthist
may
provide
5
care
or
services
only
if
the
care
or
services
are
provided
6
pursuant
to
an
order
from
a
licensed
physician,
a
licensed
7
podiatric
physician,
an
advanced
registered
nurse
practitioner
8
who
has
a
written
collaborative
agreement
with
a
collaborating
9
physician
or
podiatric
physician
that
specifically
authorizes
10
ordering
the
services
of
an
orthotist,
prosthetist,
or
11
pedorthist,
an
advanced
registered
nurse
practitioner
who
12
practices
in
a
hospital
or
ambulatory
surgical
treatment
center
13
and
possesses
clinical
privileges
to
order
services
of
an
14
orthotist,
prosthetist,
or
pedorthist,
or
a
physician
assistant
15
who
has
been
delegated
the
authority
to
order
the
services
of
16
an
orthotist,
prosthetist,
or
pedorthist
by
the
assistant’s
17
supervising
physician.
A
licensed
podiatric
physician
or
an
18
advanced
registered
nurse
practitioner
collaborating
with
a
19
podiatric
physician
may
only
order
care
or
services
concerning
20
the
foot
from
a
licensed
prosthetist.
21
Sec.
13.
Section
272C.1,
subsection
6,
Code
2011,
is
amended
22
by
adding
the
following
new
paragraph:
23
NEW
PARAGRAPH
.
ag.
The
board
of
orthotics,
prosthetics,
and
24
pedorthics,
created
pursuant
to
chapter
147.
25
Sec.
14.
INITIAL
BOARD.
The
initial
members
of
the
board
of
26
orthotics,
prosthetics,
and
pedorthics
established
pursuant
to
27
this
Act
shall
be
appointed
to
the
following
terms:
28
1.
Two
professional
members
eligible
for
licensure
and
one
29
public
member
shall
be
appointed
for
a
term
of
two
years.
30
2.
One
professional
member
eligible
for
licensure
and
one
31
public
member
shall
be
appointed
for
a
term
of
one
year.
32
EXPLANATION
33
This
bill
creates
new
Code
chapter
148F
that
requires
34
the
licensure
of
persons
offering
orthotic,
prosthetic,
or
35
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pedorthic
services.
The
bill
provides
for
the
establishment
of
1
a
five-member
licensing
board
consisting
of
three
professional
2
members
and
two
members
who
represent
the
general
public.
3
The
bill
provides
for
fees
to
fund
the
board
and
provides
4
penalties
for
violation
of
the
practice
requirement.
The
5
penalties,
including
criminal
penalties,
are
set
out
for
all
6
health-related
boards
in
Code
chapters
147
and
272C.
The
board
7
is
similar
in
composition
and
responsibilities
to
the
other
8
health-related
licensing
boards.
9
Orthotics
is
the
science
and
practice
of
evaluating,
10
measuring,
designing,
fabricating,
assembling,
fitting,
11
adjusting,
or
servicing
a
custom-fabricated
or
custom-fitted
12
brace
or
support
for
the
correction
or
alleviation
of
13
neuromuscular
or
musculoskeletal
dysfunction,
disease,
injury,
14
or
deformity.
15
Pedorthics
is
the
science
and
practice
of
evaluating,
16
measuring,
designing,
fabricating,
assembling,
fitting,
17
adjusting,
or
servicing
a
specially
designed
shoe
or
shoe
18
insert
for
the
correction
or
alleviation
of
neuromuscular
or
19
musculoskeletal
dysfunction,
disease,
injury,
or
deformity.
20
Prosthetics
is
the
science
and
practice
of
evaluating,
21
measuring,
designing,
fabricating,
assembling,
fitting,
22
adjusting,
or
servicing
an
artificial
medical
device
that
is
23
not
surgically
implanted
and
that
is
used
to
replace
a
missing
24
limb,
appendage,
or
any
other
external
human
body
part.
25
The
bill
provides
qualifications
for
licensure
as
an
26
orthotist,
prosthetist,
or
pedorthist
and
requirements
for
27
assistants
and
technicians
to
be
supervised
by
such
licensees.
28
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