Senate File 294 - Introduced SENATE FILE 294 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO SF 150) A BILL FOR An Act relating to persons offering orthotic, prosthetic, and 1 pedorthic services to the public, and relating to the scope 2 of orthotic, prosthetic, and pedorthic services which may 3 be ordered by certain health care providers, and including 4 transition provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1532SV (1) 85 jr/sc

S.F. 294 Section 1. Section 148F.2, subsections 2 and 4, Code 2013, 1 are amended to read as follows: 2 2. “Orthosis” means a custom-fabricated or custom-fitted 3 brace or support designed to provide for alignment, correction, 4 or prevention of neuromuscular or musculoskeletal dysfunction, 5 disease, injury, or deformity. “Orthosis” does not include 6 fabric or elastic supports, corsets, arch supports, low 7 temperature plastic splints, trusses, elastic hoses hose , 8 canes, crutches, soft cervical collars, dental appliances, 9 or other similar devices carried in stock and sold as 10 “over-the-counter” items by a drug store, department store, 11 corset shop, or surgical supply facility. 12 4. “Orthotic and prosthetic scope of practice” means a 13 list of tasks, with relative weight given to such factors as 14 importance, criticality, and frequency, based on nationally 15 accepted standards of orthotic and prosthetic care as 16 outlined by the American board for certification in orthotics, 17 prosthetics, and pedorthics , incorporated . 18 Sec. 2. Section 148F.2, subsection 3, unnumbered paragraph 19 1, Code 2013, is amended to read as follows: 20 “Orthotic and prosthetic education program” means a course 21 of instruction accredited by the national commission on 22 accreditation of allied health education programs, consisting 23 of both of the following: 24 Sec. 3. Section 148F.2, subsection 8, unnumbered paragraph 25 1, Code 2013, is amended to read as follows: 26 “Pedorthic education program” means an educational program 27 accredited by the American board for certification in 28 orthotics, prosthetics, and pedorthics approved by the national 29 commission on orthotic and prosthetic education consisting of 30 all of the following: 31 Sec. 4. Section 148F.2, subsections 9 and 16, Code 2013, are 32 amended to read as follows: 33 9. “Pedorthic scope of practice” means a list of tasks 34 with relative weight given to such factors as importance, 35 -1- LSB 1532SV (1) 85 jr/sc 1/ 4

S.F. 294 criticality, and frequency based on nationally accepted 1 standards of pedorthic care as outlined by the American board 2 for certification in orthotics, prosthetics , and pedorthics , 3 incorporated . 4 16. “Resident” means a person who has completed an education 5 program in either orthotics or prosthetics and is continuing 6 the person’s clinical education in a residency accredited by 7 the American board for certification in orthotics, prosthetics 8 and pedorthics national commission on orthotic and prosthetic 9 education . 10 Sec. 5. Section 148F.5, subsection 2, paragraph c, Code 11 2013, is amended to read as follows: 12 c. Complete a qualified work clinical experience program 13 or internship in pedorthics that has a minimum of one thousand 14 hours of pedorthic patient care experience in accordance 15 with any standards, guidelines, or procedures established 16 and approved by the board. The majority of training must 17 be devoted to services performed under the supervision of a 18 licensed orthotist or licensed practitioner of pedorthics or a 19 person certified as a certified pedorthist whose practice is 20 located outside the state. 21 Sec. 6. Section 148F.7, Code 2013, is amended to read as 22 follows: 23 148F.7 Limitation on provision of care and services. 24 A licensed orthotist, prosthetist, or pedorthist may provide 25 care or services only if the care or services are provided 26 pursuant to an order from a licensed physician, a licensed 27 podiatric physician, an advanced registered nurse practitioner 28 who has a written collaborative agreement with a collaborating 29 physician or podiatric physician that specifically authorizes 30 ordering the services of an orthotist, prosthetist, or 31 pedorthist, an advanced registered nurse practitioner who 32 practices in a hospital or ambulatory surgical treatment center 33 and possesses clinical privileges to order services of an 34 orthotist, prosthetist, or pedorthist licensed pursuant to 35 -2- LSB 1532SV (1) 85 jr/sc 2/ 4

S.F. 294 chapter 152 or 152E , or a physician assistant who has been 1 delegated the authority to order the services of an orthotist, 2 prosthetist, or pedorthist by the assistant’s supervising 3 physician. A licensed podiatric physician or an advanced 4 registered nurse practitioner collaborating with a podiatric 5 physician may only order care or services concerning the foot 6 from a licensed pedorthist or orthotist. 7 Sec. 7. NEW SECTION . 148F.9 Transition period. 8 1. Through June 30, 2014, a person certified as an 9 orthotist, prosthetist, or pedorthist by the American board 10 for certification in orthotics, prosthetics, and pedorthics, 11 incorporated, or holding similar certification from other 12 accrediting bodies, may apply for and may be issued an initial 13 license to practice orthotics, prosthetics, or pedorthics under 14 the provisions of this chapter without meeting the requirements 15 of section 148F.5, upon proof of current certification in good 16 standing and payment of the required licensure fees. 17 2. Through June 30, 2014, a person not certified as 18 described in subsection 1 who has practiced continuously 19 for at least thirty hours per week on average for at least 20 five of seven years in an accredited and bonded facility 21 as an orthotist, prosthetist, or pedorthist may file an 22 application with the board to continue to practice orthotics, 23 prosthetics, or pedorthics. The practice described under this 24 subsection shall only be required to have been performed in 25 an accredited and bonded facility if the facility is required 26 to be accredited and bonded by Medicare. The five years of 27 continuous practice must occur between July 1, 2007, and July 28 1, 2014. A person applying under this subsection may be 29 issued an initial license to practice orthotics, prosthetics, 30 or pedorthics under the provisions of this chapter without 31 meeting the requirements of section 148F.5, upon payment of the 32 licensure fees required by the department and after the board 33 has reviewed the application. 34 3. On or after July 1, 2014, an applicant for licensure 35 -3- LSB 1532SV (1) 85 jr/sc 3/ 4

S.F. 294 as an orthotist, prosthetist, or pedorthist shall meet the 1 requirements of section 148F.5. 2 4. The board shall adopt rules to administer this section. 3 EXPLANATION 4 This bill contains several amendments to Code chapter 148F 5 regulating orthotic, prosthetic, and pedorthic practice and 6 services. The name of the national organization which approves 7 the course of instruction has been changed, and the bill makes 8 related conforming changes. The bill also provides that the 9 work component of the licensing requirement include a clinical 10 component and eliminates provisions for internships. 11 The bill strikes a provision in Code section 148F.7 that 12 specified circumstances under which a licensed advanced 13 registered nurse practitioner could order care or services 14 concerning the foot from a licensed pedorthist or orthotist, 15 and, instead, generally gives a licensed advanced registered 16 nurse practitioner that authority. 17 The bill creates a transition period through June 30, 18 2014, allowing persons who are certified as an orthotist, 19 prosthetist, or pedorthist by a national organization or who 20 have worked continuously as an orthotist, prosthetist, or 21 pedorthist for five of seven specified years to be licensed 22 without otherwise meeting the requirements of Code chapter 23 148F. 24 -4- LSB 1532SV (1) 85 jr/sc 4/ 4