Current through Register Vol. 49, No. 9, September, 2024
SECTION 3:
Definitions
1)
Act means the Arkansas
Orthotics, Prosthetics and Pedorthics Practice Act of 2007, as may be amended,
and codified at Ark. Code Ann. §
17-107-101 et seq.
2)
Advisory Board or
board means the Arkansas Orthotics, Prosthetics and Pedorthics
Advisory Board.
3)
Board for
Certification in Pedorthics has merged and is now known as the American
Board for Certification in Orthotics, Prosthetics, and Pedorthics,
Inc
4)
Board of Health
means the Arkansas State Board of Health.
5)
Department means the Arkansas
Department of Health.
6)
Custom Fabricated and Fitted Devices.
a. Custom fabricated and fitted device means
an orthosis, prosthesis, or pedorthic device which is fabricated to original
measurements or a mold for use by a patient in accordance with a prescription
from a health care practitioner authorized by law to write such prescriptions
and which requires substantial clinical and technical judgment in its design
and fitting.
b. Custom fitted
device means a prefabricated orthosis, prosthesis, or pedorthic device sized or
modified for use by the patient in accordance with a prescription from a health
care practitioner authorized by law to write such prescriptions and which
requires substantial clinical judgment and substantive alteration for
appropriate use.
c. Custom
fabricated devices and custom fabricated and fitted devices must be dispensed
by a licensed health care practitioner or by a person licensed under these
rules in accordance with a prescription from a licensed health care
practitioner.
7)
Off-the-shelf device means a prefabricated prosthesis or orthosis
sized or modified for use by the patient in accordance with a prescription from
a health care practitioner authorized by law to write such prescriptions and
which does not require substantial clinical judgment and substantive alteration
for appropriate use.
a. The sale of
over-the-counter and off-the-shelf devices by non-licensed persons is not
prohibited by these rules.
8)
Orthosis means an external
device that is:
a. Intended to restore
physiological function or cosmesis to a patient; and
b. Custom-designed, fabricated, assembled,
fitted, or adjusted for the patient using the device prior to or concurrent
with the delivery of the device to the patient.
c. Orthosis does not include a cane, crutch,
corset, dental appliance, elastic hose, elastic support, fabric support,
generic arch support, low-temperature plastic splint, soft cervical collar,
truss, or other similar device that:
i. Is
carried in stock and sold without therapeutic modification by a corset shop,
department store, drug store, surgical supply facility, or similar retail
entity; and
ii. Has no significant
impact on the neuromuscular, musculoskeletal, or neuromusculoskeletal functions
of the body.
9)
Orthotics means the science and practice of providing or managing
the provision of an orthosis based on clinical assessment, technical judgment,
and an order from a health care practitioner authorized by law to write an
order for an orthosis.
10)
Orthotic assistant means an individual who is licensed under this
chapter to assist an orthotist or an orthotist/prosthetist with patient care
services and fabrication of orthoses under the supervision of an orthotist or
an orthotist/prosthetist.
11)
Orthotic education program means a course of instruction in
orthotics:
a. Accredited by the Commission on
Accreditation of Allied Health Education Programs; and
b. Approved by the Advisory Board.
12)
Orthotic resident
means an individual who has completed an orthotic education program and is
continuing his or her clinical education in an orthotic residency program:
a. Accredited by the National Commission on
Orthotic and Prosthetic Education; and
b. Approved by the Advisory Board.
13) Orthotic/prosthetic assistant
means an individual who is licensed under this chapter to assist both an
orthotist and a prosthetist with patient care services and fabrication of
prostheses, orthoses, or pedorthic devices under the supervision of an
orthotist, an orthotist/prosthetist, or a prosthetist as appropriate.
14)
Orthotist means an
individual who is licensed under this chapter to practice orthotics and
pedorthics.
15)
Orthotist/prosthetist means an individual who is licensed to
practice orthotics, pedorthics, and prosthetics.
16)
Over-the-Counter means a
prefabricated, mass-produced device that is prepackaged and requires no
professional advice or judgment in either size selection or use, including
fabric or elastic supports, corsets, generic arch supports and elastic
hoses.
17)
Pedorthic
device means therapeutic footwear, foot orthoses for use at the ankle or
below, or footwear modified for therapeutic purposes as ordered by a licensed
health care practitioner authorized by law to write an order for a pedorthic
device. "Pedorthic device" does not include:
a. Nontherapeutic accommodative inlays or
nontherapeutic accommodative footwear regardless of method of
manufacture;
b. Shoes modified or
made for nontherapeutic purposes;
c. Unmodified shoes; or
d. Prefabricated foot care
products;.
18)
Pedorthic education program means a course of instruction in
pedorthics:
a. Accredited by the American
Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc.;
and
b. Approved by the Advisory
Board.
19)
Pedorthics means the science and practice of providing or managing
the provision of a pedorthic device based on clinical assessment, technical
judgment, and an order from a health care practitioner authorized by law to
write an order for a pedorthic device;
20)
Pedorthist means an
individual who is licensed under this chapter to practice pedorthics.
21)
Prefabricated device means a
mass-produced device that:
a. Is prepackaged,
carried in stock, and sold off the shelf or over the counter by a corset shop,
department store, drug store, surgical supply facility, or similar retail
entity; and
b. Does not require
clinical assessment, technical judgment, or therapeutic modification for
appropriate use by the customer.
c.
"Prefabricated device" may include a cane, a crutch, a corset, an elastic hose,
an elastic support, a fabric support, a generic arch support, a low-temperature
plastic splint, a soft cervical collar, a truss, or other similar
device.
22)
Prosthesis means an external device that is:
a. Intended to replace an absent external
body part for the purpose of restoring physiological function or cosmesis to a
patient; and
b. Custom-designed,
fabricated, assembled, fitted, or adjusted for the patient using the device
prior to or concurrent with being delivered to the patient.
c. "Prosthesis" does not include an
artificial eye, an artificial ear, a dental appliance, a cosmetic device, such
as artificial eyelashes or wigs, an artificial facial device, or other device
that does not have a significant impact on the neuromuscular, musculoskeletal,
or neuromusculoskeletal functions of the body.
23) Prosthetic assistant means an individual
who is licensed under this chapter to assist a prosthetist or
orthotist/prosthetist with patient care services and fabrication of prostheses
under the supervision of a prosthetist or an orthotist/prosthetist.
24)
Prosthetic education program
means a course of instruction in prosthetics:
a. Accredited by the Commission on
Accreditation of Allied Health Education Programs; and
b. Approved by the Advisory Board.
25)
Prosthetic
resident means an individual who has completed a prosthetic education
program and is continuing his or her clinical education in a prosthetic
residency program:
a. Accredited by the
National Commission on Orthotic and Prosthetic Education; and
b. Approved by the Advisory Board.
26)
Prosthetics means
the science and practice of providing or managing the provision of a prosthesis
based on clinical assessment, technical judgment, and an order from a health
care practitioner authorized to write an order for a prosthesis.
27)
Prosthetist means an
individual who is licensed under this chapter to practice
prosthetics.
28)
Therapeutic
Footwear. The following actions with respect to therapeutic footwear and
medical devices for the foot and ankle must be performed by a licensed health
care practitioner who is acting within his or her lawful scope of practice:
a. Modifications or additions to the interior
or exterior of footwear for therapeutic purposes, including but not limited to
heel lifts, outflare heels, Thomas heels, full sole lifts, wedged soles, rocker
bottom soles, metatarsal bars, metatarsal raises or inserts that have fillers
as part of their construction, toe fillers, and partial foot fillers;
b. Permanent or temporary attachment of an
orthosis to the footwear;
c.
Addition or modification of a removable or attached therapeutic foot device
inside the shoe which was fabricated based on a cast, impression, mold, scan,
imprint or tracing;
d. Creation of
an image of a person's foot or ankle through the use of a mold, cast, scanning
device, digital appliance, tracing, pressure sensitive device or other similar
device; and
e. Analysis,
evaluation, measurement, assessment, or screening of a foot for the purpose of
making a therapeutic recommendation.
SECTION 4:
Restrictions on the Practice
of Orthotists, Prosthetists and Pedorthists
1) A licensed orthotist, prosthetist or
pedorthist may provide care or services only if the care or services are
provided pursuant to an order from a licensed health care practitioner
authorized to issue such an order.
2) A licensed orthotist, prosthetist, or
pedorthist must provide services from a facility which has appropriate clinical
and laboratory space and equipment to allow that licensee to provide orthotic,
prosthetic, or pedorthic care.
3)
The scope of practice of a licensed orthotist, prosthetist, or pedorthist does
not include the right to diagnose a medical problem or condition or the right
to give medical advice as to the nature, cause, or treatment for the problem or
condition for which the orthosis, prosthesis, or pedorthic device is being
dispensed. However, the scope of practice of a licensed orthotist, prosthetist,
or pedorthist does include the right to provide information or demonstration or
training, regarding the proper use and care of the device and to make
adjustments to the device as needed.
4) Assistant orthotist/prosthetist must
practice within a one (1) hour radius of the supervising
practitioner.
5) A licensed
orthotist, prosthetist, or pedorthist may utilize one or more non-licensed
persons to assist in the provision of services, but the non-licensed person
shall be limited to the performance of minor repairs on devices which have been
previously dispensed to a patient.
SECTION 5:
Necessity of
Licensure
Upon promulgation of these Rules, no person shall practice
orthotics, prosthetics, or pedorthics in Arkansas, or hold himself or herself
out as being able to practice such professions, or dispense an orthosis,
prosthesis, or pedorthic device, unless such person is licensed in
Arkansas.
SECTION 6:
Qualifications for Licensure
1)
Orthotist - To qualify for a license to practice orthotics, a person shall:
a. Complete an orthotics education program
which is accredited by the Commission on Accreditation of Allied Health
Education Programs or its successor organization;
b. Possess a baccalaureate degree or have
successfully completed the number of semester hours equivalent to four (4)
years of study at a four-year college or university;
c. Successfully complete a clinical NCOPE
residency in orthotics; and
d.
Successfully complete ABCOPP Certification examination or equivalent as
required by the Advisory Board.
2) Prosthetist - To qualify for a license to
practice prosthetics, a person shall:
a.
Complete a prosthetics education program which is accredited by the Commission
on Accreditation of Allied Health Education Programs or its successor
organization;
b. Possess a
baccalaureate degree or have successfully completed the number of semester
hours equivalent to four (4) years of study at a four-year college or
university;
c. Successfully
complete a clinical NCOPE residency in prosthetics; and
d. Successfully complete ABCOPP Certification
examination or equivalent as required by the Advisory Board.
3) Pedorthist - To qualify for a
license to practice pedorthics a person shall:
a. Possess a high school diploma or
GED;
b. Possess the Certified
Pedorthotist credential from the American Board for Certification in Orthotics,
Prosthetics, and Pedorthics, Inc.; and
c. Successfully complete ABCOPP Certification
examination or equivalent as required by the Advisory Board.
4) Assistant - An applicant for
certification to practice as an orthotic assistant, prosthetic assistant, or
orthotic/prosthetic assistant shall submit to the written evidence, verified by
oath, that the applicant
a. Possesses a high
school diploma or GED;
b. Has a
minimum of five (5) years of experience in the field in which the person is
seeking licensure as an assistant; and
c. Has written documentation from a licensed
prosthetist or a licensed orthotist that the applicant is qualified to perform
as an assistant in the field in which the person is seeking licensure as the
assistant.
SECTION
7:
Procedures for Licensure
1) An applicant shall obtain a current
application packet from the Advisory Board, respond truthfully and completely
to every question or request for information contained in the application form,
and submit it, along with all documents and fees required, to the Department.
It is the intent of this Rule that all steps necessary to accomplish the filing
of the required documentation be completed prior to filing an application and
that all materials be filed simultaneously.
2) An applicant shall complete the
application with the supporting documentation proscribed to the Arkansas
Department of Health.
3) An
applicant shall disclose the circumstances surrounding any of the following:
a. Conviction of a crime in any country,
state, or municipality, except minor traffic violations;
b. The denial of certification or licensure
application by any other state or country, or the discipline of the certificate
holder or licensee in any state or country;
c. Loss, restriction, or voluntary surrender
of certification or licensure privileges; and
d. Any judgment or settlement in a civil suit
in which the applicant was a party defendant, including malpractice, unethical
conduct, breach of contract, or any other civil action remedy recognized by the
country's or state's statutory, common law, or case law.
4) When necessary, all required documents
shall be translated into English and such translation, together with the
original document, shall be certified as to authenticity by the issuing source.
Both versions must be submitted simultaneously.
5) Application review, approval, denial, and
interview decisions shall be made by the Advisory Board.
6) The requirement for licensure under these
Rules shall not apply to:
A person who is an employee of any bureau, division, or agency
of the federal government while in the discharge of the employee's official
duties;
a. A student enrolled in an
educational program at a college or university which will enable that student
to obtain a license to practice orthotics, prosthetics, or pedorthics upon
graduation from the program;
b. A
resident continuing such resident's clinical education in a residency
accredited by the National Commission on Orthotic and Prosthetic Education;
and
c. A student in a qualified
work experience program or internship in pedorthics.
7) Licensee shall notify the Advisory Board
within thirty (30) days of any:
a. Extension
of the discipline of practice,
b.
Name and address changes.
SECTION 8:
Examinations
1) An applicant for licensure as an
orthotist, prosthetist, or pedorthist must successfully complete and make a
passing score on the examination(s) approved and offered by the American Board
for Certification in Orthotics, Prosthetics and Pedorthics, Inc., the Board for
Certification in Pedorthics, or other examination(s) approved by the Advisory
Board.
2) Passing scores shall be
determined by the testing agencies and/or exam providers.
3) Examination fees shall be sent from the
applicant directly to the testing agencies and/or exam providers.
SECTION 9:
Fees
1) License fee for initial licensure and
renewal of licensure for the practice of orthotics, prosthetics, or pedorthics,
shall be three hundred dollars ($300) every two (2) years.
2) License fee for initial licensure and
renewal of licensure as an orthotic assistant, an orthotic/prosthetic assistant
or a prosthetic assistant shall be one hundred dollars ($100.00) every two (2)
years.
3) Late Renewal
$100.00.
4) Reinstatement
$300.00.
5) Reinstatement for
Assistant $100.00.
6) All fees are
non-refundable.
SECTION
10:
Renewal of Licensure
1) Licenses are valid through December 31st
of the expiration year.
2) Renewal
notifications will be sent by the Department Health Facility Services Section
of the Arkansas Department of Health, to the last address on file with the
Advisory Board. Failure to receive such notification does not relieve the
licensee from the responsibility of meeting all requirements for
renewal.
3) A license issued
pursuant to these rules is renewable by the expiration date. To be eligible for
renewal an individual must submit an application on or before the expiration
date the following:
a. A completed renewal
application form; and
b. The
renewal fee as required.
4) To be eligible for renewal an individual
must have completed the continuing education requirements and must attest to
such completion on the renewal application. An individual who fails to obtain
continuing education hours will be ineligible for renewal.
5) Any licensee who fails to renew his or her
license as provided in this section may be reinstated by the board on payment
of the renewal fee plus a late fee unless waived by the Board.
6) Reinstatement of a license that has
expired as a result of failure to timely renew may be accomplished upon meeting
the following conditions:
a. Payment of all
past due renewal fees;
b. Payment
of the late renewal fee; and
c.
Compliance with continuing education requirements.
SECTION 11:
Inactivation
& Reactivation
1) Inactive status:
a. An individual licensed or certified under
this chapter may place his or her license or certification on inactive status
by notifying the Advisory Board in writing.
b. The holder of an inactive license or
certification is excused from payment of renewal fees and shall not practice in
his or her area of licensure or certification in this state.
2) A person who holds an active
license may apply for inactive status in the following manner:
a. Obtain, complete, and submit to the
Advisory Board an affidavit of retirement form; and
b. Submit any supporting documentation which
may be required to the Advisory Board's administrative office.
3) A licensee whose certificate
has been inactivated may re-enter active status by doing the following:
a. Submit an application and pay the renewal
fee; and
b. Submit verification of
successful completion of continuing education hours for the period of
inactivity.
4) Any person
who engages in practice while his or her license or certification is inactive
shall be considered to be practicing without a license, which shall be grounds
for discipline under §
17-107-310.
SECTION 15:
Continuing Education
1) Required
hours;
a. Orthotists and prosthetists must
biennially complete thirty (30) hours of continuing education in courses
applicable to his/her profession. A person who is licensed in more than one (1)
profession under these rules shall biennially complete forty (40) hours of
continuing education in courses applicable to the professions in which he/she
is licensed.
b. Pedorthotists must
complete 22 hours biennially.
c.
Assistants must complete 15 hours if employed in one discipline or 20 hours if
employed in both, biennially.
d. At
least six (6) hours of the continuing education each year shall be offered to
licensees from providers in the state of Arkansas.
2) Acceptable continuing education shall
consist of courses provided, approved, or sponsored by:
a. The American Board for Certification in
Orthotics, Prosthetics and Pedorthics, Inc.;
b. The Board for Orthotist/Prosthetist
Certification;
c. The Pedorthic
Footwear Association;
d. Any other
entity whose education programs have been approved by the Advisory
Board.
3) Each licensee
must maintain proof of attendance and completion of all continuing education
requirements. This documentation must be retained for a period of four (4)
years from the end of the calendar year in which the continuing education was
required. This documentation must be produced for inspection and verification,
if requested in writing by the Advisory Board during its verification
process.
4) Each licensee must,
within thirty (30) days of a request from the Advisory Board, provide evidence
of continuing education activities. Certificates verifying the individual's
attendance or documents from course providers are such evidence.
5) Violations: Any person who falsely attests
to attendance and completion of the required hours of continuing education may
be subject to disciplinary action.
SECTION 16:
Severability
If any provision of these Rules and Regulations or the
application thereof to any person or circumstances is held invalid, such
invalidity shall not affect other provisions or applications of these Rules and
Regulations which can give effect without the invalid provisions or
applications and to this end the provision hereto are declared
severable.
Addendum A: Code of Ethics
1) PREAMBLE. The purpose of a code of ethics
is to acknowledge a professions acceptance of the responsibility and trust
conferred upon it by society and to recognize the internal obligations inherent
in that trust. The following paragraphs delineate the standards governing the
conduct of Orthotic, Prosthetic and Pedorthic Providers in their professional
interactions with patients, colleagues, other health professionals and the
general public. Realizing that no code can encompass all ethical
responsibilities of the Orthotic, Prosthetic and Pedorthic Providers, this
enumeration of obligations in the code of ethics is not comprehensive and does
not constitute a denial of the existence of other obligations, equally
imperative, and not specifically mentioned herein. This code of ethics shall be
binding on all Orthotic, Prosthetic and Pedorthic Providers in Arkansas.
a. CANON 1
Orthotic, Prosthetic and Pedorthic Providers must uphold the
dignity and honor of the profession, accept its disciplines and expose without
hesitation illegal, unethical and incompetent conduct.
INTERPRETIVE STATEMENTS
Orthotic, Prosthetic and Pedorthic Providers are part of a
collaborative effort to deliver proper health care to the patient under the
Orthotic, Prosthetic and Pedorthic Provider's care.
The Orthotic, Prosthetic and Pedorthic Provider has a personal,
as well as a professional, obligation to protect and safeguard the patients
from illegal and/or unethical actions or the incompetence of any person.
The Orthotic, Prosthetic and Pedorthic Provider must maintain
personal integrity and establish the appropriate means to fully protect his
freedom of conscience for the delivery of services to the patient.
The Orthotic, Prosthetic and Pedorthic Provider who
demonstrates incompetence or illegal conduct as it pertains to the Code of
Ethics shall be exposed to the proper authorities.
b. CANON 2
Orthotic, Prosthetic and Pedorthic Providers shall respect the
patient's rights and dignity and shall uphold the doctrine of confidentiality
regarding privileged patient information.
INTERPRETIVE STATEMENTS
Information about the patient's clinical situation will be kept
confidential, unless otherwise required by law, in order to protect the welfare
of an individual or community.
Written guidelines or protocols of an institution or department
may be instrumental in deciding the manner in which confidential information is
handled for release.
c.
CANON 3
Orthotic, Prosthetic and Pedorthic Providers shall provide only
those services for which they are qualified. Orthotic, Prosthetic and Pedorthic
Providers shall not misrepresent in any manner, either directly or indirectly,
their skills, training, professional credentials, identity or services.
INTERPRETIVE STATEMENTS
Orthotic, Prosthetic and Pedorthic Providers will accept
responsibility for the exercise of sound judgment in the delivery of services
to the patient and shall be accountable for the quality of the service
provided.
Orthotic, Prosthetic and Pedorthic Providers will provide
accurate information about the profession, and services they provide, as well
as the Orthotic, Prosthetic and Pedorthic Provider's own qualifications.
Orthotic, Prosthetic and Pedorthic Providers shall not engage
in practices beyond their competence or training.
Orthotic, Prosthetic and Pedorthic Providers shall not delegate
to a less qualified person any activity, which requires the unique skill,
knowledge and judgment of a formally educated Orthotic, Prosthetic and
Pedorthic Provider. Services rendered by supportive personnel will be under the
supervision of a formally educated Orthotic, Prosthetic and Pedorthic
Provider.
d. CANON 4
Orthotic, Prosthetic and Pedorthic Providers shall strive to
improve their medical knowledge and skills on a continuing basis.
INTERPRETIVE STATEMENTS
Orthotic, Prosthetic and Pedorthic Providers shall support
quality didactic and clinical education.
Professional conduct will be maintained toward Orthotic,
Prosthetic and Pedorthic Providers peers, students, medical staff and
patients.
Orthotic, Prosthetic and Pedorthic Providers shall participate
in educational activities, either by individual study or through continuing
education, which will enhance their basic knowledge in order to continue to
provide quality health care to the patient.
e. CANON 5
Orthotic, Prosthetic and Pedorthic Providers shall maintain and
promote high standards for their practice and include education, research and
scientific presentations and/or publications.
f. CANON 6
An Orthotic, Prosthetic and Pedorthic Provider shall at all
times hold the well-being of the patient to be paramount and shall not act in
such a way as to bring the member's interests into conflict with the patient's
interests. An Orthotic, Prosthetic and Pedorthic Provider shall deliver health
care services without regard to race, color, creed, national origin, sex, age,
religion, sexual preference or physical and/or mental condition.
INTERPRETIVE STATEMENTS
Orthotic, Prosthetic and Pedorthic Provider's practice and
adherence to ethical principles shall take preference over business practices.
Orthotic, Prosthetic and Pedorthic Providers shall place service before
material gain.
Orthotic, Prosthetic and Pedorthic Providers shall fully
disclose to clientele other business practices that may appear as conflict of
interest to clientele and/or public.
These may include but are not limited to:
1) Consultant for fee.
2) Clinical instructor (support staff for
industry).
3) Sales
representative.
4) Technical
advisor.
5) Lecture for
fee.
6) Acceptance of fees,
gratuities, funding from industry.
2) To this end, the State Board of Health
holds that each Orthotic, Prosthetic and Pedorthic Provider has the following
ethical and professional responsibilities:
a.
The Orthotic, Prosthetic and Pedorthic Provider will always attempt to fairly
evaluate all competing products and services, with the principal selection
criteria being that of regard for patient safety and well-being.
b. The Orthotic, Prosthetic and Pedorthic
Provider shall always base any decision on product and service selection on
clinical evaluations and documented clinical and scientific data.
In conclusion, it is the responsibility of the Orthotic,
Prosthetic and Pedorthic Provider to make decisions regarding the selection of
clinical products with the patient as the primary concern.
