US Politics Wexler / Harkin O&P Federal Legislation
Tony Barr
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Title:
US Politics Wexler / Harkin O&P Federal Legislation
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Tony Barr
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It is my understanding that the purpose of this listserver is to dissemenate information to all O&P practitioners.
It has also been used for AOPA to solicit a grassroots support effort for the Harkin Bill and it has been requested to
use AOPA has the proper clearinghouse!
So in the interest of the profession and the consumer and at the invitation of AOPA for non members to comment,
I would like to raise the below questions and concerns related to AOPA's recent endorsement of the Harkin bill.
For those that are not aware of it , there are two proposed O&P legislation bills that will soon be debated on the hill.
Supporters of each of the legislative proposals are looking for grassroots support from consumers and professionals.
AOPA has an investment of close to $300,000 and two years in the Harkin version.
Only a handfull of consumers, O&P professionals and disability rights organizations have two years and far less money invested in the Wexler version.
The Congressman Robert Wexler (D-FLA) HR 1938 version and Senator Thomas Harkin (D- IA) Senate 1451
I have reviewed a copy of each. I am not a legislation expert and understand that some form of meaningfull O&P legislation is better than none, but perhaps the Academy members can enlighten me, while they still exist as an independent professional organization.
It appears that the proposed Harkin version quidelines for educational standards are far less stringent, than is Wexlers's ABC (CAAHEP) quidelines. This does not appear to be inline with the mission statements of any the three O&P organizations,, perhaps soon to be one !, particullary ABC and the Academy's, of providing the highest possible standards of competency and ethical conduct.
The Harkin version provides 'qualification' of any certified practitioner , or non ABC facility , deemed qualified by the Secretary.
AOPA, supporter of the Harkin version, appears to be opening the doors to less than ABC qualified practitioners and to those that have no certification or lesser standards of ABC quidelines to comply.
There is far less substance and teeth in the Harkin version exposing the consumer to unqualified practitioners and other providers of O&P services that have less than highest standards that exist today.
Basic point of differences:
Practitioner Qualifications-Harkin specifies three ways to become QUALIFIED!
1. ABC certified or credentialed by a program approved by the Secretary. This may allow BOC or whatever to become a credentialing program. Highly likely, especially after they convinenced the VA into accepting their certification. Wexler's is somewhat better in this reguard in that it specifies the Secretary to adopt the requirements of only CAAHEP quidelines.
2. Licensed by the State. The problem is there are no requirements for minimal education, training, or testing. Currently all the license states fairly closely follow ABC, but there is nothing to prevent a state to accept much lower standards for license.This poor exemption may even encourage some states to pass license law, but without significant high standards and requirements.
3. Grandfather, allows for anyone with 10 years practice to become qualified. The Secretary would have wide latitude in making the rules which will determine what constitutes 10 years practice. Again, no minimum standards. Wexler's is better.
Wexler's HR 1938 mandates the Secretary to establish a process for certification' (his term for qualified and not to confused with ABC certified), by the Secretary, or by the State, or by a third party. He then requires O&P practitioners meet CAAHEP guidelines, no matter by which of the three methods above they are certified/qualified. This is good! Unless the Secretary goes against the guidelines of the law, every program approved will be based on essentially ABC certification.
Examples are the HALO brace, and scoliosis systems. I would like to see the bill opened up, all patients deserve the same protection not only those recieving custom devices. Additionally, most of the fraud sited by the OIG's report was of prefab items provided to inappropriate patients. This process would not have controlled this.
Have the members of the Academy and ABC practioners been notified as to the differences of both legislative bills?
Are they willing to compromise their code of standards and ethics in the spirit of compromise and for a path of less resistance?
Please understand I think that we all want the highest standards to be mandated to protect the consumer and to better ensure proper O&P coverages in the future.But by supporting the Harkin version are you not violating the Academy's bylaw and mission statement for the : attainment of the highest standards of technical competence and ethical conduct by its members, as well
as the ABC's mission to advance the highest levels of competency and ethics in the practice of orthotists and prosthetists ?
I am hopefull that meaningfull federal legislation will be passed . Ideally, perhaps the best scenario would be to blend the best aspects of both bills redefining terms and expanding the coverage for all P&O not just custom.
Would not a blended House and Senate version be better accepted with less resistance as non partisan legislation?
How do we generate mutual support and present a united front of this concept from members of AOPA, AAOP and ABC and BOC practitioners while they are still independent organizations???
Perhaps obtaining unilateral agreement would be a sign of things to come under the new consolidation proposal which will be decided next week!
Tony Barr
It has also been used for AOPA to solicit a grassroots support effort for the Harkin Bill and it has been requested to
use AOPA has the proper clearinghouse!
So in the interest of the profession and the consumer and at the invitation of AOPA for non members to comment,
I would like to raise the below questions and concerns related to AOPA's recent endorsement of the Harkin bill.
For those that are not aware of it , there are two proposed O&P legislation bills that will soon be debated on the hill.
Supporters of each of the legislative proposals are looking for grassroots support from consumers and professionals.
AOPA has an investment of close to $300,000 and two years in the Harkin version.
Only a handfull of consumers, O&P professionals and disability rights organizations have two years and far less money invested in the Wexler version.
The Congressman Robert Wexler (D-FLA) HR 1938 version and Senator Thomas Harkin (D- IA) Senate 1451
I have reviewed a copy of each. I am not a legislation expert and understand that some form of meaningfull O&P legislation is better than none, but perhaps the Academy members can enlighten me, while they still exist as an independent professional organization.
It appears that the proposed Harkin version quidelines for educational standards are far less stringent, than is Wexlers's ABC (CAAHEP) quidelines. This does not appear to be inline with the mission statements of any the three O&P organizations,, perhaps soon to be one !, particullary ABC and the Academy's, of providing the highest possible standards of competency and ethical conduct.
The Harkin version provides 'qualification' of any certified practitioner , or non ABC facility , deemed qualified by the Secretary.
AOPA, supporter of the Harkin version, appears to be opening the doors to less than ABC qualified practitioners and to those that have no certification or lesser standards of ABC quidelines to comply.
There is far less substance and teeth in the Harkin version exposing the consumer to unqualified practitioners and other providers of O&P services that have less than highest standards that exist today.
Basic point of differences:
Practitioner Qualifications-Harkin specifies three ways to become QUALIFIED!
1. ABC certified or credentialed by a program approved by the Secretary. This may allow BOC or whatever to become a credentialing program. Highly likely, especially after they convinenced the VA into accepting their certification. Wexler's is somewhat better in this reguard in that it specifies the Secretary to adopt the requirements of only CAAHEP quidelines.
2. Licensed by the State. The problem is there are no requirements for minimal education, training, or testing. Currently all the license states fairly closely follow ABC, but there is nothing to prevent a state to accept much lower standards for license.This poor exemption may even encourage some states to pass license law, but without significant high standards and requirements.
3. Grandfather, allows for anyone with 10 years practice to become qualified. The Secretary would have wide latitude in making the rules which will determine what constitutes 10 years practice. Again, no minimum standards. Wexler's is better.
Wexler's HR 1938 mandates the Secretary to establish a process for certification' (his term for qualified and not to confused with ABC certified), by the Secretary, or by the State, or by a third party. He then requires O&P practitioners meet CAAHEP guidelines, no matter by which of the three methods above they are certified/qualified. This is good! Unless the Secretary goes against the guidelines of the law, every program approved will be based on essentially ABC certification.
Examples are the HALO brace, and scoliosis systems. I would like to see the bill opened up, all patients deserve the same protection not only those recieving custom devices. Additionally, most of the fraud sited by the OIG's report was of prefab items provided to inappropriate patients. This process would not have controlled this.
Have the members of the Academy and ABC practioners been notified as to the differences of both legislative bills?
Are they willing to compromise their code of standards and ethics in the spirit of compromise and for a path of less resistance?
Please understand I think that we all want the highest standards to be mandated to protect the consumer and to better ensure proper O&P coverages in the future.But by supporting the Harkin version are you not violating the Academy's bylaw and mission statement for the : attainment of the highest standards of technical competence and ethical conduct by its members, as well
as the ABC's mission to advance the highest levels of competency and ethics in the practice of orthotists and prosthetists ?
I am hopefull that meaningfull federal legislation will be passed . Ideally, perhaps the best scenario would be to blend the best aspects of both bills redefining terms and expanding the coverage for all P&O not just custom.
Would not a blended House and Senate version be better accepted with less resistance as non partisan legislation?
How do we generate mutual support and present a united front of this concept from members of AOPA, AAOP and ABC and BOC practitioners while they are still independent organizations???
Perhaps obtaining unilateral agreement would be a sign of things to come under the new consolidation proposal which will be decided next week!
Tony Barr
Citation
Tony Barr, “US Politics Wexler / Harkin O&P Federal Legislation,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/212692.
