Re: Qualifications
Tony Barr
Description
Collection
Title:
Re: Qualifications
Creator:
Tony Barr
Date:
12/15/2005
Text:
OK, I waited a couple of hours to respond.
Thank you Terry. No question about historical perspective and hands on
experience and knowledge of the O&P industry.
I recommend to everyone to read Terry's published article Stricter
Standards Ensure Better Care and summaries of the Hotle and Moshi Reports
defining P&O services, curriculum content, practitioner training ,and the
role of research.
I would like to remind Terry and all the subscribers of this listserve,
that two years prior to the Harkin Bill and establishment of BIPA 2000,
Section 427 , and Neg Reg , this industry /profession had a chance to
introduce and establish federal provider qualifications on their own.
In May of 1998 , Florida US Congressman Robert Wexler , at my request, and
shortly after Fla.O&P Licensure Bill was passed, attempted to introduce
federal legislation Federal standards in O&P was (and is still) long
overdue.
The legslation was meant to mandate federal standards for O&P providers,
The draft bill was named the William G. Barr Amputee Protection Act ,
The bill, established the requirement of ABC certification as the only
educational pathway recognized by CAAHEP and the US Department of Education
and all providers would required to be ABC ceriifed or state
licensed.Current BOC certifees would be grandfathered.
It failed to gain the support of AOPA and NAAOP and never reached committee.
AOPA, cited reasons for not supporting the bill:
Congress Wexler is a freshman US Congressman and we dont want to put
all our eggs in one basket.
Coincidently, the president of AOPA at the time was William DeToro, who is
currently president of ABC.
I consider Bill a friend and that he had honorable intentions of uniting the
profession which it desperately needed to survive, by supporting ABC /BOC
unification.
However, I have great concerns of the conflicts in the incestuous and
musical chair approach of leadership from industry to professional and
accreditation organizations that has been occurring regularly since 1948.
I would like to remind Terry, that there were flickers of light early on
that soon turned to spitting matches at the NRM .
Having also been appointed to the Neg Reg fiasco, the early meetings had
generated visions of hope and consensus of agreement.
Believe it or not, the O&P industry members (NAAOP,AOPA,NOMA ) and the
professional interest groups (ABC , BOC,APTA , AOTA ,Coalition of Licensed
States), patient groups, AAOS and AAPM&R and others ALL initially agreed
to ONE point of consensus, all 26 members!
any and all qualified providers of comprehensive prosthetic devices and
services must be ABC /BOC certified or state licensed (within the respective
state's Scope of Services ) and within that particular allied health care
science , (O or P) to be considered qualified and receive reimbursement from
Medicare/Medicaid .
This was agreed to by all 26 members of NRM initially. Later consent was
withdrawn by most of the O&P groups, first led by the O&P industry
organizations.
Good faith was not displayed by any of the O&P , nor national PT/OT
groups.
I personally, in attempting to obtain consensus to the above, and in a
feeble attempt to resolve the growing feeling of distrust, magnified by
the retraction of the initial consensus (above), made a motion to the floor,
for the members to consider grandfathering the licensed PTS as qualified
O&P providers located in the states that already included within their
state regulation act, the legal authority and ability for PTs to provide
comprehensive O&P services ( there were no more than 10 states at the time)
and for all other licensed PTS (in the other 40 states) must agree to
become ABC/BOC certified of licensed in that particular allied health care
science to be deemed a qualified provider in the eyes of CMS.
Sounded reasonable to me since no one can undo state laws that already
provided PTs that right but the O&P groups refused to recognize this as a
alternative and discussions ended.
It soon became clear to me, knowing now that both O&P credentialing
associations condone the cross credentialing of their members, and do not
provide any oversight to their certifees, that these adversarial groups
would never reach consensus, without joint leadership, direction and support
from the medical community (i.e..AAOS & AAPM&R) and governmental agencies
such as CMS and MOST IMPORTANTLY others who fund research, education and /or
clinical services in O&P.
Don't count on the industry's or the physicals intervention.
The physicians, who determine the need of comprehensive O&P treatment , the
folks writing the prescriptions, members of AAOS and AAPM &R , for the over
20 million Americans with disabilities that require these services, remain
silent . Go figure !!
One might also ask, does a national trade industry association, really want
to risk limiting the number of their buyers of their members products ,by
supporting mandatory and higher qualifications for O&P providers?
Tony
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Terry Supan
Sent: Thursday, December 15, 2005 12:19 PM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] Qualifications
I would like to take the time to compliment both Jim and Carol for their
posting this morning. Carol and I have had several private messaged and I
am grateful for her further explanation today.
Jim, if anyone is offended by your thoughtful post, then they need to reread
it and think about what you said. As a former member of the AAOP, NCOPE,
CAAHEP, US-ISPO, ABC, CARF, and NRM boards/commission/committee, I will echo
your frustration with the whole situation. Having spent twenty-five years
working to help develop a professional pathway based on education and
clinical training, it became very disheartening to see BIPA 2000, Section
427 cut the foundation from under my profession.
I do not like what the ABC Board felt they had to do about trying to merge
the BOC accredited individuals into their ranks, but when the President
signed BIPA 2000, an Act of Congress stated that the ABC and BOC were equal.
One certification body with uniform standard, after any grandfathering, was
their goal. I am sure that the ABC negotiating team bargained in good faith
and I am also sure that irrespective of what the BOC board member wanted to
do, the BOC administration, as it had done several times in the past, caused
those negotiations to fail.
That same Act of Congress said that qualified physical therapist and
qualified occupational therapists could also be providers of custom
orthoses and prostheses. To almost everyone at the NRM that meant that the
therapists needed additional O&P education and clinical experience.
To the APTA qualified meant licensed and nothing more. Even though the
therapist members of the NRM committee admitted that the vast majority of
PTs would never fabricate and rarely fit a custom orthosis or prosthesis,
they still would not even discuss any compromise on their position. That is
why the NRM failed.
As for licensure, my only remaining official position is Vice Chair of the
Illinois O, P, & Ped Licensure Board. Ours is one of the tougher Practice
Acts which, since grandfathering ended in 2003, requires CAAHEP education,
NCOPE residency and passage of the complete ABC examination. There are no
$75 short cuts. IF you practice without a license or beyond your scope of
practice, you would be putting any other license at risk for ethical
violations. With the new CMS regulations it should be cut and dry in states
with licensure. (That is if the DMERCs follow the rules and don't make
another multi-million dollar mistake like they did in Miami.) To echo
Carol, the only way to regulate this
profession is through licensure. Certification is voluntary and only
affects those that are certified. Licensure gives you the privilege to
practice but it can always be taken away.
Terry Supan, CPO, FAAOP, FISPO
Jim DeWees wrote:
> ...
>
> Just as a warning, this will most likely offend many people out there.
> I am sorry if it does, but I am trying to be careful and avoid
> generalities. I will use specific issues, specific cases, but for
> these cases, there are many other ones very similar to what I am
> getting at.
>
> I decided to go into prosthetics after having an accident and becoming
> a BK amputee myself in 1998. I was already in the medical field,
> doing pathology at a university hospital for about 9 years. I had a
> couple choices to make...
******************** To unsubscribe, send a
message to: <Email Address Redacted> with the words UNSUB OANDP-L in the body
of the message.
If you have a problem unsubscribing,or have other questions, send e-mail to
the moderator Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics related to Orthotics and
Prosthetics.
Public commercial postings are forbidden. Responses to inquiries should not
be sent to the entire oandp-l list. Professional credentials or affiliations
should be used in all communications.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Thank you Terry. No question about historical perspective and hands on
experience and knowledge of the O&P industry.
I recommend to everyone to read Terry's published article Stricter
Standards Ensure Better Care and summaries of the Hotle and Moshi Reports
defining P&O services, curriculum content, practitioner training ,and the
role of research.
I would like to remind Terry and all the subscribers of this listserve,
that two years prior to the Harkin Bill and establishment of BIPA 2000,
Section 427 , and Neg Reg , this industry /profession had a chance to
introduce and establish federal provider qualifications on their own.
In May of 1998 , Florida US Congressman Robert Wexler , at my request, and
shortly after Fla.O&P Licensure Bill was passed, attempted to introduce
federal legislation Federal standards in O&P was (and is still) long
overdue.
The legslation was meant to mandate federal standards for O&P providers,
The draft bill was named the William G. Barr Amputee Protection Act ,
The bill, established the requirement of ABC certification as the only
educational pathway recognized by CAAHEP and the US Department of Education
and all providers would required to be ABC ceriifed or state
licensed.Current BOC certifees would be grandfathered.
It failed to gain the support of AOPA and NAAOP and never reached committee.
AOPA, cited reasons for not supporting the bill:
Congress Wexler is a freshman US Congressman and we dont want to put
all our eggs in one basket.
Coincidently, the president of AOPA at the time was William DeToro, who is
currently president of ABC.
I consider Bill a friend and that he had honorable intentions of uniting the
profession which it desperately needed to survive, by supporting ABC /BOC
unification.
However, I have great concerns of the conflicts in the incestuous and
musical chair approach of leadership from industry to professional and
accreditation organizations that has been occurring regularly since 1948.
I would like to remind Terry, that there were flickers of light early on
that soon turned to spitting matches at the NRM .
Having also been appointed to the Neg Reg fiasco, the early meetings had
generated visions of hope and consensus of agreement.
Believe it or not, the O&P industry members (NAAOP,AOPA,NOMA ) and the
professional interest groups (ABC , BOC,APTA , AOTA ,Coalition of Licensed
States), patient groups, AAOS and AAPM&R and others ALL initially agreed
to ONE point of consensus, all 26 members!
any and all qualified providers of comprehensive prosthetic devices and
services must be ABC /BOC certified or state licensed (within the respective
state's Scope of Services ) and within that particular allied health care
science , (O or P) to be considered qualified and receive reimbursement from
Medicare/Medicaid .
This was agreed to by all 26 members of NRM initially. Later consent was
withdrawn by most of the O&P groups, first led by the O&P industry
organizations.
Good faith was not displayed by any of the O&P , nor national PT/OT
groups.
I personally, in attempting to obtain consensus to the above, and in a
feeble attempt to resolve the growing feeling of distrust, magnified by
the retraction of the initial consensus (above), made a motion to the floor,
for the members to consider grandfathering the licensed PTS as qualified
O&P providers located in the states that already included within their
state regulation act, the legal authority and ability for PTs to provide
comprehensive O&P services ( there were no more than 10 states at the time)
and for all other licensed PTS (in the other 40 states) must agree to
become ABC/BOC certified of licensed in that particular allied health care
science to be deemed a qualified provider in the eyes of CMS.
Sounded reasonable to me since no one can undo state laws that already
provided PTs that right but the O&P groups refused to recognize this as a
alternative and discussions ended.
It soon became clear to me, knowing now that both O&P credentialing
associations condone the cross credentialing of their members, and do not
provide any oversight to their certifees, that these adversarial groups
would never reach consensus, without joint leadership, direction and support
from the medical community (i.e..AAOS & AAPM&R) and governmental agencies
such as CMS and MOST IMPORTANTLY others who fund research, education and /or
clinical services in O&P.
Don't count on the industry's or the physicals intervention.
The physicians, who determine the need of comprehensive O&P treatment , the
folks writing the prescriptions, members of AAOS and AAPM &R , for the over
20 million Americans with disabilities that require these services, remain
silent . Go figure !!
One might also ask, does a national trade industry association, really want
to risk limiting the number of their buyers of their members products ,by
supporting mandatory and higher qualifications for O&P providers?
Tony
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Terry Supan
Sent: Thursday, December 15, 2005 12:19 PM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] Qualifications
I would like to take the time to compliment both Jim and Carol for their
posting this morning. Carol and I have had several private messaged and I
am grateful for her further explanation today.
Jim, if anyone is offended by your thoughtful post, then they need to reread
it and think about what you said. As a former member of the AAOP, NCOPE,
CAAHEP, US-ISPO, ABC, CARF, and NRM boards/commission/committee, I will echo
your frustration with the whole situation. Having spent twenty-five years
working to help develop a professional pathway based on education and
clinical training, it became very disheartening to see BIPA 2000, Section
427 cut the foundation from under my profession.
I do not like what the ABC Board felt they had to do about trying to merge
the BOC accredited individuals into their ranks, but when the President
signed BIPA 2000, an Act of Congress stated that the ABC and BOC were equal.
One certification body with uniform standard, after any grandfathering, was
their goal. I am sure that the ABC negotiating team bargained in good faith
and I am also sure that irrespective of what the BOC board member wanted to
do, the BOC administration, as it had done several times in the past, caused
those negotiations to fail.
That same Act of Congress said that qualified physical therapist and
qualified occupational therapists could also be providers of custom
orthoses and prostheses. To almost everyone at the NRM that meant that the
therapists needed additional O&P education and clinical experience.
To the APTA qualified meant licensed and nothing more. Even though the
therapist members of the NRM committee admitted that the vast majority of
PTs would never fabricate and rarely fit a custom orthosis or prosthesis,
they still would not even discuss any compromise on their position. That is
why the NRM failed.
As for licensure, my only remaining official position is Vice Chair of the
Illinois O, P, & Ped Licensure Board. Ours is one of the tougher Practice
Acts which, since grandfathering ended in 2003, requires CAAHEP education,
NCOPE residency and passage of the complete ABC examination. There are no
$75 short cuts. IF you practice without a license or beyond your scope of
practice, you would be putting any other license at risk for ethical
violations. With the new CMS regulations it should be cut and dry in states
with licensure. (That is if the DMERCs follow the rules and don't make
another multi-million dollar mistake like they did in Miami.) To echo
Carol, the only way to regulate this
profession is through licensure. Certification is voluntary and only
affects those that are certified. Licensure gives you the privilege to
practice but it can always be taken away.
Terry Supan, CPO, FAAOP, FISPO
Jim DeWees wrote:
> ...
>
> Just as a warning, this will most likely offend many people out there.
> I am sorry if it does, but I am trying to be careful and avoid
> generalities. I will use specific issues, specific cases, but for
> these cases, there are many other ones very similar to what I am
> getting at.
>
> I decided to go into prosthetics after having an accident and becoming
> a BK amputee myself in 1998. I was already in the medical field,
> doing pathology at a university hospital for about 9 years. I had a
> couple choices to make...
******************** To unsubscribe, send a
message to: <Email Address Redacted> with the words UNSUB OANDP-L in the body
of the message.
If you have a problem unsubscribing,or have other questions, send e-mail to
the moderator Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics related to Orthotics and
Prosthetics.
Public commercial postings are forbidden. Responses to inquiries should not
be sent to the entire oandp-l list. Professional credentials or affiliations
should be used in all communications.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Tony Barr, “Re: Qualifications,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225894.
