Responses to question re: Oregon Licensure Bill

Responses to question re: Oregon Licensure Bill

Warren Mays

2/22/2007

Original question:

 

Our lobbyist, working towards passing a licensure bill here in Oregon, has
asked us to name a few of the states whom we feel have done the best job in
putting together a solid bill that protects the patients, the profession,
and punishes those who attempt to provide orthotic and prosthetic services
without a license. So.of those states out there who have passed licensure
bills, how do you think you've done? Whose state has produced the bill with
the sharpest teeth in dealing with violators?

 

Thanks to all who responded. It is clear that there are different opinions
as to the effectiveness of each states bill. It certainly seems, from your
opinions, that licensure does a good job of policing those who are licensed,
but little to penalize those who choose to ignore it.

 

Moving on, the way a profession licenses itself in Oregon is to first
approve and then appoint a board to actually come up with the licensure
rules. Did any of you have to also do it this way? Do you see any advantages
or disadvantages to this method? Apparently, we have no choice in using this
process here.

 

Finally, I want to ask another question of you: Can any of you site me an
example, without naming names, of an instance in your state, where a
non-certified person was reprimanded by their state for practicing without a
license, and what the penalty was? Please be sure to indicate what state you
practice in.

 

Thanks again,

 

Warren R Mays, CPO

 

And the responses are:

 

 

-I think that Illinois did a good job of drafting this legislation. It
upholds high standards for practitioners and protects the patients from
incompetence.

 

-I believe we have done a pretty good job in Georgia. It is a simple bill
without licenses for fitters, but only practitioners. If you go to the
Georgia Society of Orthotists and Prosthetists website, I don't have it
right in front of me but you can google it, there is a link to the language.
NOMA was the biggest problem we had of course. Feel free to call me if you
want to discuss it further.

 

 

-I would have to say the state I work in and that is Florida.. And cost the
most too.
It is not cheap being an Orthotist here.

 

 

-Those actively involved in creating and establishing a licensure bill for
the state of Oklahoma found out that manufactures of off the shelf orthotics
slipped in a provision that allows manufactures of DME and off the shelf
orthotics to practice as practitioners.

Jonathan Day, Chief of Prosthetics and Orthotics at the University of
Oklahoma Health and Sciences Center, was extremely involved in writing the
bill that should have been passed into law, without additional provisions
being added behind closed doors. Mr. Day's hind sight would be instrumental
in writing a successful bill.

 

 

-Don't look to Ohio. It has stopped no one from doing any type of O&P work
that isn't licensed and has just added more fees to the legit O&P people.

 

 

-I was involved in the writing of the statute for Florida, the first state
to implement licensure, and served on the Board for six years. My
observation is that each subsequent state passing licensure has a watered
down version of the original. This is due to several factors such as the
opponents being more skilled and prepared to water down the bill, the
drafters not having their goals sufficiently high, and the politics of
ABC/BOC. Above all remember the lobbyist doesn't really understand what you
are trying to achieve, and if you let them they will pass a bill that has
the least opposition but that doesn't necessarily do what you intended.

I suggest you first define what you want to accomplish then write the
statute to that end. Therefore if you believe education and training are
essential to the Profession of O&P then you must base your requirements on
those ideals, not some third-party standards that may change on a whim.
Likewise if you think sales reps shouldn't be fitting patients then you must
not allow the NOMA lobby to water down your bill.

Once you have your ideas on paper as a proposed bill I would like to
critique it. We found that the more educated opinions we received prior to
introducing the bill the less problems in passage.

 

 

-As you probably know Washington, in my opinion, has used the P & O
licensure as another source of revenue while offering next to no protection
from infringement. Just an example of state licensing without teeth.

 

-Florida has a very strong bill, with all oof the things that your lobbyist
is looking for. HOWEVER, as strong as the law is, there is little or no
enforcement. Most of the fines that have been levied were to those dumb
enough to appear before The Board and admit that they had been practicing
while still attempting to get their license.

The agency that is charged with enforcement has so few resources as to be
not only toothless, but also useless. They also take the view that
complaints filed by practitioners are mostly because of a competitive
problem and not really related to breach of the law so as to hurt the
patient population.

I'm not of the opinion that the public has been protected to the same extent
that many of my younger colleagues are. I've been branded as
anti-licensure, which I am not. However, If your results are no better than
those in Florida, the only good to come from your law will be your ability
to say that orthotists and prosthetists are licensed in Oregon.

Many orthotists/prosthetists in Florida believe that the practice has
assumed a higher level of competence because of licensure. I see no such
evidence.

Good luck and do your level best to know what you're getting. Remember, be
careful of what you wish for.

 

-Probably Florida

 

 

-Here in FL licensure has done a good job in policing the licensees but has
been very ineffective in penalizing the unqualified or non-licensed people.

 

 

-Alabama is just now really going after violators. We have had licensure
for several years. We have not seen teeth yet.

 

 

 -I like Florida's Lic/bill. It following ed. requirements, not so much
just to have a abc, or boc but they need to have a BA OR A BS degree.

 

 

- I believe you will find that any state with license legislation can shut
you down, if you violate the law.
The state would have to find you, or a complaint lodged against illegal
behavior. That is the situation with the Oklahoma legislation. Every state
without licensure can have any willing individual provide custom service.

 

 

-I have worked extensively on ky o&p bill. Call me and I will give you the
ins and outs.

 

 

-I was thinking about the licensure bill and the statement I've heard made,
that the only one's that licensure affects are the licensed individuals.
(not reps, PT's, anyone who chooses to bill insurances that accept them) I
haven't looked closely, but is there exclusionary language in our bill as to
who can actually provide the services, or just says that if you claim to be
an orthotist/prosthetist, must abide by the rules of the licensure.
Essentially, if it doesn't, then they will simply be regulating the ones who
actually know what they are doing, and no affect on the others. I know that
you know this, and this question that you posted is to address this, but may
be good for the Lobbyist to let the group sponsoring the bill know that we
agree with them, as long as we are not the only ones to pay and be governed.

 

 

Thanks again to all who responded.