Replies to Assistant Question
Hewey, Bernard
Description
Collection
Title:
Replies to Assistant Question
Creator:
Hewey, Bernard
Date:
2/23/2011
Text:
Hi Everyone,
Below are replies I have received so far concerning the Assistant credential. It appears that there are many federal and state regulatory and stakeholder issues impacting this element of the O&P care continuum.
Original post:
Hi to Everyone,
I would like to ask members of the listserv how the current Assistant credential's experiential requirement is being addressed on the state level, especially in those states with licensure. My impression is that the 2-year experiential requirement would be problematic in the regulated states where there is no specific language allowing for assistant-level patient care. Among the questions I have are:
* Are there efforts underway to amend legislation to include assistants?
* How are state-level professional associations responding to this?
* How are employers looking at the assistant in their business models?
I hope to use any information received to provide perspective on these issues for a presentation I will be giving on emerging trends in the O&P profession. Thank you in advance for any information and insight.
Replies:
To my knowledge there are no efforts underway in Florida to amend legislation to include assistants. Currently the law allows for qualified supervising licensed staff to provide direct supervision for assigned support staff to provide care. The supervisor assumes the responsibility for the outcome of care while utilizing support staff.
Support staff qualifications are determined by the qualified supervising licensed practitioner.
However; the qualified licensed practitioner must assess the patient needs; prior to assigning tasks to support personnel and must check the device following completion of the assigned tasks and prior to delivery of devices.
I have not heard of any activity by the state association to do anything regarding the inclusion of the assistant into state licensure legislation. The assistants would be treated as support staff personnel requiring direct supervision under the current law, since the credential is not recognized.
Please find the Texas board rules on Licensed Assistants
<URL Redacted> ( I placed this link in lieu of the author's original full statute text in the interest of reducing space)
Feel free to contact me if you have any questions.
Is an assistant or fitter considered the same as a certified orthotist or prosthetist in the eyes of the law? Below is a link to the Medi-Cal definition of qualifications.
CERTIFICATION
Prior to applying to Medi-Cal, first check the American Board for Certification in Orthotics and Prosthetics website at www.abcop.org< <URL Redacted>> or the Board for Orthotist/Prosthetist Certification website at www.bocusa.org< <URL Redacted>>. The state of California currently does not require state licensure for Orthotists, however, to enroll as a Medi-Cal Orthotics Provider, ABC Certification in Orthotics or BOPC Certification in Orthotics is necessary. Currently, Medi-Cal does not enroll Registered Assistants, Technicians and/or Certified Fitters as providers.
Required Documents
Next, make legible copies of current documents that are required to be submitted with your Medi-Cal application forms, as listed below.
1. Certification as an Orthotics Practitioner from ABCOP or BOC
Link is at: http://www.dhcs.ca.gov/provgovpart/Pages/OrthotistApplicationPackage.aspx
There is not and there will not be a license for assistants in IL. Assistants and technicians must be supervised by licensees. You can review the Practice Act & Administrative Rules through the website. <idfpr.com< http://idfpr.com >>
Speaking in regards to Florida
We have in place a statutory method to deal with assistants. In our statute is a provision for support personnel. The statute defines the duties of both the supervising practitioner and the support person, and then the rules further flesh out the scope of practice and standards of care for each. Unfortunately when we crafted our law 12 years ago there was no Assistant and ABC did not want, for whatever reason, to create/redo the standard. We had language to include an assistant, but without a national standard for education, training, and examination we chose not to include. At that time it would have been relatively easy to include in the statute. Presently it is unlikely we would reopen our statute to add an Assistant license/registration. Every time you open the statute you place everything on the table, allowing folks with less then good intentions to muck up a good law. Plus its expensive, and I can't see ABC handing over $$thousands to get it implemented. We did add a method to register residents, and ABC didn't fork over any money there either.
The other license states are much less tightly worded then Florida's so I don't know how they will cope, or even if they can address without a major legislative change.
From an employers standpoint, especially in a license state, I don't see a benefit to paying increased salary for a Certified Assistant who can't produce additional revenue over what my license law already allows. There may be some merit in having your assistants credentialed from the standpoint of legal defense in case of litigation.
The states without license law are the ones that really need to be vigilant. Since the assistant will be Certified by ABC/BOC, does it mean they can apply for and receive a Medicare provider number? How about the other 3rd party payers? They consider us DME now, so how will they segregate the Certified Assistant from the Certified Orthotist from the wheelchair dealer?
Besides the licensure aspect, you completely missed Social Security Act section 1834(h)(1)(F). With this law, it does not matter if it is a licensure state or not. In fact, this is part of the OIG 2011 work plan. Should you have questions, you may want to run this aspect by a lawyer.
Personally, I will get as many assistants as my bosses will let me. With right people and under right supervision, it is a huge relief on practitioners.
As of the other 2 questions, it's a great one. I am most curious how it will work out, as I already have one guy almost done for as assistant.
________________________________
Thanks to everyone who replied. I seems that here are many layers of this onion yet to be peeled away before the Assistant can truly be realized.
Bernard Hewey, Instructor
Orthotics-Prosthetics Technology Program
Spokane Falls Community College
3410 W. Fort George Wright Drive MS 3190
Spokane, WA 99224-5288
Phone (509) 533-3733
Fax (509) 533-4143
<Email Address Redacted> <mailto:<Email Address Redacted>>
Below are replies I have received so far concerning the Assistant credential. It appears that there are many federal and state regulatory and stakeholder issues impacting this element of the O&P care continuum.
Original post:
Hi to Everyone,
I would like to ask members of the listserv how the current Assistant credential's experiential requirement is being addressed on the state level, especially in those states with licensure. My impression is that the 2-year experiential requirement would be problematic in the regulated states where there is no specific language allowing for assistant-level patient care. Among the questions I have are:
* Are there efforts underway to amend legislation to include assistants?
* How are state-level professional associations responding to this?
* How are employers looking at the assistant in their business models?
I hope to use any information received to provide perspective on these issues for a presentation I will be giving on emerging trends in the O&P profession. Thank you in advance for any information and insight.
Replies:
To my knowledge there are no efforts underway in Florida to amend legislation to include assistants. Currently the law allows for qualified supervising licensed staff to provide direct supervision for assigned support staff to provide care. The supervisor assumes the responsibility for the outcome of care while utilizing support staff.
Support staff qualifications are determined by the qualified supervising licensed practitioner.
However; the qualified licensed practitioner must assess the patient needs; prior to assigning tasks to support personnel and must check the device following completion of the assigned tasks and prior to delivery of devices.
I have not heard of any activity by the state association to do anything regarding the inclusion of the assistant into state licensure legislation. The assistants would be treated as support staff personnel requiring direct supervision under the current law, since the credential is not recognized.
Please find the Texas board rules on Licensed Assistants
<URL Redacted> ( I placed this link in lieu of the author's original full statute text in the interest of reducing space)
Feel free to contact me if you have any questions.
Is an assistant or fitter considered the same as a certified orthotist or prosthetist in the eyes of the law? Below is a link to the Medi-Cal definition of qualifications.
CERTIFICATION
Prior to applying to Medi-Cal, first check the American Board for Certification in Orthotics and Prosthetics website at www.abcop.org< <URL Redacted>> or the Board for Orthotist/Prosthetist Certification website at www.bocusa.org< <URL Redacted>>. The state of California currently does not require state licensure for Orthotists, however, to enroll as a Medi-Cal Orthotics Provider, ABC Certification in Orthotics or BOPC Certification in Orthotics is necessary. Currently, Medi-Cal does not enroll Registered Assistants, Technicians and/or Certified Fitters as providers.
Required Documents
Next, make legible copies of current documents that are required to be submitted with your Medi-Cal application forms, as listed below.
1. Certification as an Orthotics Practitioner from ABCOP or BOC
Link is at: http://www.dhcs.ca.gov/provgovpart/Pages/OrthotistApplicationPackage.aspx
There is not and there will not be a license for assistants in IL. Assistants and technicians must be supervised by licensees. You can review the Practice Act & Administrative Rules through the website. <idfpr.com< http://idfpr.com >>
Speaking in regards to Florida
We have in place a statutory method to deal with assistants. In our statute is a provision for support personnel. The statute defines the duties of both the supervising practitioner and the support person, and then the rules further flesh out the scope of practice and standards of care for each. Unfortunately when we crafted our law 12 years ago there was no Assistant and ABC did not want, for whatever reason, to create/redo the standard. We had language to include an assistant, but without a national standard for education, training, and examination we chose not to include. At that time it would have been relatively easy to include in the statute. Presently it is unlikely we would reopen our statute to add an Assistant license/registration. Every time you open the statute you place everything on the table, allowing folks with less then good intentions to muck up a good law. Plus its expensive, and I can't see ABC handing over $$thousands to get it implemented. We did add a method to register residents, and ABC didn't fork over any money there either.
The other license states are much less tightly worded then Florida's so I don't know how they will cope, or even if they can address without a major legislative change.
From an employers standpoint, especially in a license state, I don't see a benefit to paying increased salary for a Certified Assistant who can't produce additional revenue over what my license law already allows. There may be some merit in having your assistants credentialed from the standpoint of legal defense in case of litigation.
The states without license law are the ones that really need to be vigilant. Since the assistant will be Certified by ABC/BOC, does it mean they can apply for and receive a Medicare provider number? How about the other 3rd party payers? They consider us DME now, so how will they segregate the Certified Assistant from the Certified Orthotist from the wheelchair dealer?
Besides the licensure aspect, you completely missed Social Security Act section 1834(h)(1)(F). With this law, it does not matter if it is a licensure state or not. In fact, this is part of the OIG 2011 work plan. Should you have questions, you may want to run this aspect by a lawyer.
Personally, I will get as many assistants as my bosses will let me. With right people and under right supervision, it is a huge relief on practitioners.
As of the other 2 questions, it's a great one. I am most curious how it will work out, as I already have one guy almost done for as assistant.
________________________________
Thanks to everyone who replied. I seems that here are many layers of this onion yet to be peeled away before the Assistant can truly be realized.
Bernard Hewey, Instructor
Orthotics-Prosthetics Technology Program
Spokane Falls Community College
3410 W. Fort George Wright Drive MS 3190
Spokane, WA 99224-5288
Phone (509) 533-3733
Fax (509) 533-4143
<Email Address Redacted> <mailto:<Email Address Redacted>>
Citation
Hewey, Bernard, “Replies to Assistant Question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 17, 2024, https://library.drfop.org/items/show/232334.
