Custom bracing available from online vendors
Anne Dubois
Description
Collection
Title:
Custom bracing available from online vendors
Creator:
Anne Dubois
Date:
3/27/2013
Text:
I was hoping to get some input from Florida practitioners regarding the online sale of custom braces.
betterbraces.com sells a custom DonJoy Defiance III on it's website for $899.99. According to them, after the payment has cleared, you get the opportunity to be custom fitted by one of the DonJoy bracing experts. I did some research into these bracing experts. They are Florida licensed CNAs.
As many hoops as I had to jump through to be able to measure for and fit custom braces without supervision in the state of Florida, I assumed our licensure law would prohibit CNAs from legally doing the same thing I do. Most of you reading this have spent great time, effort, and expense becoming orthotists. To put it in perspective, a CNA needs no formal training. They merely need a high school diploma (or equivalent) and to pass a 50 question, multiple choice test. If they are unable to read English, the test can be administered orally in English or Spanish.
The disturbing part (the part I really hope I'm wrong about) is what the Florida statutes read concerning the practice of orthotics and exemption from licensure.
The following was taken directly from Chapter 468, Part XIV, Florida Statutes: Orthotists & Prosthetists Practice Act< <URL Redacted>>2012->Chapter%20468->Part%20XIV>. This is Florida statute 468.812 Exemptions from licensure:
(2) This part does not require an additional license of, or regulate the practice of, any other licensed health care professional within the state, or prevent a qualified member of any other profession or any person employed under the supervision of such a licensed professional from doing work of a nature consistent with that person's training, as long as the person does not hold himself or herself out to the public as a licensee under this act.
I'm not a lawyer, but it sounds to me like any other healthcare professional who holds a license in ANYTHING can perform the duties of an orthotist as long as it pertains to their job and they do not call themselves orthotists. In short, this statute exempts them from all of those laws governing us.
But is providing custom knee braces really within the scope of practice of a CNA? According to Florida statute 464.201 (Definitions):
(5) Practice of a certified nursing assistant means providing care and assisting persons with tasks relating to the activities of daily living. Such tasks are those associated with personal care, maintaining mobility, nutrition and hydration, toileting and elimination, assistive devices, safety and cleanliness, data gathering, reporting abnormal signs and symptoms, postmortem care, patient socialization and reality orientation, end-of-life care, cardiopulmonary resuscitation and emergency care, residents' or patients' rights, documentation of nursing-assistant services, and other tasks that a certified nurse assistant may perform after training beyond that required for initial certification and upon validation of competence in that skill by a registered nurse.
So, a knee brace helps a patient maintain mobility. And measuring for a fitting custom orthotic devices seems be a task associated with maintaining mobility. So does casting or scanning an AK, sending it to C-Fab, fitting it, and adjusting it, for that matter. It seems we have no legal recourse to prevent CNAs from practicing orthotics or prosthetics, we can only prohibit them from using the title orthotist or prosthetist.
As I said, I truly hope I am wrong but, if not, I think the statutes need to be revised to prevent the online sale of custom braces which are measured and fit by CNAs before they expand to providing more custom orthotics and prosthetics.
Anne DuBois, CO,LO
betterbraces.com sells a custom DonJoy Defiance III on it's website for $899.99. According to them, after the payment has cleared, you get the opportunity to be custom fitted by one of the DonJoy bracing experts. I did some research into these bracing experts. They are Florida licensed CNAs.
As many hoops as I had to jump through to be able to measure for and fit custom braces without supervision in the state of Florida, I assumed our licensure law would prohibit CNAs from legally doing the same thing I do. Most of you reading this have spent great time, effort, and expense becoming orthotists. To put it in perspective, a CNA needs no formal training. They merely need a high school diploma (or equivalent) and to pass a 50 question, multiple choice test. If they are unable to read English, the test can be administered orally in English or Spanish.
The disturbing part (the part I really hope I'm wrong about) is what the Florida statutes read concerning the practice of orthotics and exemption from licensure.
The following was taken directly from Chapter 468, Part XIV, Florida Statutes: Orthotists & Prosthetists Practice Act< <URL Redacted>>2012->Chapter%20468->Part%20XIV>. This is Florida statute 468.812 Exemptions from licensure:
(2) This part does not require an additional license of, or regulate the practice of, any other licensed health care professional within the state, or prevent a qualified member of any other profession or any person employed under the supervision of such a licensed professional from doing work of a nature consistent with that person's training, as long as the person does not hold himself or herself out to the public as a licensee under this act.
I'm not a lawyer, but it sounds to me like any other healthcare professional who holds a license in ANYTHING can perform the duties of an orthotist as long as it pertains to their job and they do not call themselves orthotists. In short, this statute exempts them from all of those laws governing us.
But is providing custom knee braces really within the scope of practice of a CNA? According to Florida statute 464.201 (Definitions):
(5) Practice of a certified nursing assistant means providing care and assisting persons with tasks relating to the activities of daily living. Such tasks are those associated with personal care, maintaining mobility, nutrition and hydration, toileting and elimination, assistive devices, safety and cleanliness, data gathering, reporting abnormal signs and symptoms, postmortem care, patient socialization and reality orientation, end-of-life care, cardiopulmonary resuscitation and emergency care, residents' or patients' rights, documentation of nursing-assistant services, and other tasks that a certified nurse assistant may perform after training beyond that required for initial certification and upon validation of competence in that skill by a registered nurse.
So, a knee brace helps a patient maintain mobility. And measuring for a fitting custom orthotic devices seems be a task associated with maintaining mobility. So does casting or scanning an AK, sending it to C-Fab, fitting it, and adjusting it, for that matter. It seems we have no legal recourse to prevent CNAs from practicing orthotics or prosthetics, we can only prohibit them from using the title orthotist or prosthetist.
As I said, I truly hope I am wrong but, if not, I think the statutes need to be revised to prevent the online sale of custom braces which are measured and fit by CNAs before they expand to providing more custom orthotics and prosthetics.
Anne DuBois, CO,LO
Citation
Anne Dubois, “Custom bracing available from online vendors,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/234812.
