NEW JERSEY REGISTER
VOLUME 33, NUMBER 11
MONDAY, JUNE 4, 2001
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS
CLINICAL INTERNSHIPS; LICENSURE WITHOUT EXAMINATION (GRANDFATHERING); TEMPORARY
LICENSURE; LICENSING OF ORTHOTIST ASSISTANTS, PROSTHETIST ASSISTANTS AND
PROSTHETIST-ORTHOTIST ASSISTANTS

Additions are indicated by <<+ Text +>>; deletions by <<- Text - >>. Changes in tables are made but not highlighted.

Proposed Amendments: N.J.A.C. 13:44H-1.1, 1.2, 2.1, 2.2, 2.3, 3.1, 3.2, 3.3, 3.4, 6.2, 7.1, 7.2, 8.4, 8.6, 8.8 and 9.1

Proposed New Rules: N.J.A.C. 13:44H-2.4, 3.5 and 3.7

Proposed Repeals: N.J.A.C. 13:44H-4

Proposed Repeal and New Rule: N.J.A.C. 13:44H-3.6

Authorized By: Orthotics and Prosthetics Board of Examiners, Laura Anderson, Executive Director.

Authority: N.J.S.A. 45:12B-1 et seq., specifically 45:12B-26. Proposal Number: PRN 2001-187.

Submit written comments by July 4, 2001 to:

Laura Anderson, Executive Director
Orthotics and Prosthetics Board of Examiners
PO Box 45034
124 Halsey Street
Newark, NJ 07101

The agency proposal follows:

Summary

Rules governing the practice of orthotics and prosthetics were first adopted on February 2, 1998 at 30 N.J.R. 553(a). On May 21, 1999, new law P.L. 1999, c.115 (N.J.S.A. 45:12B-1 et seq.) was enacted, necessitating amendments to the rules. Pursuant to this new law, and the rulemaking authority in N.J.S.A. 45:12B-26, the Orthotics and Prosthetics Board of Examiners (the Board) proposes amendments, new rules and repeals of certain provisions in N.J.A.C. 13:44H concerning the licensure of orthotists, prosthetists, prosthetist-orthotists, orthotist assistants, prosthetist assistants and prosthetist-orthotist assistants.

N.J.A.C. 13:44H-1.1 sets forth the purpose and scope of the rules in chapter 44H. Subsection (c) is amended to list those individuals to whom the rules do not apply, pursuant to N.J.S.A. 45:12B-18. This list includes any person licensed to practice medicine and surgery, dentistry or podiatry in New Jersey; a college student in orthotics or prosthetics program who is supervised by a licensee; a student prosthetist assistant, a student orthotist assistant or a student prosthetist-orthotist assistant; a licensed occupational therapist or licensed physical therapist who fabricates or applies upper extremity adaptive equipment, finger splints or hand splints; a licensed physical therapist who provides corsets, soft cervical collars or lower extremity orthotics made of fabric, canvas, neoprene or elastic; a licensed physical therapist who provides lower extremity, low temperature splint or ankle foot orthotics that are provided for the evaluation or treatment of an adult patient for less than three months or a pediatric patient for less than one year when these braces do not become the patient's property; a licensed physical therapist who provides any off-the-shelf ankle foot orthosis made of fabric, canvas, neoprene or elastic and any low temperature posterior leaf ankle foot orthosis; a licensed physical therapist who provides any high temperature posterior leaf ankle foot orthosis when the licensed physical therapist is conducting research at a college or university; a licensed physical therapist who manages lower extremity prosthetic volumetric changes, provided that the physical therapist consults with a prosthetist prior to addressing any non- reversible changes; or a certified pedorthist who is limited to the practice of orthotics and prosthetics to the ankle and below.

*

N.J.A.C. 13:44H-1.2 sets forth definitions of words and terms used in the chapter. Definitions for "orthotist," "orthotist assistant," "pedorthist," "prosthetist," "prosthetist assistant," "prosthetist-orthotist" and "prosthetist-orthotist assistant" are proposed to be added to this section.

N.J.A.C. 13:44H-2.1 sets forth the scope of practice for a licensed orthotist and a licensed orthotist assistant. Subsection (a) is amended to remove reference to "pain"; this amendment is proposed because the term "pain" is not in N.J.S.A. 45:12B-3, which sets forth the definition of "orthotics." Subsection (b) is amended to remove reference to "a technician" and to allow orthotists to employ a licensed orthotist assistant. This amendment is proposed because, pursuant to N.J.S.A. 45:12B-1 et seq., orthotists are no longer permitted to use unlicensed "technicians" in their establishments. Pursuant to the new law, every person who works in an orthotic or prosthetic establishment must be either a licensed orthotist, prosthetist-orthotist, licensed orthotist assistant, licensed prothetist-orthotist assistant or licensed pedorthist. The subsection is also amended to require that any assistant be supervised pursuant to N.J.A.C. 13:44H-3.6.

N.J.A.C. 13:44H-2.2 sets forth the scope of practice for a prosthetist and a licensed prosthetist assistant. Subsection (a) is amended to remove reference to the definition of lower extremity prosthetic appliance found in N.J.S.A. 45:12B-3. The Board believes that the term "lower extremity prosthetic appliance" does not require a reference to the statute as "prosthetic appliance" is currently defined in N.J.A.C. 13:44H-1.2. Subsection (b) is amended to remove the term "technician" and to allow prosthetists to employ a licensed prosthetist assistant. The subsection is also amended to remove reference to the statutory definition of lower extremity prosthetic appliance at N.J.S.A. 45:12B-3 and to require that the licensed prosthetist supervise the licensed prosthetist assistant pursuant to N.J.A.C. 13:44H-3.6.

N.J.A.C. 13:44H-2.3 sets forth the limitations for the practice of certified pedorthists. Subsection (b) currently allows a pedorthist to employ a technician. Because P.L. 1999, c.115 abolished this category of employee, subsection (b) is proposed for deletion to reflect the statutory change.

Proposed new rule N.J.A.C. 13:44H-2.4 outlines those practices which are prohibited. Subsection (a) prohibits any person from practicing orthotics or prosthetics, or acting as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant, without obtaining a license pursuant to N.J.S.A. 45:12B-1 et seq. and these rules. Subsection (b) states that no licensed orthotist, prosthetist or prosthetist-orthotist may employ a person to act as an orthotist, prosthetist, prosthetist-orthotist, orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant unless that person has been licensed by the Board.

N.J.A.C. 13:44H-3.1 sets forth the application requirements for licensure as an orthotist, prosthetist or prosthetist-orthotist. Subsection (a) is a new provision which requires that those who wish to be licensed as an orthotist, prosthetist or prosthetist-orthotist pass the American Board for Certification in Orthotics and Prosthetics examination. Subsection (b) is a recodification of the current subsection (a), that outlines what an applicant for licensure as an orthotist, prosthetist or prosthetist-orthotist must submit to the Board. Proposed amendments delete the phrase "of applicant's education including transcripts" from subparagraph (b)1i and require that the applicant receive a bachelor's degree from a college or university accredited by an accrediting agency recognized by the United States Department of Education. Subparagraph (b)1ii is amended to require that the applicant complete a clinical internship, consisting of at least 1,900 hours, under the supervision of a licensee. The rule is also amended to require that the applicant pass the licensing examination and to reflect that the fee schedule for these rules is codified at N.J.A.C. 13:44H-10.1 and not 12.1.

Subsection (c) of N.J.A.C. 13:44H-3.1 is new and sets forth application requirements for an applicant who applies for licensure within five years of the effective date of the rule. Such an applicant would have to show that he or she has earned an associates degree, with course work in biology, anatomy and physiology, physics and chemistry. The college or university the applicant attends must be accredited by an accrediting agency which is recognized by the United States Department of Education. The applicant is also required to complete a 1,900 hour internship under the supervision of a licensee, successfully pass the licensing examination and pay the licensing fee required by N.J.A.C. 13:44H-10.1. Proposed new N.J.A.C. 13:44H-3.1(d) allows an applicant within one year ofthe effective date of this section to complete the 1,900 hours of clinical practice under the supervision of a person who would qualify for licensure as an orthotist, a prosthetist or a prosthetist- orthotist. N.J.A.C. 13:44H-3.1(a)3 is proposed for recodification as N.J.A.C. 13:44H-3.1(e) and amended to clarify that the Board will consider a foreign-trained applicant's credentials by reviewing an evaluation of those credentials from a credentialing agency recognized by the American Board for Certification in Orthotics and Prosthetics, its successor or the International Society of Prosthetists and Orthotists. N.J.A.C. 13:44H-3.1(a)4 is proposed for deletion because it has been superseded by the clinical internship required by N.J.S.A. 45:12B-11. Subsection (b), which deals with exemptions to N.J.A.C. 13:44H-3.1(a)4, has been deleted because it has been superseded by the requirements of N.J.S.A. 45:12B-11.

N.J.A.C. 13:44H-3.2 is amended to remove a requirement that applicants for licensure as a certified pedorthist complete a bachelors degree. There is no requirement in N.J.S.A. 45:12B-18 that a pedorthist complete a bachelors degree and the Board does not believe it can require this without statutory authorization. The rule is also amended to reflect that the fee schedule is codified at N.J.A.C. 13:44H-10.1.

N.J.A.C. 13:44H-3.3 is amended in order to clarify the process by which an orthotist, prosthetist or prosthetist-orthotist who is currently working may qualify for licensure. When the rules were originally proposed, on January 21, 1997 at 29 N.J.R. 310(a), concerns were raised regarding this section. Several individuals believed that the rule would not allow the Board to recognize experience gained prior to the adoption of the rules. In response to these concerns, and in order to correct this anomaly, the Board did not adopt the rule and proposed a new rule on October 5, 1998, at 30 N.J.R. 3605(a). During review of that rule prior to adoption, the Board decided to delay adoption of the rule until new legislation was enacted. As that legislation has been enacted, as P.L. 1999, c.115, the Board now proposes amendments to N.J.A.C. 13:44H-3.3 which respond to the commenters original concerns. The proposed amendments to subsection (a) would allow a person to apply for licensure without meeting the requirements of N.J.A.C. 13:44H-3.1 if that person applies within 180 days from the effective date of the rule and has practiced as an orthotist, prosthetist or prosthetist-orthotist for at least 1,750 hours a year for three years prior to the effective date of the rule. Subsection (b) is amended to require that an applicant submit a passport size photograph and recommendation from his or her employer. The rule is also amended to indicate that the fee schedule is codified at N.J.A.C. 13:44H- 10.1. Subsection (c) is amended to clarify that the Board will conduct an investigation of the applicant's work history in order to determine whether the applicant has presented evidence which establishes the applicant's qualifications for licensure.

N.J.A.C. 13:44H-3.4 sets forth the requirements for granting a temporary license to an applicant who is licensed in another state. Subsection (a) is amended to require that an applicant be licensed in a state that has licensing standards that are equivalent to New Jersey's. Subsection (b) is amended to require that the holder of a temporary license practice in the field in which he or she is licensed in the other state. For example, an orthotist licensed in another state would only be allowed to practice as an orthotist in this State pursuant to a temporary license. Subsection (c) is new and states that a holder of a temporary license must be supervised by a licensee pursuant to N.J.A.C. 13:44H-3.6(e). New subsection (d) states that a temporary license will be valid for one year. The rule also requires that the holder of a temporary license take the first available licensing examination and allows the Board to renew the temporary license if the holder shows good cause for the renewal and the renewal would serve the well-being and interests of the clients of the establishment in which the holder works. The rule also requires that the holder of a renewed temporary license be supervised pursuant to N.J.A.C. 13:44H- 3.6(d). New subsection (e) sets forth procedures for renewal of a temporary license. An applicant for renewal must send an application to the Board at least 90 days before the temporary license expires. The rule requires that the holder of a renewed temporary license take the next available examination and states that the renewed temporary license will expire after the results of that examination are issued. New subsection (f) states that a person whose temporary license has expired may no longer work as an orthotist, prosthetist or prosthetist-orthotist but may continue to take the licensing examination. The rule also states that if a person passes the licensing examination after the temporary license has expired, he or she may apply for licensure pursuant to N.J.A.C. 13:44H-3.1.

N.J.A.C. 13:44H-3.5 is a proposed new rule which outlines the application procedure for licensure as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant. Subsection (a) requires that an applicant submit to the Board an application that includes: proof that the applicant is at least 18 years old, and has a high school diploma, a certification from the applicant's supervising licensee that states that the applicant has completed a 40 hour course of training as an orthotist assistant or prosthetist assistant or 80 hours of training as a prosthetist-orthotist assistant; and a certification from the applicant's supervising licensee that states that the applicant has completed 1,900 hours of clinical practice in the area of licensure. The applicant must also submit proof that he or she has passed the licensing examination and must submit the application fee. Subsection (b) provides an exception to the requirements of subsection (a) for individuals who apply for licensure as an orthotist assistant, a prosthetist assistant or a prosthetist-orthotist assistant within one year of the effective date of the rule. These applicants will qualify for licensure if they have completed 1,900 hours of clinical practice under the supervision of a person who would qualify for licensure as an orthotist, a prosthetist or a prosthetist-orthotist pursuant to N.J.A.C. 13:44H-3.3. This exception is provided because, as the Board has not yet licensed anyone as an orthotist, prosthetist or prosthetist- orthotist, therefore, there is no one who, pursuant to subsection (a), currently would qualify to supervise an applicant during the required 1,900 hours of clinical practice.

Existing N.J.A.C. 13:44H-3.6, Failure of examination; when retaking permitted, is proposed for repeal. The Board proposes to repeal this rule because its provisions are either imposed by the organization which conducts the licensing examination and is therefore outside of the Board's control, allowing applicants to take the part of the examination they have failed, or it is outside of the Board's statutory authority, requiring that applicants take a remedial class.

Proposed new rule N.J.A.C. 13:44H-3.6 sets forth standards for the supervision of orthotist assistants, prosthetist assistants, prosthetist- orthotist assistants, students and holders of temporary licenses. Subsection (a) allows a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license to receive supervision from either a licensed orthotist, licensed prosthetist, licensed prosthetist-orthotist or by a person who has a pending application for licensure as an orthotist, prosthetist or prosthetist- orthotist. This provision only applies for a one year period from the effective date of this section, after that period the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license shall only be supervised by a licensed orthotist, licensed prosthetist or licensed prosthetist-orthotist. Subsection (b) requires that an assistant, a student or a holder of a temporary license be supervised by a licensee who practices in their field. For instance, a prosthetist assistant may only be supervised by a licensed prosthetist. Subsection (c) states that a licensed orthotist assistant, a licensed prosthetist assistant, a licensed prosthetist-orthotist assistant, a student or a holder of a temporary license cannot perform laboratory or clinical work unless he or she is being closely or routinely supervised by a supervising licensee. The rule defines a supervising licensee as a licensed orthotist, prosthetist or prosthetist-orthotist who works in the same facility as a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license and who provides direction to, and close or routine supervision of, the assistant, student or holder of a temporary license. Subsection (d) requires that licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist- orthotist assistants and students receive close supervision from a supervising licensee. The rule defines "close supervision" as daily, face-to-face contact and observation of the performance of laboratory and clinical work at the location where the supervisee's services are being performed. Subsection (e) requires that the holder of a temporary license receive routine supervision from a supervising licensee. The rule defines "routine supervision" as face-to- face contact with and observation of the performance of the laboratory and clinical work of the holder of a temporary license at least once a week at the location at which services are being performed by the holder of the temporary permit. Subsection (f) states that the supervising licensee shall be responsible for the laboratory and clinical work performed by a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist- orthotist assistant, student or holder of a temporary license. Subsection (g) states that a supervising licensee may only supervise three licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist-orthotist assistants, students or holders of a temporary license at one time. Subsection (h) requires that the supervising licensee be physically present during the initial evaluation of the patient and the final provision of the orthotic or prosthetic device so that he or she can determine the appropriateness of the device for the patient's needs. Subsection (i) requires the supervising licensee to provide direction to the orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant, student or holder of a temporary license. Subsection (j) requires an orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant, student or holder of a temporary license to maintain a daily record which contains the name and license number of the supervising licensee, the date services are provided and what services the orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant, student or holder of a temporary license performed. The rule also requires that the supervising licensee initial this record every day. Subsection (k) requires that the supervising licensee name another licensee to supervise the orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant, student or holder of a temporary license whenever the supervising licensee is absent.

Proposed new rule N.J.A.C. 13:44H-3.7 requires an applicant who has qualified for licensure to send in the licensing fee from N.J.A.C. 13:44H- 10.1 before the Board will send the applicant his or her license. The rule also requires licensees to renew their license and pay the license renewal fee every two years.

Subchapter 4 outlines the requirements for a clinical residency for orthotics and prosthetics. This residency program has been superseded by the clinical internship that is required by N.J.S.A. 45:12B-11 and the proposed amendments to N.J.A.C. 13:44H-3.1. Subchapter 4 is, therefore, proposed for repeal.

N.J.A.C. 13:44H-6.2 outlines what constitutes unlicensed practice of orthotics, prosthetics and prosthetics-orthotics. Subsection (a) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants and to cite to the exemptions listed in N.J.A.C. 13:44H-1.1(c).

N.J.A.C. 13:44H-7.1 requires licensees to display a notice of licensure and fees in their offices. Subsection (a) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants and to require that the sign provide actual notice to the patient.

N.J.A.C. 13:44H-8.4 outlines permissible use of professional credentials. Subsection (b) is amended to require that academic institutions to which an orthotist, prosthetist or prosthetist-orthotist refers in an advertisement must be accredited by an accrediting agency recognized by the United States Department of Education. Subsection (d) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants.

N.J.A.C. 13:44H-8.6 outlines prohibited methods of advertising. Subsection (b) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants. Subsection (c), which prohibits licensees from using any technique in advertising that is intended to intimidate, exert undue influence or unduly influence a prospective client, is proposed for deletion because the Board does not believe that an advertising technique would intimidate or exert undue influence.

N.J.A.C. 13:44H-8.8 requires a licensee to retain a copy of any advertisements for three years from the date it was initially published or disseminated. Subsection (a) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist- orthotist assistants.

N.J.A.C. 13:44H-9.1 contains standards for preparing and maintaining client records. Subsection (a) is amended to include reference to licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants.

N.J.A.C. 13:44H-10.1 is proposed for amendment to set a fee for initial licensure for orthotist assistants, prosthetist assistants and prosthetist- orthotist assistants of $150.00, if paid during the first year of the biennial renewal period and $75.00, if paid during the second year of the biennial renewal period. N.J.A.C. 13:44H-10.1(a)4 is proposed for recodification as (a)5 to accommodate the proposed new paragraph. Proposed new N.J.A.C. 13:44H-10.1(a)6 sets a biennial license renewal for an orthotist assistant, prosthetist assistant and prosthetist-orthotist assistant of $150.00. N.J.A.C. 13:44H-10.1(a)5 is proposed for recodification as (a)7. N.J.A.C. 13:44H-10.1(a)6 is proposed for deletion as this paragraph deals with the clinical internship program that will no longer be conducted. N.J.A.C. 13:44H-10.1(a)7 through 11 have been recodified as (a)8 through 12.

Social Impact

The Board believes that the proposed amendments, new rules and repeals will have a positive impact on society. These rules are proposed to implement the provisions of P.L. 1999, c.115 and to ensure that the people who work in an orthotic, prosthetic or prosthetic-orthotic establishment are licensed by the State so that they can assure that orthotists, prosthetists and prosthetists- orthotists will safely and effectively provide orthotic and prosthetic devices to the public.

The amended rules create a new category of licensees--licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotist assistants--who aid a licensed orthotist, licensed prosthetist or licensed prosthetist-orthotist in the provision of services. The amended rules state that these licensees are the only people who may work as aides to a licensed orthotist, prosthetist or prosthetist-orthotist in an orthotic or prosthetic establishment. The rules set forth licensure requirements, which include a clinical internship, for orthotists, prosthetists, prosthetist-orthotists, orthotist assistants, prosthetist assistants and prosthetist-orthotist assistants. These rules will ensure that only those who have the skill and knowledge to safely and effectively provide assistance to licensed orthotists, prosthetists and prosthetist-orthotists will work in an orthotic or prosthetic establishment. The rules also provide standards for the supervision of assistants which will ensure that assistants receive appropriate guidance and direction from the licensed orthotist, prosthetist or prosthetist-orthotist with whom they work.

The rules also benefit society by allowing those who are currently practicing as orthotists, prosthetists and prosthetist-orthotists to qualify for licensure. This benefits society by allowing orthotists, prosthetists and prosthetist-orthotists to provide evidence of professional competence to ensure that these individuals may continue to safely and effectively provide orthotic and prosthetic services.

The rules also provide for the temporary licensure of applicants who are licensed in another state to practice in New Jersey while the applicant awaits the result of the licensing examination. This ensures that the temporary license holder is supervised until such time that he or she can demonstrate, through passage of the examination, that he or she has adequate knowledge to practice without supervision. The rules provide standards for the supervision of holders of temporary licenses and students. This will ensure that the public receives safe services and devices.

Economic Impact

Implementing the provisions of P.L. 1999, c.115 in these amendments, new rules and repeals may have an economic impact on licensees and applicants for licensure. According to new rule N.J.A.C. 13:44H-2.4, any unlicensed individual who practices orthotics or prosthetics, or acts as an assistant, is engaging in unlicensed practice and may be fined by the Board. Under the proposed amendment to N.J.A.C. 13:44H-3.1, an applicant for licensure as an orthotist, prosthetist or prosthetist-orthotist must have a bachelor's degree and must take the American Board for Certification in Orthotics and Prosthetics examination. The costs of obtaining the bachelor degree and taking the examination will be borne by the applicant; however, these costs are not assessed by the Board but by the university or college the applicant attends and by the American Board for Certification in Orthotics and Prosthetics. Similarly, N.J.A.C. 13:44H-3.5 imposes costs on an applicant for licensure as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant in that the applicant is required to complete a course of training and pass the licensing examination. Again, these costs are not directly imposed by the Board but by the agency that administers the examination and the program that provides the training course.

N.J.A.C. 13:44H-3.3 imposes costs on those applicants who are currently practicing as an orthotist, prosthetist or prosthetist-orthotist. Such an applicant must submit documentation of his or her employment history and references from physicians. The cost of preparing these documents is borne by the applicant.

N.J.A.C. 13:44H-3.7 requires applicants who quality for licensure to pay the licensing fee and requires licensees to pay the biennial license renewal fee. The cost of paying these fees is borne by the applicant and licensee, respectively.

N.J.A.C. 13:44H-7.1 requires that notices be displayed in the office of a licensee that states that the licensee is licensed by the Board and that complaints may be addressed to the Board. The cost of obtaining these notices must be borne by the licensee. Amended N.J.A.C. 13:44H-3.4 does not directly impose costs; however, if a holder of a temporary license fails the licensing examination twice the temporary licensee must cease working as an orthotist, prosthetist or prosthetist-orthotist until he or she passes the licensing examination. This imposes an economic cost in that these individuals can no longer earn income in their chosen profession.

The amendments to N.J.A.C. 13:44H-10.1 impose costs by setting fees for initial licensure and biennial license renewal of orthotist assistants, prosthetist assistants and prosthetist-orthotist assistants.

Federal Standards Statement

A Federal standards analysis is not required because there are no Federal standards or requirements applicable to the proposed amendments or new rules.

Jobs Impact

The Board believes that the proposed amendments, new rules and repeals may decrease the number of jobs in New Jersey. The rules set forth the standards of how a person qualifies for licensure which may limit who can work as an orthotist, prosthetist or prosthetist-orthotist. The rules also require that those individuals who are currently working as technicians in orthotic or prosthetic establishments apply for licensure as orthotist assistants, prosthetist assistants or prosthetist-orthotist assistants. This may also limit persons who may work in an orthotic or prosthetic establishment as an assistant. These limitations are imposed by P.L. 1999, c.115 and the Board believes that they are necessary in order to ensure that those individuals who provide orthotic or prosthetic devices have the skill and knowledge necessary to safely and effectively provide these devices.

Agriculture Industry Impact

The Board does not believe that the proposed amendments, new rules and repeals will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

The Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., requires the Board to give a description of the types and an estimate of the number of small businesses to which the proposed amendments, new rules and repeals will apply. If any of the potential applicants for licensure are considered "small businesses" for the purposes of the Act, then the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the amendments, new rules and repeals including the kinds of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the amendments, new rules and repeals with an indication of the varying impact on small businesses of differing types and sizes and to outline the manner in which the rules have been designed to minimize any adverse economic impact upon small businesses. The costs imposed on small businesses by the proposal are the same costs that are imposed on all businesses as outlined in the Economic Impact above. The Board does not believe that licensees will need to employ any professional services to comply with the requirements of the proposal.

The proposed amendments and new rules impose compliance and recordkeeping requirements, but do not impose any reporting requirements. The proposed amendments to N.J.A.C. 13:44H-2.4 require that no person may practice orthotics or prosthetics without a license and that no one may employ someone who practices as an orthotist assistant, prosthetist assistant or prosthetist- orthotist assistant unless that person is licensed. The proposed amendments to N.J.A.C. 13:44H-3.1(a) require an applicant for licensure as an orthotist, prosthetist or prosthetist-orthotist to complete a 1,900 hour clinical internship and pass the licensing examination. New subsection (b) requires that an applicant who applies within five years of the effective date of the rule complete an associates degree, a 1,900 hour clinical internship, pass the licensing examination and submit the licensing fee. N.J.A.C. 13:44H-3.3(a) requires that a person who seeks to be licensed without meeting the requirements of N.J.A.C. 13:44H-3.1 apply within 180 days of the effective date of the rule and show that he or she has worked 1,750 hours a year, for the three previous years, as an orthotist, prosthetist or prosthetist-orthotist. The proposed amendments to N.J.A.C. 13:44H-3.3(b) require that an applicant submit a recommendation from his or her employer and a passport size photograph. The proposed amendments also require that the holder of a temporary permit only practice in the field in which he or she was licensed in another state, be supervised by a licensee and take the first available licensing examination. The holder of a temporary license is required to send a renewal application to the Board 90 days prior to the date his or her temporary license expires and must take the next available examination after the temporary license is renewed. The holder of a temporary license is required to cease working as an orthotist, prosthetist or prosthetist-orthotist immediately upon expiration of the license.

New rule N.J.A.C. 13:44H-3.5 requires that an applicant for licensure as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant submit a completed application form, which includes proof that the applicant is 18 years of age, has a high school diploma, has completed a 40 hour training course for an orthotist assistant or prosthetist assistant or an 80 hour course as a prosthetist-orthotist assistant and that he or she has completed 1,900 hours of clinical practice under the supervision of a licensed orthotist, prosthetist or prosthetist-orthotist. The rule also requires that the applicant pass the licensing examination and pay an application fee. The rule requires that any applicant who applies for licensure within one year from the effective date of the rule must demonstrate that the person who supervised their 1,900 hours of clinical practice would have qualified for licensure pursuant to N.J.A.C. 13:44H-3.3.

Proposed new rule N.J.A.C. 13:44H-3.6 requires that a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license be supervised by a licensed orthotist, prosthetist or prosthetist-orthotist. The rule also prohibits a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license from performing laboratory or clinical work without close or routine supervision and requires that the supervising licensee be responsible for the laboratory and clinical work performed by the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license. A supervising licensee is prohibited from supervising more than three persons who are either licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist-orthotist assistants, students or holders of a temporary license, or any combination thereof, and is required to be present during the initial evaluation of a patient and final provision of an orthotic or prosthetic device. The supervising licensee is required to give direction to the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist, student or holder of a temporary license and to designate another licensee to supervise in his or her absence. Proposed new rule N.J.A.C. 13:44H-3.7 requires the applicant to pay the licensing fee prior to being issued his or her license, and requires licensees to pay a license renewal fee every two years. The proposed amendments to N.J.A.C. 13:44H-7.1 require licensees to display a notice in the public space or the office that indicates that licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist- orthotists are licensed by the Board and address of the Board where complaints regarding the licensee may be mailed.

The proposed amendments to N.J.A.C. 13:44H-3.6(j) require a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist- orthotist assistant, student or holder of a temporary license to maintain a daily record of any services performed, along with the identity of the supervising licensee. The proposed amendments to N.J.A.C. 13:44H-8.8 require licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist-orthotists to maintain a record of all advertisements for three years. The proposed amendments to N.J.A.C. 13:44H-9.1 require licensees to maintain client records that indicate client contact with licensed orthotist assistants, licensed prosthetist assistants and licensed prosthetist- orthotists. There are no other reporting requirements.

The proposed amendments and new rules implement the provisions of P.L. 1999, c.115 and the Board believes that they further the welfare and safety of the public in its dealings with orthotists, prosthetists, prosthetist- orthotists, orthotist assistants, prosthetist assistants and prosthetist- orthotist assistants, by ensuring that these licensees have the knowledge and skill to safely provide orthotic and prosthetic devices. The proposed amendments and new rules must be applied uniformly to all regardless of their size.

Full text of the proposed repeals may be found in the New Jersey Administrative Code at N.J.A.C. 13:44H-3.6 and 4.

Full text of the proposed amendments follows:

<< NJ ADC 13:44H-1.1 >>

13:44H-1.1 Purpose and scope

(a) The rules in this chapter implement the provisions of the Orthotist and Prosthetist Licensing Act (the Act), N.J.S.A. 45:12B-1 et seq. <<-,- >> <<+as amended by P.L. 1999, c.115,+ >> regulate the practice of orthotics and prosthetics, and offer licensure to certified pedorthists within this State.

(b) (No change.)

(c) This chapter shall not apply to <<-those individuals exempt from the provisions of the Act pursuant to N.J.S.A. 45:12B-18- >> <<+:+ >>

<<+1. Any person who is licensed to practice medicine and surgery, dentistry or podiatry in this State;+>>

<<+2. A student, fellow or trainee in orthotics or prosthetics who is pursuing a course of study at a college or university accredited by an accrediting agency recognized by the United States Department of Education, or working in a training center or research facility which has a written affiliation agreement with a college or university accredited by an accrediting agency recognized by the United States Department of Education, to the extent that the activities and services performed are a part of the course of study under the supervision of a licensee pursuant to N.J.A.C. 13:44H- 3.6;+ >>

<<+3. A student who, pursuant to N.J.A.C. 13:44H-3.5, is training to be a licensed prosthetist assistant, a licensed orthotist assistant or a licensed prosthetist-orthotist assistant to the extent that the activities and services are a part of the course of study under the supervision of a licensee pursuant to N.J.A.C. 13:44H-3.6;+ >>

<<+4. A licensed occupational therapist or licensed physical therapist when designing, modifying, fabricating or applying upper extremity adaptive equipment, finger splints and hand splints;+ >>

<<+5. A licensed physical therapist in providing corsets and soft cervical collars;+ >>

<<+6. A licensed physical therapist in providing lower extremity orthotics made of fabric, canvas, neoprene or elastic with or without metal or plastic insertable or removable hinges or stays;+ >>

<<+7. A licensed physical therapist in providing any lower extremity, low temperature splint or ankle foot orthotic when such bracing is for the evaluation or treatment of an adult patient for less than three months or for a pediatric patient for less than one year without the necessity to consult with a licensed orthotist and when the braces do not become the patient's property;+ >>

<<+8. A licensed physical therapist in providing any off-the-shelf ankle foot orthosis made of fabric, canvas, neoprene or elastic and any low temperature posterior leaf ankle foot orthosis;+ >>

<<+9. A licensed physical therapist in providing any high temperature posterior leaf ankle foot orthosis when the licensed physical therapist is conducting research at a college or university accredited by a regional or national accrediting agency recognized by the United States Department of Education;+ >>

<<+10. A licensed physical therapist in managing lower extremity prosthetic volumetric changes, provided that the physical therapist consults with the dispensing prosthetist prior to implementing any non-reversible changes; and+ >>

<<+11. A certified pedorthist whose activities are limited to the practice of orthotics and prosthetics for the ankle and below.+ >>

<< NJ ADC 13:44H-1.2 >>

13:44H-1.2 Definitions

The following words and terms, as used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

<<+"Orthotist" means any person who practices orthotics and who is representing himself or herself to the public by title or by description of services, incorporating such terms as "orthotics," "orthotists," "orthotic" or "L.O." or any similar title or description of services, provided that the individual has met the eligibility requirements contained in N.J.S.A. 45:12B-11 and N.J.A.C. 13:44H-3.1, and has been licensed pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.+ >>

<<+"Orthotist assistant" means a person licensed pursuant to the provisions of P.L. 1991, c.512 and N.J.A.C. 13:44H-3.5, and who assists, and practices under the supervision of, a licensed orthotist.+ >>

<<+"Pedorthist" means a person who is certified by the American Board for Certification in Pedorthics, or its successor, in the design, manufacture, fit and modification of shoes and related foot appliances from the ankle and below as prescribed by a licensed doctor of medicine or podiatry for the amelioration of painful or disabling conditions of the foot.+ >>

<<+"Prosthetist" means a person who practices prosthetics and who represents himself or herself to the public by title or by description of services, under a title incorporating such terms as "prosthetics," "prosthetist," "prosthetic" or "L.P." or any similar title or description of services, provided that the individual has met the eligibility requirements contained in N.J.S.A. 45:12B-11 and N.J.A.C. 13:44H-3.1, and has been licensed pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.+ >>

<<+"Prosthetist assistant" means a person who is licensed pursuant to the provisions of P.L. 1991, c.512 and N.J.A.C. 13:44H-3.5, and who assists, and practices under the supervision of, a licensed prosthetist.+ >>

<<+"Prosthetist-orthotist" means any person who practices both disciplines of prosthetics and orthotics and who represents himself or herself to the public by title or by description of services, under any title incorporating such terms as "prosthetics-orthotics," "prosthetist-orthotist," "prosthetic- orthotic" or "L.P.O." or any similar title or description of services, provided that the individual has met the eligibility requirements contained in N.J.S.A. 45:12B-11 and N.J.A.C. 13:44H-3.1, and has been duly licensed in both disciplines of prosthetics and orthotics pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.+ >>

<<+"Prosthetist-orthotist assistant" means a person who is licensed pursuant to the provisions of P.L. 1991, c.512 and N.J.A.C. 13:44H-3.5, and who assists, and practices under the supervision of, a licensed prosthetist- orthotist.+ >>

<< NJ ADC 13:44H-2.1 >>

13:44H-2.1 <<-Practice as an orthotist; scope; use of a technician- >> <<+ Scope of orthotist practice; orthotist assistant+ >>

(a) The scope of practice of a licensed orthotist shall include <<-, but not be limited to,- >> patient evaluation <<-,- >> <<+for, and the+ >> measuring, designing, constructing, assembling, fitting, adjusting and servicing <<-an- >> <<+of,+ >> orthotic appliance <<+s+ >> or <<- orthosis- >> <<+orthoses+ >>, which <<-is- >> <<+are+ >> prescribed by a licensed physician, podiatrist or dentist for the correction or alleviation of musculoskeletal diseases, <<-pain,- >> injuries or deformities.

(b) A licensed orthotist may employ <<-a technician only for- >> <<+a licensed orthotist assistant for+ >> the molding, painting, cutting, mixing, grinding, polishing, sewing, laminating, gluing, screwing, riveting, fastening or vacuum forming of an orthotic appliance or orthosis, which tasks must be performed under the supervision of <<-a Board licensee- >> <<+a licensed orthotist pursuant to N.J.A.C. 13:44H-3.6+ >>.

<< NJ ADC 13:44H-2.2 >>

13:44H-2.2 <<-Practice as a prosthetist; scope; use of a technician- >> <<+Scope of prosthetist practice; prosthetist assistant+>>

(a) The scope of practice of a licensed prosthetist shall include <<-, but not be limited to,- >> patient evaluation <<-,- >> <<+for, and the+>> measuring, designing, constructing, assembling, fitting, adjusting and servicing <<+of,+>> any type of upper and lower extremity prosthetic appliance <<-as defined in N.J.S.A. 45:12B-3,- >> prescribed by a <<- licensed- >> physician <<+licensed to practice medicine or surgery+>> or <<-podiatrist- >> <<+a licensed doctor of podiatric medicine+ >>.

(b) A licensed prosthetist may employ <<-a technician only- >> <<+a prosthetist assistant+>> for the molding, painting, cutting, mixing, grinding, polishing, sewing, laminating, gluing, screwing, riveting, fastening or vacuum forming of any type of upper and lower extremity prosthetic appliance <<-as defined in N.J.S.A. 45:12B-3,- >> which tasks <<- must- >> <<+shall+>> be performed under the supervision of a <<-Board licensee- >> <<+prosthetist pursuant to N.J.A.C. 13:44H-3.6+>>.

<< NJ ADC 13:44H-2.3 >>

13:44H-2.3 Limited practice by certified pedorthists

<<-(a)- >> The scope of practice of a certified pedorthist granted a license pursuant to N.J.A.C. 13:44H-3.2 shall be limited to the design, manufacture, fit and modification of shoes and related foot appliances which <<-do not- >> extend <<-above- >> <<+from+ >> the ankle <<+and below+>> and which are prescribed by a <<-licensed- >> physician <<+ licensed to practice medicine or surgery+>> or <<-podiatrist- >> <<+a licensed doctor of podiatric medicine+>> for the amelioration of painful or disabling conditions of the foot. "Foot appliances <<-,- >>" for the purposes of this section include <<-, but are not limited to,- >> prosthetic fillers and orthotic appliances for use from the ankle and below.

<<-(b) A pedorthist licensed pursuant to this chapter may employ a technician only for the molding, painting, cutting, mixing, grinding, polishing, sewing, laminating, gluing, screwing, riveting, fastening or vacuum forming of shoes or foot appliances which do not extend above the ankle, which tasks must be performed under the supervision of a Board licensee.- >>

<< NJ ADC 13:44H-2.4 >>

<<+13:44H-2.4 Prohibited practice; practice as an orthotist assistant, prosthetist assistant or a prosthetist-orthotist assistant+>>

<<+(a) No person may practice, attempt to practice, or hold oneself out as being able to practice orthotics, prosthetics or prosthetics-orthotics or hold oneself out as being able to act, or act, as an orthotist assistant, prosthetist assistant or a prosthetist-orthotist assistant without having obtained a license pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.+>>

<<+(b) No licensed orthotist, prosthetist or prosthetist-orthotist may employ a person to practice as an orthotist, prosthetist, prosthetist- orthotist, orthotist assistant, prosthetist assistant or a prosthetist- orthotist assistant unless that person has obtained a license pursuant to N.J.S.A. 45:12B-1 et seq. and this chapter.+>>

<< NJ ADC 13:44H-3.1 >>

13:44H-3.1 Requirements for orthotists, prosthetists and prosthetists- orthotists

<<+(a) A person who wishes to be licensed as an orthotist, prosthetist or prosthetist-orthotist shall successfully complete the examination given by the American Board for Certification in Orthotics and Prosthetics or its successor.+ >>

<<-(a)- >> <<+(b) +>>An applicant for licensure as an orthotist, prosthetist or prosthetist-orthotist shall submit to the Board the following:

1. A completed application which shall include:

i. <<-Documentation of applicant's education including transcripts- >> <<+Notarized documentation+>> indicating that the applicant received a bachelor's degree or its equivalent from <<-an accredited college or university approved by the Commission on Higher Education or its successor- >> <<+a college or university accredited by a regional or national accrediting agency recognized by the United States Department of Education+>> which <<-must- >> <<+shall+ >> be forwarded to the Board <<-directly- >> by the college or university; and

ii. <<-Documentation- >> <<+Notarized documentation+ >> which indicates <<-the applicant has completed formal training consisting of a certificate program in orthotics or prosthetics from a program accredited by the Commission on Accreditation of Allied Health Education Programs ("CAAHEP") which must be forwarded to the Board directly by the program sponsor. The Board shall recognize programs whose applications in pursuit of accreditation have been accepted by CAAHEP. However, such recognition will be withdrawn if the program fails to gain accreditation within a two year period. An applicant whose bachelor's degree included a CAAHEP-approved major in orthotics and prosthetics shall be deemed to have met this requirement- >> <<+that the applicant has completed a clinical internship in the professional area for which a license is sought of at least 1,900 hours under the supervision of a licensee pursuant to N.J.A.C. 13:44H- 3.6;+>>

2. The application fee set forth in N.J.A.C. 13:44H- <<-12.1- >> <<+ 10.1+>>; <<+and+>>

<<+3. Proof that the applicant has successfully completed the licensing examination required by (a) above.+>>

<<+(c) An applicant for licensure as an orthotist, prosthetist or prosthetist-orthotist, who applies within five years (of the effective date of this amendment) may qualify for licensure by submitting the following to the Board:+>>

<<+1. Notarized documentation of an associates degree, with satisfactory completion of course work in biology, anatomy and physiology, physics, and chemistry, from a college or university accredited by a regional or national accrediting agency recognized by the United States Department of Education;+>>

<<+2. Notarized documentation that the applicants has completed a clinical internship, in the professional area for which licensure is sought, of at least 1,900 hours under the supervision of a licensee pursuant to N.J.A.C. 13:44H-3.6;+>>

<<+3. The application fee set forth in N.J.A.C. 13:44H-10.1; and+>>

<<+4. Proof that the applicant has successfully completed the licensing examination required in (a) above.+>>

<<+(d)A person who applies for licensure as an orthotist, a prosthetist or a prosthetist-orthotist within one year of (the effective date of this amendment) and who has completed 1,900 hours of clinical practice under the supervision of a person who is not a licensed orthotist, a licensed prosthetist or a licensed prosthetist-orthotist within the three years preceding (the effective date of this amendment) shall qualify for licensure as an orthotist, a prosthetist or a prosthetist-orthotist if he or she can show that the supervisor would qualify for licensure pursuant to N.J.A.C. 13:44H-3.3.+>>

<<-3.- >> <<+(e) +>>Foreign-trained applicants shall obtain an evaluation of their professional educational and professional experience credentials from a <<-Board-recognized- >> credentialing agency <<+ recognized by the American Board for Certification in Orthotics and Prosthetics, its successor or the International Society of Prosthetists and Orthotists+>>. The Board shall accept only an evaluation which is sent <<- directly- >> to the Board by the credentialing agency. Upon receipt of <<- said- >> <<+the+>> evaluation <<+by the Board+>>, the Board shall <<+review the evaluation and+>> determine whether the applicant's education <<-al- >> and experience credentials are substantially equivalent to those required in (a)1 above <<-;- >> <<+.+>>

<<-4. A supervisor's certification indicating that the applicant has completed, subsequent to graduation from an accredited degree or certificate program in orthotics or prosthetics and within the five-year period immediately preceding application, a one-year internship or clinical residency in the professional area for which licensure is sought, pursuant to the standards set forth in N.J.A.C. 13:44H-4. The Board shall accept only a certification which is sent directly to the Board by the internship or residency sponsor. An applicant for a prosthetist-orthotist license shall be required to document completion of a one-year residency or internship in orthotics and a one-year residency or internship in prosthetics; and- >>

<<-5. (Reserved)- >>

<<-(b) If an applicant is unable to obtain a supervisor's certification as required by (a)4 above, the Board may, in its discretion, and for good cause shown, accept the applicant's affidavit in lieu of the supervisor's certification.- >>

<< NJ ADC 13:44H-3.2 >>

13:44H-3.2 Requirements for licensure <<-;- >> <<+of+ >> certified pedorthist

(a) A certified pedorthist <<-seeking- >> <<+who seeks+ >> licensure <<-pursuant to this chapter- >> shall submit <<+to the Board+>> the following:

1. A completed <<+and notarized+>> application form <<-which shall include an official transcript indicating that the applicant has received a bachelor's degree or its equivalent from an accredited college or university approved by the Commission on Higher Education or its successor which must be forwarded to the Board directly by the college or university.- >> <<+;+>>

2. The application fee set forth in N.J.A.C. 13:44H- <<-12.1(a)- >> <<+ 10.1+>>; and

3. Proof of certification by the American Board for Certification of Pedorthists or its successor sent <<-directly- >> to the Board by the American Board for Certification of Pedorthists.

<< NJ ADC 13:44H-3.3 >>

13:44H-3.3 <<-Credential requirements; licensure- >> <<+Licensure+>> without examination (grandfathering); orthotists and prosthetists <<+; credential requirements+>>

(a) <<-(Reserved)- >> <<+Within 180 days from (the effective date of this amendment), a person who has practiced for at least 1,750 hours a year as an orthotist, prosthetist or prosthetist-orthotist in an established orthotic, prosthetic or prosthetic-orthotic facility for at least three years prior to (the effective date of this amendment) may apply for licensure without satisfying the requirements of N.J.A.C. 13:44H-3.1.+>>

(b) <<-For consideration for licensure under this section, the- >> <<+ An+>> applicant <<+who seeks licensure without examination under this section+>> shall submit to the Board:

1. A completed application which shall include:

i. <<-Documentation of the applicant's education including transcripts from all educational institutions and certificate programs attended, which must be sent directly to the Board by the institution or program sponsor- >> <<+A certified statement from applicant documenting their work history+ >>;

ii. <<-Documentation- >> <<+Notarized documentation from the employer+>> of applicant's employment history <<+,+ >> including Employers Statement Form <<+,+>> <<-(- >>supplied by the Board <<-)- >>, <<+and a recommendation+>> which must be sent <<- directly- >> to the Board by the employer; and

iii. A minimum of four Physician Reference Forms <<+,+>> <<- (- >>supplied by the Board <<-)- >> <<+,+ >> completed by physicians who have medical rehabilitation <<-/- >> <<+and/or+>> orthopedic experience, <<+and who are familiar with the applicant's work,+>> which must be sent directly to the Board by the physician; and

<<+iv. A passport size photograph; and+>>

2. <<-The required fee- >> <<+The application fee set forth in N.J.A.C. 13:44-10.1+>>.

(c) The Board shall <<-complete its- >> <<+conduct an+ >> investigation <<+of the applicant's work history+>> within six months of the date of receipt of the completed application <<+in order to determine whether the application contains sufficient evidence that the applicant qualifies for licensure without examination as an orthotist, prosthetist or prosthetist-orthotists.+>>

<< NJ ADC 13:44H-3.4 >>

13:44H-3.4 Requirements for temporary license for licensees of other jurisdictions

(a) The Board shall issue a temporary license to an individual licensed in another state <<-who- >> <<+which has licensing standards equivalent to those in this State if the individual+>>:

1. Has applied for licensure as an orthotist, prosthetist or <<- both- >> <<+prosthetist-orthotist+>>, in the State of New Jersey; and

2. Is a licensee in good standing in any state in which he or she is licensed.

(b) <<-A temporary license shall be issued for a one-year period and may be renewed once for an additional year upon presentation to the Board of evidence of good cause for renewal.- >> <<+The temporary license shall authorize its holder to practice in the field in which the holder was licensed in the other state. For example, an individual licensed in another state as an orthotist may only practice as an orthotist in this State pursuant to a temporary license.+>>

<<+(c) The holder of a temporary license shall be supervised by a licensee pursuant to N.J.A.C. 13:44H-3.6(e).+>>

<<+(d) A temporary license shall be issued for a one year period. The holder of a temporary license shall take the first available licensing examination administered after receipt of the temporary license. An applicant who does not take the next administered examination for reasons of hardship such as illness, disability or other good cause may take the examination offered after the next administered examination. At the end of the one year period, the Board may renew the temporary license if the holder has taken the first scheduled examination, shows good cause for the renewal and if the renewal of the temporary license would serve the well-being and interests of the clients of the establishment in which the holder practices. The holder of a renewed temporary license shall be supervised pursuant to N.J.A.C. 13:44H- 3.6(d).+>>

<<+(e) An application for renewal of the temporary license shall be sent to the Board at least 90 days before the temporary license expires. The holder of a renewed temporary license shall take the next available examination after the temporary license is renewed. The renewed temporary license shall expire immediately after the results of the second licensing examination are issued.+>>

<<+(f) A person whose temporary license has expired shall cease working as an orthotist, prosthetist or prosthetist-orthotist, but may continue to take the licensing examination. If the person passes the licensing examination he or she shall, within 60 days, apply for licensure pursuant to N.J.A.C. 13:44H- 3.1.+>>

<< NJ ADC 13:44H-3.5 >>

13:44H-3.5 <<-(Reserved)- >> <<+Licensure as a prosthetist assistant, orthotist assistant or prosthetist-orthotist assistant+>>

<<+(a) An applicant for licensure as a prosthetist assistant, orthotist assistant or prosthetist-orthotist assistant shall submit to the Board:+>>

<<+1. A completed application form which shall include:+>>

<<+i. Proof that the applicant is at least 18 years of age;+>>

<<+ii. Proof of high school diploma or its equivalent;+>>

<<+iii. A certification from the applicant's supervising licensee stating that the applicant has completed a course of training in orthotics or prosthetics of at least 40 hours for licensure as an orthotist assistant or a prosthetist assistant, or a course of training of at least 80 hours for licensure as a prosthetist-orthotist assistant;+>>

<<+iv. A certification from the applicant's supervising licensee stating that the applicant has completed 1,900 hours of clinical practice in the area of licensure sought under the supervision of a licensed orthotist or prosthetist;+>>

<<+2. Proof that the applicant has passed the written, oral and practical examination; and+>>

<<+3. An application fee as set forth in N.J.A.C. 13:44H-10.1.+>>

<<+(b) A person who applies for licensure as an orthotist assistant, a prosthetist assistant or a prosthetist-orthotist assistant within one year of (the effective date of this section) and who has completed 1,900 hours of clinical practice under the supervision of a person who is not a licensed orthotist, a licensed prosthetist or a licensed prosthetist-orthotist in this State within the three years preceding (the effective date of this section) shall qualify for licensure as an orthotist assistant, a prosthetist assistant or a prosthetist-orthotist assistant if he or she is able to demonstrate that the supervisor would qualify for licensure pursuant to N.J.A.C. 13:44H- 3.3.+ >>

<< NJ ADC 13:44H-3.6 >>

<<+13:44H-3.6 Supervision of an orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant, student or holder of a temporary license+>>

<<+(a) From (the effective date of this section) until (one year from the effective date of this section), a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license shall be supervised, pursuant to (b) through (k) below, by either a licensed orthotist, licensed prosthetist, licensed prosthetist-orthotist or by a person who has a pending application for licensure as an orthotist, prosthetist or prosthetist-orthotist, which demonstrates that the supervisor would qualify for licensure. After that time period, the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license shall only be supervised by a licensed orthotist, licensed prosthetist or licensed prosthetist-orthotist pursuant to (b) through (k) below.+>>

<<+(b) A licensed orthotist assistant, orthotist student or holder of a temporary orthotist license shall be supervised by a licensed orthotist. A licensed prosthetist assistant, prosthetist student or holder of a temporary prosthetist license shall be supervised by a licensed prosthetist. A licensed prosthetist-orthotist assistant, prosthetist-orthotist student or holder of a temporary prosthetist-orthotist license shall be supervised by a licensed prosthetist-orthotist.+>>

<<+(c) A licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license shall not render nor continue to perform laboratory or clinical work unless he or she has obtained close or routine supervision from his or her supervising licensee. For purposes of this section, a "supervising licensee" is a licensed orthotist, licensed prosthetist or licensed prosthetist-orthotist who provides close or routine supervision in the same facility as, and who provides direction to a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license.+>>

<<+(d) A supervising licensee shall be responsible for the close supervision of a licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, or student. For purposes of this section, "close supervision" means daily, face-to-face contact and observation of the performance of the laboratory and clinical work of the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant or student at the location where his or her services are being performed.+>>

<<+(e) A supervising licensee shall be responsible for the routine supervision of the holder of a temporary license. For purposes of this section, "routine supervision" means face-to-face contact with and observation of the performance of the laboratory and clinical work of the holder of a temporary license at least once a week at the location where his or her services are being performed.+>>

<<+(f) The supervising licensee shall be personally responsible for the laboratory and clinical work of the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license.+>>

<<+(g) A supervising licensee shall not supervise more than three licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist- orthotist assistants, students or holders of a temporary license, or any combination thereof, at a time.+>>

<<+(h) The supervising licensee shall be physically present at both the initial evaluation of the patient and the final provision of the orthotic or prosthetic device by a licensed orthotist assistant, licensed prothetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license to determine the appropriateness of the device delivered.+ >>

<<+(i) The supervising licensee shall provide direction to the licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist- orthotist assistant, student or holder of a temporary license.+ >>

<<+(j) A licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license, shall maintain a daily record which shall contain the name and license number of the supervising licensee, the date when any services were performed and the clinical or laboratory services performed. The supervising licensee shall initial this record daily.+>>

<<+(k) The supervising licensee shall designate another licensee who shall perform the appropriate level of supervision, as detailed above, of licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist- orthotist assistants, students or holders of a temporary license in his or her absence.+>>

<< NJ ADC 13:44H-3.7 >>

<<+13:44H-3.7 Licensing and biennial renewal+>>

<<+(a) Once the Board has determined that an applicant should be issued a license, it shall send notification to the applicant that he or she should send the Board the licensing fee pursuant to N.J.A.C. 13:44H-10.1(a)3, for orthotists, prosthetists and prosthetist-orthotists, or N.J.A.C. 13:44H- 10.1(a)4, for orthotist assistants, prosthetist assistants or prosthetist- orthotist assistants. The Board shall send a license to the applicant upon receipt of this fee.+>>

<<+(b) Licenses shall be valid for two years. Prior to the expiration of a license, the Board shall send out notification to licensees that the license will expire unless renewed. The Board shall renew the license upon receipt of a completed renewal form and the renewal fee pursuant to N.J.A.C. 13:44H- 10.1(a)5, for orthotists, prosthetists and prosthetist-orthotists, or N.J.A.C. 13:44H-10.2(a)6, for orthotist assistants, prosthetist assistants or prosthetist-orthotist assistants.+>>

SUBCHAPTER 4. <<+(RESERVED)+>>

<< NJ ADC 13:44H-6.2 >>

13:44H-6.2 Unlicensed practice of prosthetics, orthotics and prosthetics- orthotics

(a) The following acts or practices shall be deemed to be the unlicensed practice of prosthetics, orthotics and prosthetics-orthotics:

1. Offering or rendering orthotics or prosthetics services by any person other than a licensed orthotist, licensed prosthetist, licensed prosthetist- orthotist, certified pedorthist, pedorthist licensed to the practice of orthotics and prosthetics on the ankle and below <<+, licensed orthotist assistant, a licensed prosthetist, a licensed prosthetist-orthotist assistant+>> or by a licensed professional acting within his or her scope of practice and exempt pursuant to <<-N.J.S.A. 45:12B-18- >> <<+ N.J.A.C. 13:44H-1.1(c)+>>.

2. (No change.)

(b) (No change.)

<< NJ ADC 13:44H-7.1 >>

13:44H-7.1 Display of notice of licensure; notification of availability of fee information

(a) All licensed orthotists, prosthetists, prosthetist-orthotist <<+, licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist-orthotist assistants+>> and pedorthists licensed to practice orthotics and prosthetics to the ankle and below shall ensure that the following notices are prominently displayed in a waiting room or other area where they will be visible to patients <<+to provide actual notice to the patient+ >>:

1. "ORTHOTISTS, PROSTHETISTS <<-AND- >> <<+,+>> PROSTHETIST- ORTHOTISTS <<+, ORTHOTIST ASSISTANTS, PROSTHETIST ASSISTANTS AND PROSTHETIST- ORTHOTIST ASSISTANTS+>> ARE LICENSED BY THE ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS, AN AGENCY OF THE DIVISION OF CONSUMER AFFAIRS. CERTIFIED PEDORTHISTS MAY OBTAIN VOLUNTARY LICENSURE TO PRACTICE ORTHOTICS AND PROSTHETICS TO THE ANKLE AND BELOW. ANY MEMBER OF THE PUBLIC MAY NOTIFY THE BOARD OF ANY COMPLAINT RELATIVE TO THE PRACTICE CONDUCTED BY AN ORTHOTIST, PROSTHETIST, PROSTHETIST-ORTHOTIST <<+, ORTHOTIST ASSISTANT, PROSTHETIST ASSISTANT, PROSTHETIST-ORTHOTIST ASSISTANT+>> OR A CERTIFIED PEDORTHIST LICENSED BY THE ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS. THE BOARD'S ADDRESS IS:

<<+NEW JERSEY+>> DIVISION OF CONSUMER AFFAIRS

ORTHOTICS AND PROSTHETICS BOARD
OF EXAMINERS
PO BOX 45034
124 HALSEY STREET
NEWARK, NEW JERSEY 07101"

2. "INFORMATION ON PROFESSIONAL FEES IS AVAILABLE UPON REQUEST FROM THIS OFFICE."

<< NJ ADC 13:44H-7.2 >>

13:44H-7.2 Excessive fees

(a) A licensee shall not charge an excessive fee for services. Factors which the Board may consider in determining whether a fee is excessive include <<-, but are not limited to,- >> the following:

1.-5. (No change.)

<< NJ ADC 13:44H-8.4 >>

13:44H-8.4 Use of professional credentials and certification

(a) (No change.)

(b) An advertisement which includes information on professional credentials shall contain the highest academic degrees or certifications attained related to the regulated practice of orthotics, prosthetics, or prosthetic-orthotics and shall refer only to degrees obtained from academic institutions accredited by <<-the New Jersey Commission on Higher Education or its successor- >> <<+a national or regional accrediting agency recognized by the United States Department of Education+>>.

(c) (No change.)

(d) In addition to the information required to appear pursuant to (b) and (c) above, letters or abbreviations which may appear immediately adjacent to the <<+name of an+>> orthotist <<-'s- >>, prosthetist <<-'s- >>, prosthetist-orthotist <<-'s- >> <<+, orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant+ >> or pedorthist <<-'s name- >> shall be limited to those representing the following:

1.-2. (No change.)

(e) (No change.)

<< NJ ADC 13:44H-8.6 >>

13:44H-8.6 Prohibited types or methods of advertising

(a) (No change.)

(b) A licensee shall not offer a professional service which the orthotist, prosthetist, prosthetist-orthotist <<+, orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant+>> or pedorthist knows, or should know, is beyond his or her ability to perform.

<<-(c) A licensee shall not advertise any technique which is intended to intimidate, exert undue pressure or unduly influence a prospective client.- >>

<< NJ ADC 13:44H-8.8 >>

13:44H-8.8 Retention of advertisements

(a) A licensee shall retain, for a period of three years from the date of initial publication or dissemination, a copy of every advertisement appearing in print media as well as a video or audio tape of every advertisement communicated by telephonic or electronic media. The orthotist, prosthetist, prosthetist-orthotist <<+, orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant+>> or pedorthist shall indicate on all advertisements in his or her possession the date <<+, name+>> and place of publication.

(b) (No change.)

<< NJ ADC 13:44H-9.1 >>

13:44H-9.1 Preparation and maintenance of client records

(a) A licensee shall prepare and maintain for each client a contemporaneous, permanent client record which accurately reflects the client contact with the orthotist, prosthetist, prosthetist-orthotist <<+, orthotist assistant, prosthetist assistant, prosthetist-orthotist assistant+>> or pedorthist, whether in an office, hospital or other evaluation or consultation setting.

(b)-(e) (No change.)

<< NJ ADC 13:44H-10.1 >>

13:44H-10.1 Fee schedule

(a) The following fees shall be charged by the Orthotics and Prosthetics Board of Examiners:

1.-2. (No change.)

3. Initial license fee <<+for orthotist, prosthetist and prosthetist- orthotist+>>:

i. If paid during the first year of the biennial renewal period .................................................. $350.00

ii. If paid during the second year of the biennial renewal period .................................................. $175.00

4. Initial license fee for orthotist assistant, prosthetist assistant and prosthetist-orthotist assistant:

i. If paid during the first year of the biennial renewal period .................................................. $150.00

ii. If paid during the second year of the biennial renewal period .................................................. $ 75.00

5. Biennial license renewal for orthotist, prosthetist and prosthetics-orthotist ............................................... $350.00

6. Biennial license renewal orthotist assistant, prosthetist assistant and prosthetist-orthotist assistant ................................. $150.00

7. (No change in text.)

8. Late renewal ....................................................... $100.00

Recodify existing 8.-11. as <<+9.-12.+>> (No change in text.)


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Posted June 2001