WSR 98-21-086

PERMANENT RULES

DEPARTMENT OF HEALTH

[Filed October 21, 1998, 11:11 a.m.]

Date of Adoption: October 8, 1998.

Purpose: To implement chapter 18.200 RCW enacted by the legislature in 1997 and providing for licensure of orthotists and prosthetists in Washington.

Statutory Authority for Adoption: RCW 18.200.050(1).

Adopted under notice filed as WSR 98-18-065 on August 31, 1998.

Changes Other than Editing from Proposed to Adopted Version: The proposed language in WAC 246-850-110(3) provided that approved programs include required coursework within a minimum of three quarters or two semesters. A phrase has been added to allow approved programs to obtain required course in a substantially equivalent accelerated program.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 0, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 10, amended 0, repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 10, amended 0, repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, amended 0, repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 10, amended 0, repealed 0.

Effective Date of Rule: Thirty-one days after filing.

October 21, 1998

Kristine Van Gorkom

Deputy Secretary

OTS-2326.4

Chapter 246-850 WAC

ORTHOTICS AND PROSTHETICS RULES

NEW SECTION

WAC 246-850-010  Definitions. "Maintenance of an orthosis or prosthesis" includes replacement or repair of component parts that is equivalent to the original component and is required due to wear or failure. Maintenance of an orthosis or prosthesis does not include altering the original components or complete replacement of the orthosis or prosthesis.

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NEW SECTION

WAC 246-850-020  Requirements for licensure. To qualify for licensure as either an orthotist or prosthetist in this state, a candidate must:

(1) Possess a bachelor degree in orthotics or prosthetics from an approved orthotic or prosthetic educational program as provided in WAC 246-850-110; alternatively, a candidate may complete a certificate program in orthotics or prosthetics from an approved education program as provided in WAC 246-850-110;

(2) Complete a clinical internship or residency of 1900 hours as required in WAC 246-850-050; and

(3) Complete an examination as required in WAC 246-850-060.

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NEW SECTION

WAC 246-850-030  Application requirements. An applicant for licensure shall submit the following:

(1) A completed application and fee as required in chapter 246-12 WAC, Part 2;

(2) Official transcripts, certificate, or other documentation forwarded directly from the issuing agency where the applicant has earned a bachelor degree or completed a certificate program from an NCOPE or CAAHEP accredited program as set forth in WAC 246-850-110;

(3) Documentation of completion of an internship or residency of at least 1900 hours as provided in WAC 246-850-050;

(4) Documentation of successful completion of a licensing examination as approved by the secretary;

(5) Verification of four clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.

(6) Verification from all states in which the applicant holds or has held a license, whether active or inactive, indicating that the applicant is or has not been subject to charges or disciplinary action for unprofessional conduct or impairment; and

(7) Additional documentation as required by the secretary to determine whether an applicant is eligible for licensure.

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NEW SECTION

WAC 246-850-040  Licensure without examination. (1) The secretary may grant a license to an applicant who has practiced full time for five of the six years prior to December 1, 1998, and who has provided comprehensive services in an established practice as determined by the secretary.

(2) Applications must be received no later than December 1, 1999.

(3) For the purposes of this section, the following terms have the following meanings:

(a) "Full time" means at least 30 hours per week.

(b) "Comprehensive services" includes the continuum of direct patient care utilizing primary diagnostic evaluation, assessment and follow up and measurable experience in initiating and providing independent measurement, design, fabrication, assembling, fitting, adjusting and servicing. Comprehensive services does not include the provision of incidental repairs, maintenance, or other services at the direction, or under the supervision of, a primary orthotic or prosthetic practitioner.

(c) "Established practice" means a recognized place of business with access to equipment essential to the provision of comprehensive orthotic and/or prosthetic services.

(4) An applicant for licensure without examination must provide the following:

(a) A completed application and fee as required in chapter 246-12 WAC, Part 2;

(b) Official certificates or transcripts sent directly from the issuing agency or institution documenting formal education, if any, including internships or residencies in the professional area for which a license is sought;

(c) Documentation of employment or work history in the professional area for which the license is sought, including the names and qualifications of individuals providing direction or supervision;

(d) A statement describing scope of practice of employment or work experience;

(e) Certification received directly from at least one supervisor describing the applicant's scope of practice and work experience and assessing the applicant's competence and skill level;

(f) Three letters of recommendation from employers or physicians from whom the applicant has received referrals;

(g) Verification of four clock hours of AIDS education as required in chapter 246-12 WAC, Part 8;

(h) Verification from all states in which the applicant holds or has held a health care practitioner license, whether active or inactive, indicating that the applicant has not been subject to charges or disciplinary action for unprofessional conduct or impairment; and

(i) Additional documentation as required by the secretary to determine whether an applicant is eligible for licensure.

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NEW SECTION

WAC 246-850-050  Approved internship or residency requirement. Applicants must complete an internship of at least 1900 hours in each area for which a license is sought. Individual internships must be completed within a minimum period of one year and a maximum period of two years unless extended by the secretary for good cause shown. The internship or residency must be completed under a supervisor qualified by training and experience in an established facility and incorporate patient management and clinical experience in rehabilitation, acute and chronic care in pediatrics and of adults. Applicants who submit evidence of completion of a 1900 hour internship or residency which is approved by the National Commission on Orthotic and Prosthetic Education (NCOPE) or Commission for Accreditation of Allied Health Education Programs (CAAHEP) are considered to have met the requirements of this section. The 1900 hours of internship training must be completed subsequent to graduation from an approved program.

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NEW SECTION

WAC 246-850-090  Inactive credential. A practitioner may obtain an inactive credential. Refer to the requirements of chapter 246-12 WAC, Part 4.

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NEW SECTION

WAC 246-850-100  Retired active credential. A practitioner may obtain a retired active credential. Refer to the requirements of chapter 246-12 WAC, Part 5.

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NEW SECTION

WAC 246-850-110  Approval of orthotic and prosthetic educational programs. (1) For purposes of WAC 246-850-020, the secretary recognizes as approved those orthotic and prosthetic programs that:

(a) Are approved by the National Commission on Orthotic and Prosthetic Education (NCOPE) or its successor, or the Commission on Accreditation of Allied Health Programs (CAAHEP) or its successor or other accrediting body with substantially equivalent requirements; and

(b) Meet the requirements of subsections (2) and (3) of this section.

(2) Approved baccalaureate degree programs or certificate programs must have as prerequisites the following college level coursework:

(a) Biology.

(b) Psychology.

(c) Physics.

(d) Chemistry.

(e) Physiology.

(f) Human anatomy.

(g) Algebra/higher math.

(3) Approved baccalaureate degree programs or certificate programs must include the following coursework within a minimum of three quarters or two semesters, or in a substantially equivalent accelerated program, in each practice area for which a license is sought.

(a) Orthotics only:

(i) Lower extremity orthotics.

(ii) Upper extremity orthotics.

(iii) Spinal orthotics.

(iv) Pathophysiology.

(v) Biomechanics and kinesiology.

(vi) Radiographic interpretation.

(vii) Normal and pathological gait.

(viii) Clinical evaluation.

(ix) Clinical affiliation.

(x) Research methods.

(xi) Practice management.

(b) Prosthetics only:

(i) Lower extremity prosthetics.

(ii) Upper extremity prosthetics.

(iii) Pathophysiology.

(iv) Biomechanics and kinesiology.

(v) Radiographic interpretation.

(vi) Normal and pathological gait.

(vii) Clinical evaluation.

(viii) Clinical affiliation.

(ix) Research methods.

(x) Practice management.

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NEW SECTION

WAC 246-850-120  Withdrawal of program approval. Approval of educational programs may be withdrawn by the secretary, as provided in chapter 34.05 RCW and chapter 246-10 WAC, if:

(1) A program ceases to be approved by NCOPE or CAAHEP; or

(2) Fails to maintain the accreditation standards of NCOPE or CAAHEP; or

(3) Does not meet the minimum curriculum requirements as provided in WAC 246-850-110.

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NEW SECTION

WAC 246-850-990  Orthotic and prosthetic fees. (1) Licenses must be renewed every year on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

(2) The following nonrefundable fees will be charged:

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