Terry Supan has been involved with Prosthetic and Orthotic licensure activities since 1980 when he was the President of the Midwest Chapter of AAOP during the first attempt at licensure in Illinois. He was chair of the Illinois Society of Orthotists, Prosthetists & Pedorthists’ Licensure Committee both when the original Illinois Orthotic, Prosthetic, & Pedorthic Practice Act was passed in 1999 and when the Act went through its Sunset revision in 2009. As a member of the Licensure Board he was also actively involved with the drafting of the Act’s Administrative Rules in 2000 and their revision in 2011-12.
Due to this experience, he was asked to Chair the ABC’s Licensure Committee when the first ABC Model Practice Act and the ABC Licensure Handbook were created. He has served on Licensure Committees for both the AAOP and the American Orthotic and Prosthetic Association (AOPA). As the ABC committee chair, he provided guidance to the state P&O organizations in Georgia and Oklahoma during their successful attempts at licensure.
After the Board of Certification/Accreditation, International signed the “Historic Agreement” to uphold NCOPE’s educational standards as the pathway for practitioner’s certification, Mr. Supan agreed to work with the Board creation of their own model act. In 2010 he assisted the BOC by developing the BOC Model Licensure Act which is based on the principles of patient protection through professional educational standards or clinical supervision during care by non-licensed individuals.
Mr. Supan has also made recommendations on draft legislation to state organizations in Wisconsin, Minnesota, Iowa, and Louisiana. He is available to other state and regional organizations to assist them in their efforts to pass Prosthetic and Orthotic Licensure Legislation and to draft a bill which is compatible with that State’s other Practice Acts while maintaining the goal of patient protection through education, clinical experience and comprehensive examination.
Links to the ABC’s Model Licensure Act and Handbook: the BOC Model Licensure Act: and the AAOP Licensure Tool Kit:
A License or Just Board Certification*
exerts from "Licensure vs. Certification-How it can affect you!", Terry Supan, CPO, in Motion, Volume 9, Issue 6, p 27, November/December 1999.
Licensure:
The act or practice of granting licenses, as to practice a profession.
Certification:
A document certifying that one has met specified requirements, as for teaching.
There has been an ongoing debate on the merits of mandatory state regulation versus voluntary national accreditation. The intent of this article is to make the consumer aware of the differences between the two and how they could affect your prosthetic care. It will also provide an update on which states have passed legislation affecting prosthetists, orthotists and pedorthists (foot prosthetists) and where they are in the implementation process.
In 1996, inMotion published an article on the history of educational and accreditation standards for the prosthetics profession. In 1993, the American Medical Association (AMA) finally recognized the practice of orthotics and prosthetics (O&P) in the United States as an allied health profession. Educational standards established by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) were implemented the following year.
The difference between licensure and certification is the force of law. The state agency that regulates any health profession can prevent an individual from providing health care in that state. Certification or any other voluntary accreditation cannot provide the same safeguards to the public. In states without licensure, anyone can provide prostheses, regardless of their education, competency, or business ethics.
The practice of O&P serves to improve and enhance the lives of individuals with disabilities, by enabling them to resume productive lives following serious illness, injury or trauma. Americans deserve the best care available, and will benefit from the assurance of initial and ongoing professional competence of orthotists and prosthetists practicing in the United States.
States that have passed legislation believe that the increasing population of elderly and physically challenged individuals who need O&P services requires that the O&P profession be regulated to ensure the provision of high quality services and devices. The present unregulated system for dispensing O&P care does not adequately meet the needs or serve the interests of the public. In keeping with state requirements imposed on similar health disciplines, licensure of the O&P profession will help ensure the health and safety of consumers, as well as maximize their functional abilities and productivity levels.
The rationale behind certification of individuals and accreditation of organizations providing prosthetic care is self-regulation. Professional accreditation boards will police themselves by endorsing educational standards, establishing minimal competencies, and enforcing standards of ethical conduct and business practice. But the maximum penalty for individuals/companies that violate those policies is the removal of their certification or accreditation. The only redress that a consumer would have against a prosthetist or the prosthetic facility would be civil litigation.
Through licensure, states will also establish the same types of policies to regulate the prosthetic profession. But their policies are mandated and violation of those policies could lead to fines, loss of license, the right to practice in that state and, in the most severe cases, imprisonment. They will restrict the provision of prostheses by individuals that do not meet the state's requirements. Instead of the consumer seeking redress for him or herself, the state is obligated to do it for them...
As a consumer, what does all this mean to you?
First, if you live in a state that requires a license to practice as a prosthetist, make sure that your prosthetist is licensed. If you have problems, bring it to the attention of the regulatory agency or board that oversees prosthetic care.
In states that do not have licensure, seek out individuals who have national accreditation that is based on the highest standards in the areas of competency and education. If you have problems, bring it to the attention of the accreditation board that has accredited the individual. If you think licensing of prosthetists is a good idea, work with statewide, professional groups and consumer advocacy groups to pass prosthetic, orthotic and pedorthic legislation.
Unfortunately, no license or certification is a guarantee of total satisfaction with your prosthetic care. Both are only benchmarks of established educational standards and minimal competency. A successful outcome in prosthetics, like most of medicine, is greatly influenced by the technology available, and the health condition and attitude of the amputee and not just the ability of the health care professional.
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