Search

Chapter 246-850 WAC

Last Update: 10/4/11

ORTHOTICS AND PROSTHETICS RULES

WAC Sections

Definitions.
Requirements for licensure.
Application requirements.
Licensure without examination.
Approved internship or residency requirement.
Examination requirements.
Inactive credential.
Retired active credential.
Approval of orthotic and prosthetic educational programs.
Withdrawal of program approval.
ORTHOTICS AND PROSTHETICS CONTINUING COMPETENCY RULES
Continuing competency scope and purpose.
Continuing competency requirements for orthotists and prosthetists.
Classification of categories of continuing competency.
Auditing for compliance.
Orthotic and prosthetic fees.


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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-010, filed 10/21/98, effective 11/21/98.]



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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-020, filed 10/21/98, effective 11/21/98.]



246-850-030
Application requirements.

An applicant for licensure shall submit the following:
(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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-030, filed 10/21/98, effective 11/21/98.]



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:
(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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-040, filed 10/21/98, effective 11/21/98.]



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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-050, filed 10/21/98, effective 11/21/98.]



246-850-060
Examination requirements.

(1) An applicant for licensure as an orthotist must successfully complete the following examinations:
(a) The orthotic written multiple choice examination prepared and administered by the American Board for Certification in Orthotics and Prosthetics, Inc., administered after July 1, 1991. The passing score is determined by utilizing a criterion-referenced cut score methodology.
(b) The orthotic written simulation examination prepared and administered by the American Board for Certification in Orthotics and Prosthetics, Inc., administered after July 1, 1991. The passing score is determined by utilizing a criterion-referenced cut score methodology.
(2) An applicant for licensure as a prosthetist must successfully complete the following examinations:
(a) The prosthetic written multiple choice examination prepared and administered by the American Board for Certification in Orthotics and Prosthetics, Inc., administered after July 1, 1991. The passing score is determined by utilizing a criterion-referenced cut score methodology.
(b) The prosthetic written simulation examination prepared and administered by the American Board for Certification in Orthotics and Prosthetics, Inc., administered after July 1, 1991. The passing score is determined by utilizing a criterion-referenced cut score methodology.
[Statutory Authority: RCW 18.200.050(8). WSR 99-07-122, § 246-850-060, filed 3/24/99, effective 4/24/99.]



246-850-090
Inactive credential.

[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-090, filed 10/21/98, effective 11/21/98.]



246-850-100
Retired active credential.

[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-100, filed 10/21/98, effective 11/21/98.]



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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-110, filed 10/21/98, effective 11/21/98.]



246-850-120
Withdrawal of program approval.

(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.
[Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-120, filed 10/21/98, effective 11/21/98.]



246-850-130
Continuing competency scope and purpose.

The purpose of continuing competency requirements is to maintain and enhance the professional competency of services provided by licensed orthotists and prosthetists. A successful continuing competency program focuses on all aspects of the practice to ensure that the practitioner is competent to provide safe and quality care to patients.
[Statutory Authority: RCW 18.200.050(13). WSR 03-17-093, § 246-850-130, filed 8/20/03, effective 12/1/03.]



246-850-140
Continuing competency requirements for orthotists and prosthetists.

(1) Beginning on January 1, 2004, all orthotists and prosthetists shall report continuing competency activities every three years. The reporting cycle begins at the first license renewal following initial licensing.
(2) Each licensed orthotist and prosthetist shall complete a professional enhancement plan describing the goals the licensee will develop to maintain proficiency in their practice. A professional enhancement plan must be completed in the first year of each three-year reporting period on forms provided by the secretary. The plan may focus on one specific area of practice or broader areas as determined by the individual's goals.
(3) All licensed orthotists and prosthetists must accumulate continuing competency hours as follows:
(a) Licensed orthotists must accumulate a minimum of forty-five continuing competency hours every three years in the area of orthotics.
(b) Licensed prosthetists must accumulate a minimum of forty-five continuing competency hours every three years in the area of prosthetics.
(c) Individuals who are licensed as both an orthotist and as a prosthetist must accumulate a minimum of sixty continuing competency hours every three years.
(4) For individuals licensed in one discipline, a maximum of eighteen Category 2 continuing competency hours may be earned in any three-year reporting period.
(5) For individuals licensed in both disciplines, a maximum of twenty-four Category 2 continuing competency hours may be earned in any three-year reporting period.
(6) Refer to chapter 246-12 WAC, Part 7 for additional requirements.
[Statutory Authority: RCW 18.200.050(13). WSR 03-17-093, § 246-850-140, filed 8/20/03, effective 12/1/03.]



246-850-150
Classification of categories of continuing competency.

Continuing competency activities are distinguished between activities which are sponsored by those organizations listed in subsection (1) of this section and those which are generally independent and/or unsupervised listed in subsection (2) of this section.
(1) Category 1. Courses offered or approved by the following organizations are presumed to qualify as Category 1 continuing competency activities. Category 1 activities receive one continuing competency credit hour for every fifty minutes spent in a course or other activity. Licensees must maintain documentation of attendance at courses. Acceptable documentation includes certificates or receipts with an authorized signature, stamp or seal.
(a) American Board for Certification in Orthotics and Prosthetics, Inc.
(b) Board for Orthotist/Prosthetist Certification.
(c) American Academy of Orthotists and Prosthetists.
(d) American Orthotic and Prosthetic Association.
(e) International Association of Orthotics and Prosthetics.
(f) International Society of Prosthetics and Orthotics.
(g) Association of American Children's Orthotics and Prosthetics Clinics.
(h) Canadian Orthotic and Prosthetic Association.
(j) Relevant school or college courses from an institution accredited by a recognized regional accrediting body.
(k) Relevant courses or seminars offered by organizations or associations such as the American Society of Orthopedic Surgeons, the American Academy of Physical Medicine and Rehabilitation, the American College of Sports Medicine, the American Medical Association, the American Occupational Therapy Association, the American Physical Therapy Association, the American Osteopathic Association, and the American Podiatric Medical Association.
(l) Manufacturer courses approved/sponsored by organizations listed in subsections (1)(a) through (k) of this section.
(2) Category 2. Category 2 continuing competency activities are primarily independent and/or unsupervised and consistent with the goals specified in the individual licensee's professional enhancement plan. Licensees must maintain documentation of completion of Category 2 activities. The following activities, and designated continuing competency credit hours, are considered Category 2 continuing competency:
(a) Relevant allied health seminars not identified as Category 1 activities. A credit hour is fifty minutes spent in a course or other activity. A maximum of five continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation includes certificates or receipts with an authorized signature, stamp or seal.
(b) Practice management. For the purpose of this section, practice management includes only those activities which are directly related to patient care. A credit hour is fifty minutes spent in this activity. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation includes verification of completion of a course or seminar, or a written certification by the licensee describing the activity, the total time required to complete the activity and the date completed.
(c) Journal reading, including electronic publications that are consistent with the goals specified in the individual licensee's professional enhancement plan.
(i) Scientific journals with required examination: Each examination qualifies for two continuing competency credit hours. A maximum of six continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a certificate issued by the sponsoring organization or author showing successful completion of the examination.
(ii) Scientific journals not requiring an examination: Each report qualifies for one continuing competency credit hour. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation for each article is a written report identifying the publication source, author, publication date, and a summary of at least five points from the article.
(iii) Business journals: Each report qualifies for one continuing competency credit hour. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation for each article, is a written report identifying the publication source, author, publication date, and a summary of at least five points from the article.
(d) Instruction video, videodisc or internet courses: A credit hour is fifty minutes spent in this activity. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a written report identifying the source of the instruction, the release date, and summarizing at least five points presented in the instruction.
(e) Manufacturer courses sponsored by organizations not identified as Category 1 activities: A credit hour is fifty minutes spent in this activity. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation includes certificates or receipts with an authorized signature, stamp or seal.
(f) Participating in peer review: For the purpose of this section, peer review means either serving on a formal peer review panel, committee or individual review of a sole provider, where the purpose of the review is to determine whether appropriate treatment was rendered, or whether the services rendered were within accepted standards. Each occurrence qualifies for three credit hours. A maximum of nine continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a certification signed by the facilitator of the peer review providing the date and the total time spent in the peer review process.
(g) Mentoring:
(i) Student mentoring. Each four-hour period spent in this activity qualifies for one credit hour. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a copy of the mentoring contract or agreement and a certification from the student substantiating the date(s) engaged in mentoring and the total mentoring time.
(ii) Peer mentoring. Each four-hour period spent in this activity qualifies for one credit hour. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a certification summarizing the subject of the mentoring, the date, and total mentoring time and signed by the licensee and at least one other practitioner participating in the mentoring activity.
(h) Documented group study: A credit hour is fifty minutes spent in this activity. A maximum of six continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a summary of the group study topics, the date, and total group study time, signed by the facilitator or other authorized personnel.
(i) Grand rounds: Each report qualifies for one credit hour. A maximum of three continuing competency credit hours may be earned in this activity in any three-year reporting period. Acceptable documentation is a report summarizing the cases presented, the location, date, and total time spent in the grand rounds activity and signed by the facilitator or other authorized personnel.
(j) Presentation or lecture to professional group: Each presentation or lecture qualifies for two credit hours. A maximum of six continuing competency credit hours may be earned in this activity in any three-year reporting period. Credit for subsequent presentations will only be considered if the licensee can demonstrate that substantial additional preparation was required. Acceptable documentation is a course outline and a certification from the licensee providing the location, date and total presentation time.
(k) Other activities that enhance or expand the practice may be submitted to the secretary for consideration.
[Statutory Authority: RCW 18.200.050(13). WSR 03-17-093, § 246-850-150, filed 8/20/03, effective 12/1/03.]



246-850-160
Auditing for compliance.

Licensed orthotists and prosthetists must comply with auditing and documentation requirements as required in chapter 246-12 WAC, Part 7. If audited, the licensee will be required to submit the professional enhancement plan and documentation of completion of the activities projected in the plan. The secretary may require additional information as needed to assess the compliance audit.
[Statutory Authority: RCW 18.200.050(13). WSR 03-17-093, § 246-850-160, filed 8/20/03, effective 12/1/03.]



246-850-990
Orthotic and prosthetic fees.

(2) The following nonrefundable fees will be charged:
Title of Fee
Fee
Orthotic application
$395.00
Prosthetic application
395.00
Orthotic renewal
190.00
Prosthetic renewal
190.00
Late renewal penalty fee
190.00
Expired credential reissuance fee
190.00
Inactive credential renewal fee
135.00
Late inactive renewal fee
135.00
Retired active credential renewal fee
135.00
Late retired active credential renewal fee
135.00
Duplicate credential
30.00
Certification of credential
30.00
[Statutory Authority: RCW 43.70.110, 43.70.250, and 2011 1st sp.s. c 50. WSR 11-20-092, § 246-850-990, filed 10/4/11, effective 12/1/11. Statutory Authority: RCW 43.70.250, [43.70.]280 and 43.70.110. WSR 05-12-012, § 246-850-990, filed 5/20/05, effective 7/1/05. Statutory Authority: RCW 43.70.250. WSR 03-21-116, § 246-850-990, filed 10/20/03, effective 12/31/03. Statutory Authority: RCW 18.200.050(1). WSR 98-21-086, § 246-850-990, filed 10/21/98, effective 11/21/98.]