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NEW JERSEY REGISTER
VOLUME 40, ISSUE 14
ISSUE DATE: JULY 21, 2008
RULE PROPOSALS
LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
ORTHOTICS AND PROSTHETICS BOARD OF EXAMINERS

Proposed Readoption with Amendments: N.J.A.C. 13:44H
Proposed Repeal: N.J.A.C. 13:44H-3.3
Proposed New Rule: N.J.A.C. 13:44H-3.8

Rules of the Orthotics and Prosthetics Board of Examiners

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

Authority: N.J.S.A. 45:12B-19 and 45:12B-26.

Calendar Reference: See Summary below for explanation of exception to calendar requirement.

Proposal Number: PRN 2008-236.

Submit written comments by September 19, 2008 to:

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

The agency proposal follows:

Summary

The Orthotics and Prosthetics Board of Examiners (the Board) proposes to readopt N.J.A.C. 13:44H with amendments, a repeal and a new rule. These rules are scheduled to expire on December 30, 2008 pursuant to N.J.S.A. 52:14B-5.1c. The Board has undertaken a review of the existing provisions of N.J.A.C. 13:44H in order to determine their necessity and reasonableness. The Board believes that the rules proposed for readoption are necessary, reasonable, understandable and responsive for the purpose for which they were originally promulgated. The following summarizes each subchapter in N.J.A.C. 13:44H and the amendments, repeal and new rule proposed to the existing rules.

N.J.A.C. 13:44H-1.1 sets forth the purpose and scope of the rules in Chapter 44H. N.J.A.C. 13:44H-l.2 provides definitions for words and terms used in the chapter. Subchapter 2 deals with scope of practice for licensees. N.J.A.C. 13:44H-2.1, 2.2 and 2.3 set forth scope of practice for licensed orthotists, licensed orthotist assistants, licensed prosthetists, licensed prosthetist assistants and certified pedorthists. N.J.A.C. 13:44H-2.4 prohibits any person from practicing orthotics or prosthetics, or acting as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant, without obtaining a license. Subchapter 3 deals with requirements for licensure. N.J.A.C. 13:44H-3.1 and 3.2 set forth application requirements for licensure as an orthotist, prosthetist, prosthetist-orthotist or pedorthist. N.J.A.C. 13:44H-3.3 sets forth application requirements for individuals who worked as orthotists or prosthetists prior to June 17, 2002. This rule required applicants to submit an application prior to December 14, 2002. As this deadline has passed, the Board proposes to repeal N.J.A.C. 13:44H-3.3.

N.J.A.C. 13:44H-3.4 sets forth requirements for granting a temporary license to an applicant who is licensed in another state. N.J.A.C. 13:44H-3.5 sets forth the application procedures for licensure as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant. N.J.A.C. 13:44H-3.6 imposes supervision requirements on orthotist assistants, prosthetist assistants, prosthetist-orthotist assistants, students and holders of temporary licenses. N.J.A.C. 13:44H-3.7 sets forth licensing requirements and biennial renewal requirements for licensees. The Board proposes to delete the renewal provisions from this rule and proposes new rule N.J.A.C. 13:44H-3.8 to implement the licensure renewal requirements of N.J.S.A. 45:1-7.1, 7.2 and 7.3. The proposed new rule requires that licenses be renewed biennially. A licensee who fails to renew will be suspended without a hearing. The proposed new rule permits licensees to renew as active or inactive. An individual may be reinstated or reactivated within five years of being suspended or going on inactive status by applying to the Board. An individual who applies for reinstatement or reactivation more than five years after being suspended or going on inactive status is required to successfully complete the licensing examination.

Subchapter 4 is reserved.

Subchapter 5 deals with established orthotic and prosthetic facilities. N.J.A.C. 13:44H-5.1 requires every established orthotic or prosthetic facility to possess specific types of equipment.

Subchapter 6 sets forth the obligations for licensees and practices which are deemed unlicensed practice. N.J.A.C. 13:44H-6.1 requires licensees to notify the Board of their office address and any change in the office address. N.J.A.C. 13:44H-6.2 sets forth unlicensed practice of orthotics, prosthetics and prosthetics-orthotics. N.J.A.C. 13:44H-6.3 requires licensees to complete continuing education credits during each biennial renewal period. The rule includes procedures by which continuing education sponsors may obtain Board approval for specific courses and by which licensees may obtain continuing education credit for research projects. Subchapter 7 sets forth requirements for business practices and professional conduct. N.J.A.C. 13:44H-7.1 requires licensees to post two prescribed notices in their offices, one notifying patients where complaints regarding the licensee can be sent, and a second notifying patients that information on professional fees is available from the licensee's office upon request. N.J.A.C. 13:44H-7.2 prevents a licensee from charging an excessive fee for professional services. N.J.A.C. 13:44H-7.3 requires licensees to maintain a list of fees for standard services and provide the list upon request. N.J.A.C. 13:44H-7.4 requires licensees to advise a patient as to the nature and purpose of services rendered and the techniques for using a prescribed device. N.J.A.C. 13:44H-7.5 prohibits a licensee from paying for the referral of a client and from dividing fees.

Subchapter 8 sets forth requirements on advertising by licensees. N.J.A.C. 13:44H-8.1 provides definitions for the terms used in Subchapter 8. N.J.A.C. 13:44H-8.2 sets forth general requirements for licensees to follow when they advertise. N.J.A.C. 13:44H-8.3 sets forth information licensees are required to include in advertisements. N.J.A.C. 13:44H-8.4 sets forth the permissible use of professional credentials. N.J.A.C. 13:44H-8.5 sets forth what fees may be advertised and required disclosures when a licensee advertises fees. N.J.A.C. 13:44H-8.6 prohibits advertising that guarantees satisfaction or a cure. A licensee is also prohibited from offering a professional service beyond his or her ability to perform. N.J.A.C. 13:44H-8.7 sets forth guidelines for the use of testimonials. N.J.A.C. 13:44H-8.8 requires licensees to retain a copy of any advertisements for three years from the date the advertisement is initially published or disseminated.

Subchapter 9 deals with a licensee's records. N.J.A.C. 13:44H-9.1 requires a licensee to maintain and periodically review and update records for each client. N.J.A.C. 13:44H-9.2 requires licensees to provide a client his or her record upon request. Subchapter 10 sets forth the fees charged by the Board. The Board proposes to amend N.J.A.C. 13:44H-10.1 to delete the examination fee, which the Board does not charge. The Board also proposes to amend N.J.A.C. 13:44H-10.1 to include an initial licensing fee and renewal fee for pedorthists and an inactive license fee, which will be established by the Board by rule at a later date.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The rules proposed for readoption will continue to ensure the proper practice of prosthetics and orthotics by licensees in the State of New Jersey. The rules establish practice standards and ensure that orthotists and prosthetists remain accountable to the public and the Board. The proposed readoption of the current rules benefit the Board and licensees by providing procedures for the orderly administration of the Board and by establishing clear practice guidelines. Proposed new N.J.A.C. 13:44H-3.8 clarifies the renewal process and implements new procedures for licensees who are returning to active licensure from suspension or inactive licensure. These new procedures ensure that licensees are sufficiently prepared to safely and effectively practice as orthotists, prosthetist or prosthetist-orthotists after a period of professional inactivity.

Economic Impact

Some of the rules proposed for readoption will continue to have an economic impact on applicants for licensure and licensees. N.J.A.C. 13:44H-3.1 requires applicants for licensure as orthotists, prosthetists or prosthetist-orthotists to show that they have completed specific education requirements. The rule requires applicants to complete a clinical internship and the licensing examination. Additionally, the rule requires that applicants who were educated in another country obtain an evaluation of their education and professional experience from a credentialing agency. N.J.A.C. 13:44H-3.2 requires an applicant for licensure as a pedorthist to obtain certification from the American Board for Certification of Pedorthists. N.J.A.C. 13:44H-3.5 requires applicants for licensure as orthotist assistants, prosthetist assistants or prosthetist-orthotist assistants to complete a training course and 1,900 hours of clinical practice. Applicants are also required to pass the licensing examination. All of these costs are borne by applicants. Proposed new N.J.A.C. 13:44H-3.8 requires licensees to renew licensure biennially and to pay license renewal fees. Licensees will bear the cost of paying these fees. The proposed new rule imposes requirements for individuals who are returning to active licensure from suspension or inactive licensure. Complying with these requirements will impose a cost on these individuals. N.J.A.C. 13:44H-5.1 sets forth basic equipment that every established orthotic and prosthetic facility must have. The cost of obtaining this equipment is borne by licensees. N.J.A.C. 13:44H-7.1 requires licensees to post certain notifications in their offices. The cost of preparing these notifications is borne by licensees. N.J.A.C. 13:44H-8.3 requires that any advertisement include a licensee's name, area of licensure, license number, street address and telephone number. N.J.A.C. 13:44H-8.4 requires that any advertisement, which includes information on certification, identify the full name of the agency conferring the certification. N.J.A.C. 13:44H-8.5 requires a licensee to include specific information when he or she refers to fees in an advertisement. N.J.A.C. 13:44H-8.7 requires that, when a licensee provides compensation for a testimonial used in an advertisement, the licensee indicate that compensation has been provided for the testimonial. The cost of including this information in advertisements is borne by the licensee. N.J.A.C. 13:44H-9.1 requires all licensees to maintain client records. The cost of creating and maintaining these records is borne by licensees. N.J.A.C. 13:44H-10.1 sets forth the fees that the Board assesses for services rendered to its licensees. The fee schedule has an economic impact on licensees and applicants for licensure by establishing fees that they must pay in order for the Board to be self-funding and in compliance with N.J.S.A. 45:1-3.2. The proposed amendments to N.J.A.C. 13:44H-10.1 impose an initial licensing fee and a renewal fee on pedorthists.

Federal Standards Statement

A Federal standards statement is not required because there are no Federal standards or requirements applicable to the rules proposed for readoption with amendments, a repeal and a new rule.

Jobs Impact

The Board does not believe that the rules proposed for readoption with amendments, a repeal and a new rule will result in an increase or decrease in the number of jobs in this State.

Agriculture Industry Impact

The Board does not believe that the rules proposed for readoption with amendments, a repeal and a new rule will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

Since orthotists, prosthetists, prosthetist-orthotists, pedorthists, orthotist assistants, prosthetist assistants and prosthetist-orthotist assistants are individually licensed by the Board, they may be considered "small businesses" under the Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq. The costs imposed on small businesses by the rules are the same costs that are imposed on all licensees as outlined in the Economic Impact statement above. The Board does not believe that licensees will need to employ any professional services to comply with the rules proposed for readoption. The rules proposed for readoption with amendments, a repeal and a new rule impose compliance, reporting and recordkeeping requirements as detailed in the Summary above. As the compliance, reporting and recordkeeping requirements contained in the rules proposed for readoption with amendments, a repeal and a new rule are necessary to adequately regulate orthotists, prosthetists, prosthetist-orthotists, pedorthists, orthotist assistants, prosthetist assistants and prosthetist-orthotist assistants, and protect consumers who use their services, the Board believes that the rules must be uniformly applied to all licensees and no exemptions are provided based on the size of the licensee's business.

Smart Growth Impact

The Board does not anticipate that the rules proposed for readoption with amendments, a repeal and a new rule will have any impact on the achievement of smart growth and implementation of the State Development and Redevelopment Plan, otherwise known as the State Plan.

Full text of the rules proposed for readoption may be found in the New Jersey Administrative Code at N.J.A.C. 13:44H.

Full text of the proposed amendments, repeal and new rule follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):

13:44H-3.3 [Licensure without examination (grandfathering); orthotists and prosthetists; credential requirements] (Reserved)

[(a) By December 14, 2002, 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 June 17, 2002 may apply for licensure without satisfying the requirements of N.J.A.C. 13:44H-3.1.

(b) An applicant who seeks licensure without examination under this section shall submit to the Board:

1. A completed application which shall include:

i. A certified statement from applicant documenting their work history;

ii. 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 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 application fee set forth in N.J.A.C. 13:44-10.1.

(c) The Board shall 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.]

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.]

13:44H-3.8 Biennial renewal of licenses

(a) Licenses shall be renewed biennially on a form provided by the Board. Each applicant shall attest that the continuing education requirements of N.J.A.C. 13:44H-6.3 have been completed during the prior biennial period.

(b) The Board shall send a notice of renewal to each licensee, at least 60 days prior to the expiration of the license. If the notice to renew is not sent at least 60 days prior to the expiration date, no monetary penalties or fines shall apply to the holder for any unlicensed practice during the period following the licensure expiration, not to exceed the number of days short of the 60 before the renewals were issued.

(c) The licensee shall submit the renewal application and pay the renewal fee pursuant to N.J.A.C. 13:44H-10.1 prior to the date of expiration of the license. If the licensee does not renew the license prior to its expiration date, the licensee may renew it no later than 30 days after its expiration date by submitting a renewal application and paying a renewal fee and a late fee pursuant to N.J.A.C. 13:44H-10.1. A licensee who fails to renew the license within 30 days after the expiration date of the license shall be suspended without a hearing.

(d) Individuals who continue to practice or hold themselves out as licensed after being suspended shall be deemed to have violated N.J.S.A. 45:12B-17, even if no notice of suspension had been provided to the person.

(e) A person seeking reinstatement within five years following the suspension of a license under (c) above shall submit the following to the Board:

1. A completed reinstatement application;

2. Payment of all past delinquent renewal fees as set forth in N.J.A.C. 13:44H-10.1;

3. Payment of a reinstatement fee as set forth in N.J.A.C. 13:44H-10.1;

4. A certification verifying completion of the continuing education credits required pursuant to N.J.A.C. 13:44H-6.3 for the renewal of a license; and

5. An affidavit of employment listing each job held during the period of suspension, which includes the names, addresses, and telephone numbers of each employer.

(f) A person seeking reinstatement after more than five years following the suspension of a license under (c) above shall satisfy the requirements of (e) above and shall successfully complete the examination required for initial licensure as set forth in N.J.A.C. 13:44H-3.1(a).

(g) Renewal applications for all licenses shall provide the licensee with the option of either active or inactive renewal. Licensees electing to renew as inactive shall not hold themselves out to the public or practice as licensees.

(h) A licensee who elected inactive status and has been on inactive status for five years or less may be reinstated by the Board upon completion of the following:

1. A certification verifying completion of the continuing education hours required pursuant to N.J.A.C. 13:44H-6.3 for the renewal of a license;

2. Submission of an affidavit of employment listing each job held during the period the licensee was on inactive status, which includes the name, address, and telephone number of each employer; and

3. Payment of the reactivation fee and renewal fee as set forth in N.J.A.C. 13:44H-10.1.

(i) A licensee who has been on inactive status for more than five years who wishes to return to the practice of orthotics, prosthetics or prosthetic-orthotics shall satisfy the requirements of (h) above and shall successfully complete the examination required for initial licensure as set forth in N.J.A.C. 13:44H-3.1(a).

13:44H-10.1 Fee schedule

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

1. (No change.)

[2. Examination fee........................................... $ 200.00

(plus cost charged by examination administrator)]

Recodify existing 3. and 4. as 2. and 3. (No change in text.)

4. Initial license fee for pedorthists......................$ 150.00

5.-6. (No change.)

7. Biennial license renewal pedorthtist...................$ 150.00

Recodify existing 7.-13. as 8.-14. (No change in text.)

15. Inactive license fee...... (to be established by the Board by rule)



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