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NEW JERSEY REGISTER Proposed Readoption with Amendment: N.J.A.C. 13:44H Authorized By: Orthotics and Prosthetics Board of Examiners, Laura Anderson, Executive Director. Authority: N.J.S.A. 45:12B-26. Submit written comments by May 2, 2003 to: Laura Anderson, Executive Director The agency proposal follows: Summary The Orthotics and Prosthetics Board of Examiners (the Board) proposes to readopt N.J.A.C. 13:44H with an amendment. These rules are scheduled to expire on February 2, 2003. The expiration date of the rules is extended to August 1, 2003 pursuant to N.J.S.A. 52:14B-5.1c by the filing of this proposed readoption with the Office of Administrative Law. 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, as amended, 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 amendments 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. The rule states that the chapter implements the provisions of the Orthotist and Prosthetist Licensing Act (the Act) and that the chapter applies, except as subsection (c) outlines, to all individuals who practice orthotics and prosthetics in New Jersey, as well as those pedorthists who chose to obtain licensure. Subsection (c) lists 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 such as "orthotist," "orthotist assistant," "pedorthist," "prosthetist," "prosthetist assistant," "prosthetist-orthotist" and "prosthetist-orthotist assistant." Subchapter 2 sets forth the scope of practice for licensees. N.J.A.C. 13:44H-2.1 sets forth the scope of practice for licensed orthotists and a licensed orthotist assistants. Orthotist scope of practice includes the evaluation for, and manufacture and fitting of, orthotic devices prescribed for the correction or alleviation of musculoskeletal diseases, injuries or deformities. A licensed orthotist may employ a licensed orthotist assistant to mold, paint, cut, mix, grind, polish, sew, laminate, glue, screw, rivet, fasten or vacuum form an orthotic appliance or orthosis. Orthotist assistants must be supervised by a licensed orthotist 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 licensed prosthetists and licensed prosthetist assistants. Prosthetist scope of practice includes the evaluation for, and manufacture and fitting of, upper and lower extremity prosthetic appliances. A licensed prosthetist may employ a licensed prosthetist assistant to mold, paint, cut, mix, grind, polish, sew, laminate, glue, screw, rivet, fasten or vacuum form upper and lower extremity prosthetic appliances. Licensed prosthetist assistants must be supervised by a licensed prosthetist 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 pedorthists. Licensed pedorthists are limited to the design, manufacture, fit and modification of shoes and related foot appliances which extend from the ankle and below, which are prescribed for the amelioration of painful or disabling conditions of the foot. N.J.A.C. 13:44H-2.4 outlines prohibited practices. The rule 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 this chapter. No licensed orthotist, prosthetist, 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. Subchapter 3 sets forth requirements for licensure. N.J.A.C. 13:44H-3.1 deals with application requirements for licensure as an orthotist, prosthetist or prosthetist-orthotist. The rule requires applicants for licensure as an orthotist, prosthetist, prosthetist-orthotist to pass the American Board for Certification in Orthotics and Prosthetics examination. An applicant for licensure as an orthotist, prosthetist, or prosthetist-orthotist also must submit to the Board: a completed application which includes documentation indicating that the applicant received a bachelor's degree and has completed a clinical internship of at least 1,900 hours; the application fee set forth in N.J.A.C. 13:44H-10.1; and proof that the applicant has successfully completed the licensing examination. The rule provides separate requirements for applicants who apply for licensure by June 17, 2007. Such an applicant has to show that he or she has earned an associates degree, with course work in biology, anatomy and physiology, physics and chemistry. The applicant is also required to complete a 1,900 hour internship, successfully pass the licensing examination and pay the licensing fee required by N.J.A.C. 13:44H-10.1. Any applicant who applies by June 17, 2003 is allowed to complete the 1,900 hours of clinical practice under the supervision of an unlicensed person if the applicant can show that the supervisor would qualify for licensure pursuant to N.J.A.C. 13:44H-3.3. Subsection (e) of the rule requires a foreign-trained applicant to obtain an evaluation of his or her professional educational and professional experience credentials from a credentialing agency recognized by the American Board for Certification in Orthotics and Prosthetics or the International Society of Prosthetists and Orthotists. The Board will review this evaluation to determine if the applicant's education and experience is equivalent to the requirements of the Board. Subsection (e) is proposed for amendment to correct a cite to the Board's application requirements. The subsection currently cites to a non-existent "(a)1 above," and is amended to cite to paragraph "(b)1 above." N.J.A.C. 13:44H-3.2 requires applicants for licensure as a pedorthist to submit to the Board: a completed and notarized application; the application fee set forth in N.J.A.C. 13:44H-10.1; and proof of certification by the American Board for Certification of Pedorthists. N.J.A.C. 13:44H-3.3 sets forth application requirements for individuals who are currently working as orthotists or prosthetists. A person will qualify for licensure if that person applies by December 14, 2002 and has practiced as an orthotist, prosthetist or prosthetist-orthotist for at least 1,750 hours a year during the three years prior to June 17, 2002. An applicant for licensure pursuant to N.J.A.C. 13:44H-3.3 shall submit to the Board: a completed application which includes a certified statement from applicant documenting his or her work history; notarized documentation from the employer of the applicant's employment history; four Physician Reference Forms completed by physicians who have medical rehabilitation and/or orthopedic experience; a passport size photograph; and the application fee set forth in N.J.A.C. 13:44H-10.1. The Board is required to conduct an investigation of the applicant's work history within six months of receiving the application in order to determine whether the applicant has established his or her qualifications for licensure. 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. The Board may issue a temporary license if the applicant is licensed in another state which has licensing standards equivalent to those in New Jersey, the applicant's license is in good standing in the other state and the applicant has applied for licensure as an orthotist, prosthetist or prosthetist-orthotist in New Jersey. A temporary license will only permit its holder to 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. The holder of a temporary license must be supervised by a licensee pursuant to N.J.A.C. 13:44H-3.6. The temporary license will be valid for one year and the holder of a temporary license must take the first available licensing examination. The Board may 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. An applicant who seeks to renew a temporary license must send an application to the Board at least 90 days before the temporary license expires. The holder of a renewed temporary license must take the next available examination and the renewed temporary license will expire after the results of that examination are issued. 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. 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 outlines the application procedures for licensure as an orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant. An applicant must submit to the Board an application that includes proof that the applicant: is at least 18 years old; has a high school diploma; 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 has completed 1,900 hours of clinical practice. The applicant must also submit proof that he or she has passed the licensing examination and must submit the application fee. An individual who applies by June 17, 2003 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. 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. A licensed orthotist assistant, licensed prosthetist assistant, licensed prosthetist-orthotist assistant, student or holder of a temporary license may 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 until June 17, 2003. After that date only a licensed orthotist, licensed prosthetist or licensed prosthetist-orthotist may provide supervision. An assistant, student or holder of a temporary license must be supervised by a licensee who practices in their field and cannot perform laboratory or clinical work unless 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 an 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. Licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist-orthotist assistants and students must receive close supervision from a supervising licensee. "Close supervision" requires 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. The holder of a temporary license must receive routine supervision from a supervising licensee. "Routine supervision" requires 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. The supervising licensee is responsible for the laboratory and clinical work performed by an assistant, student or holder of a temporary license and may only supervise three assistants, students or holders of a temporary license at one time. The supervising licensee must by 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. The supervising licensee must provide direction to the assistant, student or holder of a temporary license. An assistant, student or holder of a temporary license must maintain a daily record which is initialed by the supervising licensee. The supervising licensee must name another licensee to supervise the assistant, student or holder of a temporary license whenever the supervising licensee is absent. N.J.A.C. 13:44H-3.7 requires an applicant who has qualified for licensure to send in the licensing fee. The rule also requires licensees to renew their licenses and pay the license renewal fees every two years. 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. The rule also sets forth additionally required equipment for orthotic facilities which engage in on-site fabrication, prosthetic facilities which utilize centralized fabrication services and prosthetic facilities which engage in on-site fabrication. The rule requires that established pedorthic facilities meet the facility accreditation requirements set forth by the American Board for Certification in Pedorthics. Subchapter 6 sets forth the obligations of 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 to notify the Board, in writing, within 30 days of any change in the office address. The rule states that service of an administrative complaint at the licensee's address on file with the Board is adequate notice for the commencement of any inquiry or disciplinary proceeding against the licensee. Also, licensees are required to cooperate in any inquiry, inspection or investigation conducted by or on behalf of the Board or the Director. N.J.A.C. 13:44H-6.2 outlines what constitutes unlicensed practice of orthotics, prosthetics and prosthetics-orthotics. A person is engaged in the unlicensed practice if the person offers or renders orthotics or prosthetics services and is not 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 a licensed professional acting exempt pursuant to N.J.A.C. 13:44H-1.1(c). Any person, other than a licensed orthotist, prosthetist or prosthetist-orthotist who uses a title or designation which includes the words orthotist, prosthetist or prosthetist-orthotist or the abbreviations L.O., L.P., L.P.O. or any similar abbreviations, is engaged in unlicensed practice. The rule requires licensees to use only those titles or designations that correspond to his or her licensure. Subchapter 7 sets forth requirements for business practices and professional conduct. N.J.A.C. 13:44H-7.1 requires licensees to post two notices in their offices, one of which notifies patients that any complaints regarding the licensee can be sent to the Board, the second of which notifies 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, offering to pay or receiving any fee or other form of compensation for referral of a client. A licensee is also prohibited from participating in the division of fees for professional services outside of a division among other licensees engaged in a bona fide partnership, professional service corporation or employment relationship. Subchapter 8 sets forth requirements on advertising by licensees. N.J.A.C. 13:44H-8.1 sets forth definitions for terms that are used in subchapter 8. N.J.A.C. 13:44H-8.2 sets forth general requirements for licensees to follow when they advertise. Licensees must be able to substantiate the truthfulness of anything set forth in an advertisement. If a licensee is a partner or officer of a firm identified in an advertisement as offering services or goods, the licensee is responsible for the form and content of any advertisement disseminated by the firm. A licensee is required to ensure that any advertisement he or she disseminates does not misrepresent, mislead, suppress, deceive, omit or conceal a material fact. A licensee is prohibited from improperly omitting, suppressing or concealing a material fact or preventing a prospective client from making a full and informed judgment on the basis of the information set forth in the advertisement. N.J.A.C. 13:44H-8.3 sets forth information licensees are required to include in advertisements. A licensee must include his or her name, field of licensure, license number and the street address and telephone number of the practice in all advertisements and professional representations. N.J.A.C. 13:44H-8.4 outlines permissible use of professional credentials. The rule requires a licensee to accurately represent his or her competence, education, training and experience. If a licensee includes information about professional credentials in an advertisement, the advertisement must contain the highest academic degree or certification the licensee completed that is related to the practice of orthotics or prosthetics. Any degree mentioned must be from an academic institution accredited by a national or regional accrediting agency recognized by the United States Department of Education. Any advertisement which includes information on an orthotic, prosthetic, prosthetic-orthotic or pedorthic certification must include the full name of the agency conferring the certification or the name, or abbreviation, of the certification. Letters or abbreviations which a licensee uses adjacent to his or her name must be limited to those representing either the highest academic degree earned related to orthotics or prosthetics or licenses or certifications issued by another state or Federal agency. The rule does not preclude any truthful and non-deceptive statement regarding the education or experience a licensee has in a particular area of orthotics or prosthetics. N.J.A.C. 13:44H-8.5 sets forth required disclosures when a licensee advertises fees. The only fees that may be advertised are fixed fees or a stated range of fees for specifically described professional services. Any advertisement referring to fees must include: everything which is ordinarily included in the advertised services so that the fee will be clearly understood by prospective clients; any additional services contemplated and the fee to be charged for them; and the period during which the advertised fee will remain in effect. The rule states that the advertisement of a fee does not preclude a licensee from adjusting a fee downward or waiving a fee. N.J.A.C. 13:44H-8.6 outlines prohibited methods of advertising. A licensee is prohibited from guaranteeing that satisfaction or a cure will result from the performance of professional services. A licensee is also prohibited from offering a professional service which the licensee knows, or should know, is beyond his or her ability to perform. N.J.A.C. 13:44H-8.7 sets forth guidelines for the use of testimonials. Any testimonial in an advertisement must be based upon the personal knowledge or experience of the person giving the testimonial, gained through a professional relationship with the licensee. A licensee who uses a testimonial must obtain a signed, notarized statement and release indicating the person providing the testimonial is willing to have his or her testimonial used in the advertisement. A layperson's testimonial cannot attest to, or comment upon, any technical matter beyond the layperson's competence. An expert testimonial can only be rendered by an individual possessing expertise relevant to the area in which he or she is giving the testimonial. A licensee is required to be able to substantiate any statement of fact appearing in a testimonial and to indicate that an individual has been compensated for a testimonial in the advertisement, if compensation is provided. N.J.A.C. 13:44H-8.8 deals with the retention of advertisements. A licensee must retain a copy of any advertisements for three years from the date the advertisement was initially published or disseminated. All advertisements a licensee retains pursuant to this rule must indicate the date, name and place of publication. Any documentation relating to the use of testimonials must be maintained for three years from the date of the last use of the testimonial. Subchapter 9 deals with a licensee's records. N.J.A.C. 13:44H-9.1 requires a licensee to maintain records for each client. These records shall include: the client's name, address and telephone number; the location and dates of all treatments; the identity of the licensee providing treatment and the supervisor, if any; the presenting situation; the name and address of the referring physician, podiatrist or dentist; any medications the client is taking; a treatment or service plan; contemporaneous progress notes for each session; fees charged and paid; and the name of the manufacturer of any device not made by the licensee. The rule requires a licensee to periodically review and update the treatment or service plan and to maintain client records for at least seven years from the date of the last entry. Licensees are required to comply with this section regardless of an employer's recordkeeping requirements. N.J.A.C. 13:44H-9.2 deals with the release of client records. A licensee is required to provide a client his or her record within 15 days of a request from the client or the client's guardian. A licensee may require that a record request be made in writing and may charge a fee for the reproduction of records, which shall be no greater than $1.00 per page or $100.00 for the entire record, whichever is less. A licensee is prohibited from charging for the completion of health insurance claim forms, however, a licensee is permitted to charge a fee for completion of reports required for third-party reimbursement of client treatment expenses or for use in judicial proceedings. A licensee is prohibited from requiring advance payment prior to releasing a report that is needed for the client's ongoing care by another practitioner or for use in judicial proceedings. A licensee may require advance payment for the release of a report that is to be used by the licensee while acting as an expert witness on behalf of the client. Subchapter 10 sets forth the fees charged by the Board. 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 rules proposed for readoption benefit the Board and licensees by providing procedures for the orderly administration of the Board and by establishing clear practice guidelines. Economic Impact Some of the rules proposed for readoption will 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 prosthetists-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 a orthotist assistant, prosthetist assistant or prosthetist-orthotist assistant to complete a training course and 1,900 hours of clinical practice. An applicant is also required to pass the licensing examination. All of these costs are borne by applicants. 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 the licensee. N.J.A.C. 13:44H-7.1 requires licensees to post certain notifications in their offices. The cost of obtaining these notifications is also borne by licensees. N.J.A.C. 13:44H-8.3 requires that any advertisement must include the 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 that includes information on certification must 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 an advertisement 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 which 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. 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. Jobs Impact The Board does not believe that the rules proposed for readoption 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 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 proposal will apply. If, for the purposes of the Act, the individuals who are licensed by the Board as orthotists, prosthetists, prosthetist-orthotists, pedorthists, orthotist assistants, prosthetist assistants or prosthetist-orthotist assistants are considered small businesses, then the following analysis applies. The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the rules proposed for readoption with amendment 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 rules proposed for readoption with amendment with an indication of the varying impact on small businesses of differing types and sizes and to outline the manner in which it has designed the rules to minimize any adverse economic impact upon small businesses. The costs imposed on small businesses by the rules proposed for readoption with amendment are the same costs that are imposed on all businesses as outlined above in the Economic Impact. The Board does not believe that licensees will need to employ any professional services to comply with the requirements of the rules proposed for readoption. The rules proposed for readoption impose compliance, recordkeeping and reporting requirements on licensees. The rules proposed for readoption impose several compliance requirements. N.J.A.C. 13:44H-2.4 prohibits a licensed orthotist, prosthetist or prosthetist-orthotist from employing an unlicensed assistant. N.J.A.C. 13:44H-3.4 requires that a temporary license holder be supervised by a licensee and that a temporary license holder take the first licensing examination offered after the holder receives the temporary license. The rule also requires the holder to cease working once the temporary license expires. N.J.A.C. 13:44H-3.6 requires that licensed orthotist assistants, licensed prosthetist assistants, licensed prosthetist-orthotist assistants, students and holders of temporary licenses obtain supervision from a licensed orthotist or licensed prosthetist. A supervising licensee must provide close supervision for assistants and students. A supervising licensee must provide routine supervision for the holder of a temporary license. A supervising licensee is personally responsible for any laboratory work performed by the supervisee, is required to provide direction to a supervisee, is prohibited from providing supervision for more than three individuals at a time and must be physically present during the initial evaluation of a patient and the final provision of a device by a supervisee. A supervising licensee is also required to arrange for supervision whenever he or she is unable to provide supervision. N.J.A.C. 13:44H-3.7 requires a licensee to renew licensure biennially. N.J.A.C. 13:44H-5.1 sets forth equipment that licensees must have in an established orthotic and prosthetic facility. N.J.A.C. 13:44H-6.1 requires licensees to cooperate in any inquiry, inspection or investigation conducted by the Board or the Director of the Division of Consumer Affairs. N.J.A.C. 13:44H-6.2 requires a licensee to use only those titles or designations that accurately reflect his or her licensure. N.J.A.C. 13:44H-7.1 requires a licensee to post notifications in an office regarding the Board and fees. N.J.A.C. 13:44H-7.2 prohibits a licensee from charging an excessive fee. N.J.A.C. 13:44H-7.3 requires licensees to provide a list of fees to patients upon request. N.J.A.C. 13:44H-7.4 requires a licensee to advise a patient as to the nature and purpose of the services rendered as well as the techniques for use and care of a device. N.J.A.C. 13:44H-7.5 prohibits a licensee from accepting or offering compensation for the referral of a patient or from dividing a fee for professional services outside of a partnership or other permissible business structure. N.J.A.C. 13:44H-8.2 requires licensees to be able to substantiate the truthfulness of any representation made in an advertisement. A licensee who is a partner or officer in a firm is responsible for the form and content of an advertisement made by the firm. A licensee is required to ensure that an advertisement is not misleading and does not omit or suppress material facts. N.J.A.C. 13:44H-8.3 requires advertisements to include the name, area of licensure, license number, street address and telephone number of the licensee. N.J.A.C. 13:44H-8.4 requires licensees to accurately represent his or her competence, education and experience. A licensee is also required to include in an advertisement the highest academic degree obtained from an academic institution accredited by a national or regional accrediting agency or certification attained when the advertisement includes information on professional credentials. Any advertisement which includes information on certification must include the full name of the agency conferring the certification or the name or abbreviation of the certification. Any letters or abbreviations appearing adjacent to the name of a licensee shall be limited to those that represent the highest academic degrees earned related to the practice of orthotics or prosthetics or licenses issued by another state or Federal agency. N.J.A.C. 13:44H-8.5 limits advertisement of fees to those which contain a fixed range of fees. N.J.A.C. 13:44H-8.6 prohibit a licensee from guaranteeing that satisfaction or a cure will result from professional services. A licensee is also prohibited from offering services which are beyond the licensees ability to perform. N.J.A.C. 13:44H-8.7 requires that any testimonial in an advertisement be based on information the individual giving the testimonial gained from a professional relationship with the licensee. A licensee is required to obtain a signed, notarized release allowing the use of the testimonial in an advertisement by the individual giving the testimonial. A licensee is prohibited from using a testimonial given by a layperson which attests to a technical matter beyond the layperson's ability to comment on and a licensee can only use an expert testimonial from an expert in the field. A licensee is required to be able to substantiate any statement of fact appearing in a testimonial. If a licensee provides compensation for a testimonial, an advertisement that uses the testimonial must disclose that compensation was provided. N.J.A.C. 13:44H-9.2 requires licensees to provide records to clients within 15 days of a request. A licensee is prohibited from charging more than $100.00 for the reproduction of records. A licensee is also prohibited from charging for the completion of health insurance claim forms and for records needed to enable a client to receive ongoing care by another practitioner. The rules proposed for readoption also impose reporting and recordkeeping requirements on licensees. Orthotist assistants, prosthetist assistants, prosthetist-orthotist assistants and holders of temporary licenses are required to maintain a daily record of services performed and the supervising licensee is required to initial this record. N.J.A.C. 13:44H-6.1 requires licensees to notify the Board in writing within 30 days of a change in the office address on file with the Board. N.J.A.C. 13:44H-7.3 requires licensees to maintain a record of the fees for standard services. N.J.A.C. 13:44H-8.8 requires licensees to retain copies of advertisements for three years from the last date of dissemination. The rule also requires licensees to maintain documentation relating to testimonials for three years from the date of the last use of the testimonial. N.J.A.C. 13:44H-9.1 requires licensees to maintain client records. These records must be maintained for at least seven years from the date of the last entry. As the compliance, reporting and recordkeeping requirements contained in the rules proposed for readoption with amendment as discussed above are necessary to adequately regulate licensees 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 amendment 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 proposed readoption may be found in the New Jersey Administrative Code at N.J.A.C. 13:44H. Full text of the proposed amendment follows: << NJ ADC 13:44H-3.1 >> 13:44H-3.1 Requirements for orthotists, prosthetists and prosthetists- orthotists (a)-(d) (No change.) (e) Foreign-trained applicants shall obtain an evaluation of their professional educational and professional experience 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. The Board shall accept only an evaluation which is sent to the Board by the credentialing agency. Upon receipt of the evaluation by the Board, the Board shall review the evaluation and determine whether the applicant's education and experience credentials are substantially equivalent to those required in <<-(a)1->><<+(b)1+>> above.
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