Sixty years have passed since a small group of Orthotists and Prosthetists established what is now the American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., (ABC). A central part of the original mission called for ABC to become the standard setting organization for orthotic and prosthetic patient care. Our present operational mission emphasizes that ABC “will develop and implement new programs to respond to changes within the profession, industry and consumer communities.”
ABC strongly believes that any person who delivers any level of orthotic, prosthetic or pedorthic (O, P & P) care should be educated, trained and certified specifically in the appropriate discipline. However, other allied health professions have claimed overlapping scopes of practice that include certain aspects of O, P & P and their ability to provide that care has been recognized by certain federal and state laws, rules and/or regulations. Our current environment presents unique challenges for ABC to determine ways in which we can promote competent and safe patient care and positively affect the patients served by the providers of O, P & P care.
The location, personnel and delivery methods of O, P & P care have changed dramatically. In the past, orthotic care was primarily delivered in traditional O&P facilities. The advent of the accessibility and the convenience of prefabricated orthoses have changed the settings where care is delivered and the people who are delivering that care. It is not ABC’s mission to determine the legitimacy of the various delivery models, but it is our responsibility to promote the highest standards of organizational and clinical performance in the provision of orthotic, prosthetic and pedorthic services.
Over the past few years, the need has arisen for ABC to expand our standard setting influence over nontraditional providers of O, P & P care. In response to the changing environment, the ABC Board of Directors has made a number of strategic decisions to bring more providers of O, P & P care - both traditional and non-traditional - under a common set of standards.
How Have We Moved Forward?The creation of the orthotic, mastectomy and therapeutic shoe fitter programs was a recognition of the changing models of delivering certain O, P & P care. ABC brings the same approach to these fitter certification programs as it does the practitioner credentialing programs by using a psychometrically validated Practice Analysis to define each scope of practice. These formal processes have a positive influence on the standards of patient care taking place at all levels. Also, ABC has added non-custom therapeutic shoes, off-the-shelf orthotics, post-mastectomy & ocular prosthetics facility accreditation programs. These programs allow us to be involved in the provision of care in some of the non-traditional patient care locations.
The recent successful integration with the Board for Certification in Pedorthics (BCP) came as a result of the two organizations having similar focus on appropriate standards of patient care. ABC’s staff structure and responsibilities were expanded to incorporate every aspect of the BCP programs, providing immediate benefits to Certified Pedorthists. ABC’s considerable resources, including dedicated credentialing and accreditation staff, as well as public relations and professional discipline departments, allow for responsible, accountable administration of the pedorthic certification and accreditation programs.
What is ABC Doing Next?Recognizing there are different levels of providers, ABC has expanded its accreditation programs to create standards of practice for those various levels. ABC’s accreditation programs are designed to hold any organization that provides O, P & P care accountable to the same set of standards as traditional O, P & P providers.
As ABC was preparing to move forward with its traditional accreditation programs under Medicare’s impending mandatory accreditation requirements and developing Quality Standards, it became apparent that our accreditation models did not completely fit today’s real-world environment. After an extensive survey of our certifees regarding their practice settings and the level of services provided at those locations, ABC developed two, wholly dependent, add-on accreditation programs to address their need to continue providing their full spectrum of care under Medicare’s expanding regulatory environment. Each of these new programs are designed to address the unique needs of an accredited O, P & P facility if they provide either ambulatory assistive devices, such as canes, crutches and walkers, or more extensive items of durable medical equipment (DME). Each of these accreditation programs are secondary and are only available to those O, P & P facilities that hold a primary accreditation in at least one of ABC’s other programs.
ABC recognizes that other health care providers are assuming a role in the provision of some levels of O, P & P care. Two groups have recently approached ABC seeking assistance for their constituents. Licensed podiatrists commonly provide certain lower extremity orthoses, pedorthic devices and DME as an adjunct to their podiatric care. Similarly, pharmacies provide one or more levels of care, including off-the- shelf and pre-fabricated orthoses, post-mastectomy products, therapeutic shoes and/or limited or extensive DME. As both groups provide some level of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) they will need to meet CMS’s mandatory accreditation requirements if they plan to receive payment from Medicare for certain services.
Regardless of where the beneficiary receives care, the qualifications of the providers delivering patient care must meet ABC’s stringent accreditation standards. As the preeminent, deemed authority for the accreditation of DMEPOS suppliers, ABC is poised to provide the oversight needed for those suppliers to participate under the newly regulated Medicare benefit categories.
We’re Ready for the Future Recent regulatory actions by CMS have provided the opportunity for the ABC Board of Directors to affect the non-traditional delivery of O, P and P care. This will undoubtedly bring changes to our organization, and ultimately, to the professionals we are responsible for credentialing and the locations where that care occurs. ABC will continue to grow, as will our ability to positively affect the provision of O, P & P patient care. The expansion of our credentialing and accreditation programs will allow ABC to promote the highest standards for the O, P & P profession to the public.