Effective January 1, 2019, the practice of privileging non-credentialed caregivers was eliminated. ABC’s Orthotic, Prosthetic and Pedorthic Scope of Practice has been updated to change the way individuals can be privileged to provide patient care. A new definition of Support Personnel was also created allowing ABC credential holders to delegate certain non-critical patient care tasks to non-credentialed individuals. In addition, changes were made to the definitions of Direct Supervision and Supervision and Privileging of a Credential Caregiver.

These Scope of Practice changes do not affect the privileging of certified individuals that relates specifically to HR.6. Which states that you may privilege certified or licensed staff to provide patient care beyond their defined scope of practice under the supervision of a certified or licensed individual practicing within their scope of practice.

These changes will ensure that individuals providing patient care are properly trained and educated. If you are not currently privileging non-certified individuals in your practice then no action is required. However, if you are using this business model in your practice, then you need to begin making changes. This could be accomplished either by those individuals obtaining certification or by assigning them to different roles as outlined in the Support Personnel definition.

Support Personnel
An ABC credential holder may delegate certain tasks in the provision of any custom fabricated or custom fitted orthosis, prosthesis or pedorthic device to non-credentialed support personnel. Those delegated tasks must be within the ABC credential holder’s scope of practice. These tasks must not include patient assessment, formulation of the treatment plan, final fitting and delivery and any follow-up care that modifies the function of the device as originally prescribed. Any tasks delegated to Support Personnel must be supervised under Direct Supervision.

Addressing the needs of Mastectomy Practices
In addition, there is now a separate Mastectomy Scope of Practice that recognizes the unique challenges that certified mastectomy professionals and accredited mastectomy facilities face. The most significant aspect of the scope of practice is the continued ability of certified or licensed mastectomy fitters to supervise and privilege non-credentialed caregivers in the provision of care. The board believes that the existing supervision and privileging requirements appropriately address the elements needed to protect individuals in need of post-mastectomy items and services.

We have a  helpful chart on our website detailing what types of items do or do not require credentialed staff as well as which types of certified staff can be privileged for which specific types of services.

Remember the changes to the Scope of Practice do not impact the supervision and privileging of a credentialed caregiver. One solution many companies have explored is getting their non-credentialed staff certified as an orthotic or therapeutic shoe fitter. This would allow these employees to continue to provide patient care within their scope of practice independently.

For additional information, please see the Privileging FAQs on the ABC website.