By Joan M. Zinter, CPO, Surveyor 

In the past year, I have completed surveys in Illinois, Texas, Tennessee and Georgia. These states all have one thing in common, they require that a practitioner be licensed to provide orthotic, prosthetic and sometimes pedorthic care in that state. In preparation for conducting facility accreditation surveys in a licensure state, I review the state’s Practice Act for Orthotics and Prosthetics to determine the scope of practice for practitioners.

In my review, I specifically look for how the state law may differ from ABC’s Scope of Practice.  Is the law more or less restrictive in its scope of practice, educational requirements and legal definitions? Does it allow for privileging of non-licensed practitioners or personnel? 

If you work in a licensure state, it is important for you to know if privileging is allowed in your state’s law. Privileging staff to provide patient care in licensure states is where I see the most non-compliance with standard HR.4.1 which says:  

When required by state licensure, staff providing patient care must be licensed by the orthotic, prosthetic and/or pedorthic licensure body and function within their licensure scope of practice. 

Licensure laws throughout the country contain many variations in privileging and supervision requirements. Licensure privileging varies among states, with some mandating that no patient care can be provided without a license. Other states maintain that the provision of care depends on the complexity of the device and the amount of supervision that’s required of the non-licensed personnel.  

When performing your annual compliance reviews, it is a good idea to revisit your state’s licensure law to see if there have been any revisions. It is also important to make sure staff job descriptions are compatible with these laws. If you’re located in a licensure state and are privileging or thinking of privileging staff, be sure to find out whether you are already compliant or what changes you might need to make in order to achieve compliance. 

Remember! Practicing outside of your scope of practice is risky business. Not only can it get you in trouble with your state licensure board and ABC, it can also put your patients and practice at risk.