BILL NUMBER: S1674
TITLE OF BILL :
An act to amend the education law, in relation to creating the
profession of orthotics, prosthetic and pedorthic practice
PURPOSE OR GENERAL IDEA OF BILL :
To establish a State Board of Orthotists, Prosthetists and Pedorthists
within the Department of Education; to provide for the licensing of
Orthotists, Prosthetists and Pedorthists by the State. Board of
Orthotists, Prosthetists and Pedorthists, and to add a new Article 167
to the Education Law.
SUMMARY OF SPECIFIC PROVISIONS :
The Education Law is amended by adding a new Article 167 entitled:
Orthotic and Prosthetic Practice.
For a number of significant reasons, there is a growing and perhaps
even desparate need for professionalized orthotic and prosthetic (O&P)
care in New York and the United States. Since 1973, the U.S.
Department of Education has identified O&P training as a national
priority with both a training and practitioner deficit. Several
factors now combine to exascerbate that stated need exponentionally.
Some of these factors are health related. The Department of Health and
Human Services recently reported on the twin epidemics of diabetes.
and obesity. Diabetes is the leading cause of limb loss, and the
recent explosion in cases of obesity and diabetes are expected to
result in the escalation of diabetic amputations. The number of
Americans with diagnosed diabetes is, projected to increase 165
percent by 2050. Cardiovascular disease, the nation's leading killer,
is the second leading cause of amputations. Millions of Americans
living today with cardiovascular disease are at an increased risk for
amputation. Obesity further complicates the risk of Americans
developing a chronic disease like heart disease or diabetes and
increases the risk of amputations to those living with these
The National Health Interview Survey indicates that 35 million
Americans (one in eight) have disabling conditions that interfere with
life activities and 16 percent of those individuals reported an
orthopedic impairment. In 1990, more than 3;5 million persons in the
U.S. were using some kind of orthosis, more than a 100 percent
increase since 1980. Approximately 20.3 percent of the 2 million
Americans with complete or partial paralysis of extremities use
orthoses (Nielsen, May 2002).
The demand for provider services is expected to increase by 25 percent
for orthotic care and 47 percent for prosthetic care by 2020. This
practitioner shortage means more demand than ever for graduates of the
nation's O&P education programs. Without an increase in the number of
O&P students, by the year 2020, only 61 percent or less of the
population using orthoses will be served. Similarly, only 66 percent
or less of prosthetic consumers' needs will be met by 2020-a
population expected to increase by 47 percent by that year.
In addition to these medical causes, our nation's military contributes
to the need for this legislation. Since the war on terror began in
2001, more than 14,000 troops have been wounded in Iraq and
Afghanistan. Of those, nearly half still require long-term care. The
most severely injured soldiers suffer from double and triple
amputations, severe head and body trauma, blindness, deafness, and
partial and full paralysis. The use of improvised explosive devices in
Iraq has resulted in many cases of severe bums. To meet the growing
need for the care and rehabilitation of the men and women who have
sacrificed so much, the professionalization of O&P care is essential.
Furthermore, this legislation, by providing an enhanced level of
professional care and education, will protect consumers of
orthotic-prosthetic-pedorthic treatment in New York State against
inadequate or substandard pratitioners. Our consumers are presently
exposed to actual and potential harm in the following ways:
1. PHYSICAL HARM; Orthoses, prostheses and pedorthic devices fit
intimately on the human body. Improper fit due to inadequate education
and training of the practitioner cart result in the device, rather
than improving the patient's life, actually complicating it and
increasing the risk of physical injury to the patient. A well designed
and carefully fitted orthosis or prosthesis can significantly improve
a physically challenged individual's life, allowing him or her to be a
productive member of our State to the fullest of his or her potential.
However, a poorly designed and/ or poorly fitted one can cause further
medical complications and/or result in serious physical injury to the
2. PSYCHOLOGICAL HARM; The physically challenged individual or his
loved ones, when presented with an inadequate device or incompetent
service, can and do experience emotional harm. Decreased
self-confidence, diminished self-worth, distress from chronic
discomfort, and increased self-consciousness are but a few of the
problems which cumulatively add to the grief already experienced due
to the sense of loss or diminished body image.
3. FINANCIAL HARM; Because orthotics, prosthetic and pedorthic
practice is unregulated, consumers, their loved ones and the taxpayers
of this state suffer from numerous economic hardships.
The proposed legislation is the most effective means of addressing
these harms. It will insure the public of the initial and continuing
professional ability of orthotic-prosthetic-pedorthic practitioners by
mandating their competency to provide custom-made orthoses, prostheses
and pedorthic devices. Licensure will also insure that the public has
a mechanism for lodging complaints to a disciplining authority when
they are subjected to unprofessional conduct.
Licensure is also warranted by the recognition by other medical
professionals of the emergence of the field of
orthotics-prosthetics-pedorthics as a separate and distinct health
care profession. The American Medical Association recognizes the
field of orthotics-prosthetics and Pedorthics as distinct specialties.
It has a unique and expanding body of knowledge, its own research and
training facilities and institutions, and the expertise of its
practitioners and educators is increasingly relied upon by the rest of
the medical Community.
Moreover the increasing technological sophistication of the field
makes mandated levels of training and education essential in assuring
competent care by practitioners. Medicare, recognizing the special
expertise of the prosthetist, requiring a prosthetist's evaluation of
the functional potential and appropriate components for new amputees.
This program's view that the referring physician is not the sole
repository of information for identifying a patient's functional
potential - is common. As a result, collaboration between prosthetist
and physician is also a common practice in the development of the
correct prescription for a patient.
Although there are a number of federal laws regulating prosthetic,
orthotic and pedorthic devices, none protect the consumer from
incompetent or unscrupulous practitioners. Under Title 21, Chapter 9
of the Code of Federal Regulations, the Federal Food, Drug, and
Cosmetic Act addresses prosthetic and orthotic devices within the
provisions of Subchapter V (Drugs and Devices). As a result of this
statutory frame work, the consumer is left to seek redress for any
wrongs committed by an unscrupulous or incompetent practitioner in the
The need to provide the public with a means of identifying qualified
practitioners is more compelling today than ever before. This critical
need continues to grow dramatically with each passing year, as the
field grows ever more sophisticated and broadly utilized, resulting in
ever greater public exposure to the potential for serious physical,
emotional, and financial harm.
PRIOR LEGISLATIVE HISTORY :
FISCAL IMPLICATIONS :
None to the State or local governments.
EFFECTIVE DATE :
January 1st next succeeding the date on which it shall have become a