Bill Text: IA SF364 | 2011-2012 | 84th General Assembly | Enrolled

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Bill Title: A bill for an act relating to the licensure and regulation of persons offering occupational therapy services, and orthotists, prosthetists, and pedorthists, providing exceptions for persons practicing within the scope of their professions, and providing for fees and penalties. (Formerly SF 226.) Effective 7-1-12.

Spectrum: Committee Bill

Status: (Passed) 2012-04-27 - Signed by Governor. S.J. 869. [SF364 Detail]

Download: Iowa-2011-SF364-Enrolled.html

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Senate File 364
AN ACT
RELATING TO THE LICENSURE AND REGULATION OF PERSONS OFFERING
OCCUPATIONAL THERAPY SERVICES, AND ORTHOTISTS, PROSTHETISTS,
AND PEDORTHISTS, PROVIDING EXCEPTIONS FOR PERSONS PRACTICING
WITHIN THE SCOPE OF THEIR PROFESSIONS, AND PROVIDING FOR
FEES AND PENALTIES.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. Section 147.1, subsections 3 and 6, Code 2011,
are amended to read as follows:
3. “Licensed” or “certified” , when applied to a physician
and surgeon, podiatric physician, osteopathic physician and
surgeon, physician assistant, psychologist, chiropractor,
nurse, dentist, dental hygienist, dental assistant,
optometrist, speech pathologist, audiologist, pharmacist,
physical therapist, physical therapist assistant, occupational
therapist, occupational therapy assistant, orthotist,
prosthetist, pedorthist, respiratory care practitioner,
practitioner of cosmetology arts and sciences, practitioner
of barbering, funeral director, dietitian, marital and
family therapist, mental health counselor, social worker,
massage therapist, athletic trainer, acupuncturist, nursing
home administrator, hearing aid dispenser, or sign language
interpreter or transliterator means a person licensed under
this subtitle.
6. “Profession” means medicine and surgery, podiatry,
osteopathic medicine and surgery, practice as a physician
assistant, psychology, chiropractic, nursing, dentistry,
dental hygiene, dental assisting, optometry, speech pathology,
audiology, pharmacy, physical therapy, physical therapist

Senate File 364, p. 2
assisting, occupational therapy, occupational therapy
assisting, respiratory care, cosmetology arts and sciences,
barbering, mortuary science, marital and family therapy, mental
health counseling, social work, dietetics, massage therapy,
athletic training, acupuncture, nursing home administration,
hearing aid dispensing, or sign language interpreting or
transliterating , orthotics, prosthetics, or pedorthics .
Sec. 2. Section 147.2, subsection 1, Code 2011, is amended
to read as follows:
1. A person shall not engage in the practice of medicine
and surgery, podiatry, osteopathic medicine and surgery,
psychology, chiropractic, physical therapy, physical
therapist assisting, nursing, dentistry, dental hygiene,
dental assisting, optometry, speech pathology, audiology,
occupational therapy, occupational therapy assisting,
orthotics, prosthetics, pedorthics, respiratory care,
pharmacy, cosmetology arts and sciences, barbering, social
work, dietetics, marital and family therapy or mental health
counseling, massage therapy, mortuary science, athletic
training, acupuncture, nursing home administration, hearing aid
dispensing, or sign language interpreting or transliterating,
or shall not practice as a physician assistant, unless the
person has obtained a license for that purpose from the board
for the profession.
Sec. 3. Section 147.13, Code 2011, is amended by adding the
following new subsection:
NEW SUBSECTION . 24. For orthotics, prosthetics, and
pedorthics, the board of podiatry.
Sec. 4. Section 147.14, subsection 1, paragraph s, Code
2011, is amended to read as follows:
s. For podiatry, five members licensed to practice podiatry ,
two members licensed to practice orthotics, prosthetics, or
pedorthics, and two members who are not so licensed to practice
podiatry and who shall represent the general public.
Sec. 5. Section 147.74, Code 2011, is amended by adding the
following new subsection:
NEW SUBSECTION . 24. a. An orthotist licensed under chapter
148F may use the words “licensed orthotist” after the person’s
name or signify the same by the use of the letters “L.O.” after
the person’s name.
b. A pedorthist licensed under chapter 148F may use the
words “licensed pedorthist” after the person’s name or signify
the same by the use of the letters “L.ped.” after the person’s

Senate File 364, p. 3
name.
c. A prosthetist licensed under chapter 148F may use the
words “licensed prosthetist” after the person’s name or signify
the same by the use of the letters “L.P.” after the person’s
name.
Sec. 6. Section 148B.2, subsection 2, Code 2011, is amended
to read as follows:
2. “Occupational therapy” means the therapeutic application
of specific tasks used for the purpose of evaluation and
treatment of problems interfering with functional performance
in persons impaired by physical illness or injury, emotional
disorder, congenital or developmental disability, or the aging
process in order to achieve optimum function, for maintenance
of health and prevention of disability use of occupations,
including everyday life activities with individuals, groups,
populations, or organizations to support participation,
performance, and function in roles and situations in home,
school, workplace, community, and other settings. Occupational
therapy services are provided for habilitation, rehabilitation,
and the promotion of health and wellness to those who have
or are at risk for developing an illness, injury, disease,
disorder, condition, impairment, disability, activity
limitation, or participation restriction. Occupational
therapy addresses the physical, cognitive, psychosocial,
sensory-perceptual, and other aspects of performance in a
variety of contexts and environments to support engagement in
occupations that affect physical and mental health, well-being,
and quality of life. “Occupational therapy” includes but is
not limited to providing assessment, design, fabrication,
application, and fitting of selected orthotic devices and
training in the use of prosthetic devices.
Sec. 7. Section 148B.3, subsection 5, Code 2011, is amended
by striking the subsection.
Sec. 8. Section 148B.3, subsection 6, Code 2011, is amended
to read as follows:
6. A nonresident performing occupational therapy services
in the state who is not licensed under this chapter , if the
services are performed for not more than ninety thirty days in
a calendar year in association with an occupational therapist
licensed under this chapter , and the nonresident meets either
of the following requirements:
a. The nonresident is licensed under the law of another
state which has licensure requirements at least as stringent as

Senate File 364, p. 4
the requirements of this chapter , or .
b. The nonresident meets the requirements for certification
as an occupational therapist registered (O.T.R.), or
a certified occupational therapy assistant (C.O.T.A.)
established by the American national board for certification in
occupational therapy association .
Sec. 9. Section 148B.4, Code 2011, is amended to read as
follows:
148B.4 Limited permit.
1. A limited permit to practice occupational therapy may
be granted to persons a person who have has completed the
education and experience academic and field work requirements
of for occupational therapists under this chapter and has
not yet taken or received the results of the entry-level
certification examination . This permit shall A permit granted
pursuant to this subsection shall be valid for a period of
time as determined by the board by rule and shall allow the
person to practice occupational therapy under the direction
and appropriate supervision of a licensed an occupational
therapist and shall be valid until the date on which the
results of the next qualifying examination have been made
public licensed under this chapter . This The permit shall
expire when the person is issued a license under section 148B.5
or if the person is notified that the person did not pass the
examination. The limited permit shall not be renewed if the
applicant has failed the examination .
2. A limited permit to assist in the practice of
occupational therapy may be granted to a person who has
completed the academic and field work requirements for
occupational therapy assistants under this chapter and has
not yet taken or received the results of the entry-level
certification examination. A permit granted pursuant to this
subsection shall be valid for a period of time as determined
by the board by rule and shall allow the person to assist in
the practice of occupational therapy under the direction and
appropriate supervision of an occupational therapist licensed
under this chapter. The permit shall expire when the person
is issued a license under section 148B.5 or if the person is
notified that the person did not pass the examination. The
limited permit shall not be renewed.
Sec. 10. Section 148B.6, Code 2011, is amended to read as
follows:
148B.6 Waiver of requirements for licensing.

Senate File 364, p. 5
1. The board may waive the examination and grant a license :
1. to To a person certified prior to January 1, 1981, as
an occupational therapist registered (O.T.R.) or a certified
occupational therapy assistant (C.O.T.A.) by the American
Occupational Therapy Association occupational therapy
association .
2. The board shall waive the education and experience
requirements for licensure in section 148B.5 , subsections
1 and 2 , for applicants for a license who present evidence
to the board that they have been engaged in the practice of
occupational therapy on and prior to January 1, 1981. Proof
of actual practice shall be presented to the board in a manner
as it prescribes by rule. To obtain the benefit of this
waiver, an applicant must successfully complete the examination
within one year from January 1, 1981. However, the waiver is
conditional upon the applicant satisfying the education and
experience requirements of section 148B.5 , subsections 1 and
2 , within five years of the waiver being granted and if those
requirements are not satisfied at the expiration of those five
years the board shall revoke the license.
3. 2. The board may waive the examination and grant a
license to To an applicant who presents proof of current
licensure as an occupational therapist or occupational therapy
assistant in another state, the District of Columbia, or a
territory of the United States which requires standards for
licensure considered by the board to be equivalent to the
requirements for licensure of this chapter .
Sec. 11. NEW SECTION . 148B.8 Unlawful practice.
1. A person shall not practice occupational therapy or
assist in the practice of occupational therapy, provide
occupational therapy services, hold oneself out as an
occupational therapist or occupational therapy assistant or
as being able to practice occupational therapy or assist in
the practice of occupational therapy, or provide occupational
therapy services in this state unless the person is licensed
under this chapter.
2. It is unlawful for any person not licensed as an
occupational therapist in this state or whose license is
suspended or revoked to use in connection with the person’s
name or place of business in this state the words “occupational
therapist”, “licensed occupational therapist”, or any word,
title, letters, or designation that implies that the person is
an occupational therapist.

Senate File 364, p. 6
3. It is unlawful for any person not licensed as an
occupational therapy assistant in this state or whose
license is suspended or revoked to use in connection with the
person’s name or place of business in this state, the words
“occupational therapy assistant”, “licensed occupational
therapy assistant”, or any word, title, letters, or designation
that implies that the person is an occupational therapy
assistant.
Sec. 12. NEW SECTION . 148B.9 False use of titles
prohibited.
A person or business entity, including the employees,
agents, or representatives of the business entity, shall
not use in connection with that person or business entity’s
business activity, the words “occupational therapy”,
“occupational therapist”, “licensed occupational therapist”,
“doctor of occupational therapy”, “occupational therapy
assistant”, “licensed occupational therapy assistant”, or the
letters “O.T.”, “O.T./L.”, “O.T.D.”, “O.T.A.”, “O.T.A./L.”, or
any words, abbreviations, or insignia indicating or implying
that occupational therapy is provided or supplied unless such
services are provided by or under the direction and supervision
of an occupational therapist licensed pursuant to this chapter.
Sec. 13. NEW SECTION . 148F.1 Title and purpose.
1. This chapter may be cited and referred to as the
“Orthotics, Prosthetics, and Pedorthics Practice Act” .
2. The purpose of this chapter is to provide for the
regulation of persons offering orthotic, prosthetic, and
pedorthic services to the public in order to safeguard the
public health, safety, and welfare.
Sec. 14. NEW SECTION . 148F.2 Definitions.
As used in this chapter:
1. “Board” means the board of podiatry.
2. “Orthosis” means a custom-fabricated or custom-fitted
brace or support designed to provide for alignment, correction,
or prevention of neuromuscular or musculoskeletal dysfunction,
disease, injury, or deformity. “Orthosis” does not include
fabric or elastic supports, corsets, arch supports, low
temperature plastic splints, trusses, elastic hoses, canes,
crutches, soft cervical collars, dental appliances, or other
similar devices carried in stock and sold as “over-the-counter”
items by a drug store, department store, corset shop, or
surgical supply facility.
3. “Orthotic and prosthetic education program” means a

Senate File 364, p. 7
course of instruction accredited by the national commission on
accreditation of allied health education programs, consisting
of both of the following:
a. A basic curriculum of college level instruction in math,
physics, biology, chemistry, and psychology.
b. A specific curriculum in orthotic or prosthetic courses,
including but not limited to:
(1) Lectures covering pertinent anatomy, biomechanics,
pathomechanics, prosthetic-orthotic components and materials,
training and functional capabilities, prosthetic or orthotic
performance evaluation, prescription considerations, etiology
of amputations and disease processes necessitating prosthetic
or orthotic use, and medical management.
(2) Subject matter related to pediatric and geriatric
problems.
(3) Instruction in acute care techniques, such as immediate
and early post-surgical prosthetics and fracture bracing
techniques.
(4) Lectures, demonstrations, and laboratory experiences
related to the entire process of measuring, casting, fitting,
fabricating, aligning, and completing prostheses or orthoses.
4. “Orthotic and prosthetic scope of practice” means a
list of tasks, with relative weight given to such factors as
importance, criticality, and frequency, based on nationally
accepted standards of orthotic and prosthetic care as
outlined by the American board for certification in orthotics,
prosthetics, and pedorthics.
5. “Orthotics” means the science and practice of evaluating,
measuring, designing, fabricating, assembling, fitting,
adjusting, or servicing an orthosis under an order from a
licensed physician or podiatric physician for the correction or
alleviation of neuromuscular or musculoskeletal dysfunction,
disease, injury, or deformity.
6. “Orthotist” means a health care professional,
specifically educated and trained in orthotic patient care,
who measures, designs, fabricates, fits, or services orthoses
and may assist in the formulation of the order and treatment
plan of orthoses for the support or correction of disabilities
caused by neuromusculoskeletal diseases, injuries, or
deformities.
7. “Pedorthic device” means therapeutic shoes, such as
diabetic shoes and inserts, shoe modifications made for
therapeutic purposes, below-the-ankle partial foot prostheses,

Senate File 364, p. 8
and foot orthoses for use at the ankle or below. The term also
includes subtalar-control foot orthoses designed to manage the
function of the anatomy by controlling the range of motion of
the subtalar joint. Excluding pedorthic devices which are
footwear, the proximal height of a custom pedorthic device
does not extend beyond the junction of the gastrocnemius and
the Achilles tendon. “Pedorthic device” does not include
nontherapeutic inlays or footwear regardless of method of
manufacture; unmodified, nontherapeutic over-the-counter shoes;
or prefabricated foot care products.
8. “Pedorthic education program” means an educational
program accredited by the American board for certification in
orthotics, prosthetics, and pedorthics consisting of all of the
following:
a. A basic curriculum of instruction in foot-related
pathology of diseases, anatomy, and biomechanics.
b. A specific curriculum in pedorthic courses, including
lectures covering shoes, foot orthoses, and shoe modifications,
pedorthic components and materials, training and functional
capabilities, pedorthic performance evaluation, prescription
considerations, etiology of disease processes necessitating
use of pedorthic devices, medical management, subject matter
related to pediatric and geriatric problems, and lectures,
demonstrations, and laboratory experiences related to the
entire process of measuring and casting, fitting, fabricating,
aligning, and completing pedorthic devices.
9. “Pedorthic scope of practice” means a list of tasks
with relative weight given to such factors as importance,
criticality, and frequency based on nationally accepted
standards of pedorthic care as outlined by the American board
for certification in orthotics, prosthetics and pedorthics.
10. “Pedorthics” means the science and practice of
evaluating, measuring, designing, fabricating, assembling,
fitting, adjusting, or servicing a pedorthic device under an
order from a licensed physician or podiatric physician for the
correction or alleviation of neuromuscular or musculoskeletal
dysfunction, disease, injury, or deformity.
11. “Pedorthist” means a health care professional,
specifically educated and trained in pedorthic patient
care, who measures, designs, fabricates, fits, or services
pedorthic devices and may assist in the formulation of the
order and treatment plan of pedorthic devices for the support
or correction of disabilities caused by neuromusculoskeletal

Senate File 364, p. 9
diseases, injuries, or deformities.
12. “Prosthesis” means an artificial medical device that
is not surgically implanted and that is used to replace a
missing limb, appendage, or any other external human body part
including an artificial limb, hand, or foot.
13. “Prosthetics” means the science and practice of
evaluating, measuring, designing, fabricating, assembling,
fitting, adjusting, or servicing a prosthesis under an order
from a licensed physician.
14. “Prosthetist” means a health care professional,
specifically educated and trained in prosthetic patient care,
who measures, designs, fabricates, fits, or services prostheses
and may assist in the formulation of the order and treatment
plan of prostheses for the replacement of external parts of the
human body lost due to amputation or congenital deformities or
absences.
15. “Resident” means a person who has completed an education
program in either orthotics or prosthetics and is continuing
the person’s clinical education in a residency accredited by
the American board for certification in orthotics, prosthetics
and pedorthics.
16. “Residency” means an approved supervised program of
a minimum duration of one year to acquire practical clinical
training in orthotics or prosthetics in a patient care setting.
Sec. 15. NEW SECTION . 148F.3 Duties of the board.
The board shall administer this chapter. The board’s duties
shall include but are not limited to the following:
1. Adoption of rules to administer and interpret this
chapter, chapter 147, and chapter 272C with respect to the
education and licensing of orthotists, prosthetists, and
pedorthists.
2. Adoption of rules to establish accepted standards of
orthotic and prosthetic scope of practice, including the
classification of devices and supervision of nonlicensed
caregivers. Any changes to the nationally accepted standards
by the American board for certification in orthotics,
prosthetics and pedorthics which impact scope of practice may
be approved by the board along with the adoption of rules as
required in this section.
3. Adoption of rules relating to professional conduct and
licensing and the establishment of ethical and professional
standards of practice.
4. Acting on matters concerning licensure and the process

Senate File 364, p. 10
of applying for, granting, suspending, imposing supervisory
or probationary conditions upon, reinstating, revoking, or
renewing a license.
5. Establishing and collecting licensure fees as provided
in section 147.80.
6. Developing continuing education requirements as a
condition of license renewal.
7. Evaluating requirements for licensure in other states to
determine if reciprocity may be granted.
8. Adoption of rules providing temporary licensing for
persons providing orthotic, prosthetic, and pedorthic care
in this state prior to the effective date of this Act. A
temporary license is good for no more than one year.
Sec. 16. NEW SECTION . 148F.4 Persons and practices not
affected.
This chapter does not prevent or restrict the practice,
services, or activities of any of the following:
1. A person licensed in this state by any other law from
engaging in the profession or occupation for which the person
is licensed, including but not limited to persons set out in
section 147.1, subsections 3 and 6.
2. A person employed as an orthotics, prosthetics, or
pedorthics practitioner by the government of the United States
if that person practices solely under the direction or control
of the organization by which the person is employed.
3. A person pursuing a course of study leading to a degree
or certificate in orthotics, prosthetics, or pedorthics in an
educational program accredited or approved according to rules
adopted by the board, if the activities and services constitute
a part of a supervised course of study and the person is
designated by a title which clearly indicates the person’s
status as a student, resident, or trainee.
Sec. 17. NEW SECTION . 148F.5 Qualifications for licensure
as orthotist, prosthetist, or pedorthist.
1. To qualify for a license to practice orthotics or
prosthetics, a person shall meet the following requirements:
a. Possess a baccalaureate degree from a college or
university.
b. Have completed the amount of formal training, including
but not limited to an orthotic and prosthetic education
program, and clinical practice established and approved by the
board.
c. Complete a clinical residency in the professional area

Senate File 364, p. 11
for which a license is sought in accordance with standards,
guidelines, or procedures for residencies established and
approved by the board. The majority of training must be
devoted to services performed under the supervision of a
licensed practitioner of orthotics or prosthetics or a person
certified as a certified orthotist, certified prosthetist,
or certified prosthetist orthotist whose practice is located
outside the state.
d. Pass all written, practical, and oral examinations that
are required and approved by the board.
e. Be qualified to practice in accordance with accepted
standards of orthotic and prosthetic care as established by the
board.
2. To qualify for a license to practice pedorthics, a person
shall meet the following requirements:
a. Submit proof of a high school diploma or its equivalent.
b. Have completed the amount of formal training, including
but not limited to a pedorthic education program, and clinical
practice established and approved by the board.
c. Complete a qualified work experience program or
internship in pedorthics that has a minimum of one thousand
hours of pedorthic patient care experience in accordance
with any standards, guidelines, or procedures established
and approved by the board. The majority of training must
be devoted to services performed under the supervision of a
licensed practitioner of pedorthics or a person certified as
a certified pedorthist whose practice is located outside the
state.
d. Pass all examinations that are required and approved by
the board.
e. Be qualified to practice in accordance with accepted
standards of pedorthic care as established by the board.
3. The standards and requirements for licensure established
by the board shall be substantially equal to or in excess of
standards commonly accepted in the professions of orthotics,
prosthetics, or pedorthics, as applicable. The board shall
adopt rules as necessary to set the standards and requirements.
4. A person may be licensed in more than one discipline.
Sec. 18. NEW SECTION . 148F.6 Assistants and technicians.
1. a. A person shall not work as an assistant to an
orthotist or prosthetist or provide patient care services or
fabrication of orthoses or prostheses, unless the work is
performed under the supervision of a licensed orthotist or

Senate File 364, p. 12
prosthetist.
b. An assistant may perform orthotic or prosthetic
procedures and related tasks in the management of patient care.
An assistant may also fabricate, repair, and maintain orthoses
and prostheses.
2. A technician may assist a person licensed under this
chapter with fabrication of orthoses, prostheses, or pedorthic
devices but shall not provide direct patient care.
Sec. 19. NEW SECTION . 148F.7 Limitation on provision of
care and services.
A licensed orthotist, prosthetist, or pedorthist may provide
care or services only if the care or services are provided
pursuant to an order from a licensed physician, a licensed
podiatric physician, an advanced registered nurse practitioner
who has a written collaborative agreement with a collaborating
physician or podiatric physician that specifically authorizes
ordering the services of an orthotist, prosthetist, or
pedorthist, an advanced registered nurse practitioner who
practices in a hospital or ambulatory surgical treatment center
and possesses clinical privileges to order services of an
orthotist, prosthetist, or pedorthist, or a physician assistant
who has been delegated the authority to order the services of
an orthotist, prosthetist, or pedorthist by the assistant’s
supervising physician. A licensed podiatric physician or an
advanced registered nurse practitioner collaborating with a
podiatric physician may only order care or services concerning
the foot from a licensed pedorthist or orthotist.
Sec. 20. NEW SECTION . 148F.8 Penalties.
1. If any person, company, or other entity violates a
provision of this chapter, the attorney general may petition
for an order enjoining the violation or for an order enforcing
compliance with this chapter. Upon the filing of a verified
petition in court, the court may issue a temporary restraining
order, without notice or bond, and may preliminarily and
permanently enjoin the violation. If it is established
that the person, company, or other entity has violated or is
violating the injunction, the court may punish the offender
for contempt of court. Proceedings under this section shall
be in addition to, and not in lieu of, all other remedies and
penalties provided in this chapter.
2. If a person practices as an orthotist, prosthetist,
or pedorthist or represents the person as such without being
licensed under the provisions of this chapter, then any other

Senate File 364, p. 13
licensed orthotist, pedorthist, or prosthetist, any interested
party, or any person injured by the person may petition for
relief as provided in subsection 1.
3. If a company or other entity holds itself out to provide
orthotic, prosthetic, or pedorthic services without having
an orthotist, prosthetist, or pedorthist licensed under the
provisions of this chapter on its staff to provide those
services, then any other licensed orthotist, prosthetist,
or pedorthist or any interested party or injured person may
petition for relief as provided in subsection 1.
______________________________
JOHN P. KIBBIE
President of the Senate
______________________________
KRAIG PAULSEN
Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 364, Eighty-fourth General Assembly.
______________________________
MICHAEL E. MARSHALL
Secretary of the Senate
Approved _______________, 2012
______________________________
TERRY E. BRANSTAD
Governor