First and foremost, I have found that in my world travels that people do
not stay in this profession, at any level, unless they truly want to
make the lives of individuals that have disabilities better. Because we
are committed, caring people, thing affecting our chosen profession
cause a very deep, visceral reaction. This discussion is good for our
profession and the next generation of practitioners.
As a practitioner who has spent the last thirty years volunteering for
our profession, I would like to share a few thoughts with you. (I hope
our Non-American members will forgive us self center Americans one more
time.) I was on the Academy Board when the New York Board s certifies
were brought into the ABC. My year as President of the Academy was spent
trying to increase federal education spending for O&P. I was on NCOPE
when the new education standard and residencies were created. I was on
the ABC when those new standards were wholeheartedly embraced and the
state licensure movement was endorsed by the ABC. I’m still on the
Illinois Orthotic, Prosthetic, & Pedorthic Licensure Board and last year
I was selected by CMS to represent state licensure boards during the
ill-fated Negotiated Rule Making.
I am sorry that the unification negations reached an impasse, but I
could have predicted it. I know of at least four or five time the ABC
Board has approached the BOC and each time there was no room for
compromise. Feeling the frustration again, this is the first time that
the ABC walked away from the table first. After working together at the
NRM, I hope that I would be wrong and this time would be different, but
it was not.
Unification of our accreditation bodies is necessary. Although I
strongly disagree with the BOC s current nonstructural experiential
model, I am willing to endorse the ABC s grandfathering of
practitioners accredited by the BOC. During the House/Senate negations
for BIPA 2000, the Senator from Maryland created an equality that most
ABC practitioners do not agree with. But as other have said, CMS cannot
distinguish the differences between the two accreditation organizations
since Congress has said that they are equal. Like it or not, it is a
done deal.
This grandfathering is no different than that which drafters of state
practice acts faced when they were working their state legislatures. No
state official is going to legislate someone out of a job. But they
will raise the bar for future individuals coming into the profession.
You may feel that is dumbing down the profession but with licensure
come real regulation that can reduce misconduct, malpractice, fraud and
abuse.
Some on this list server have stated that ABC done not care about
licensure. That is not true. In every state were local practitioners
have started a licensure movement since the mid 90s, the ABC has
supported them. The same can not be said of the BOC. The ABC Model
Practice Act is the basis for the Illinois, Oklahoma, Georgia, and
Alabama laws, and it is being used in at least two other states as they
go though the process. No state has chosen the BOC examination as a
requirement for state licensure, just the ABC exam.
Although it is true that the ABC or the BOC can grandfather whomever
they want into their ABC certification or BOC accreditation, that does
not make it binding on the states. State statute will determine who is
qualified to receive a license to practice independently in the
individual state. The states have set and will continue to set the
minimal educational standards. The CAAHEP standards will continue to be
the gold standard that the states will judge each other on when looking
at applicants form other states.
Others have said that the ABC no longer cares about education and CAAHEP
standards (I was on that board, too) but that is also not the case.
After the grandfathering is over any experiential pathway for access
to the ABC exam will take more time and effort that the CAAHEP/NCOPE
traditional educational pathway does. Since the O&P industry seems to be
demanding an alternative to education, the challenge facing the
profession is giving more structure to that pathway than the BOC has
done up to now.
For those of you that feel that you need to disassociate yourself with
the ABC and start a new accreditation board, I encourage you not to do
so but get involved with the Board. There will be plenty of work this
next year and they will certainly need your help. Although the election
process has changed, the majority of the practitioners on the Board were
elected by either the Academy or AOPA membership. And the others have
had a history of committee or exam involvement with the ABC.
As a Gray Beard (both figuratively and literally) I encourage you to
keep the discussions on a higher plain and engage both your head and
your heart. This is not a new challenge, but it is one that we can
overcome if we start working together from now on.
Terry Supan, CPO, FAAOP
Licensed Orthotist, Prosthetist & Pedorthist
Past President AAOP, Former Commissioner of CAAHEP and NCOPE, Former ABC
Board Member, Former Chairman UP-ISPO
Member Illinois Licensure Board for Orthotics, Prosthetics, & Pedorthics
