Your O&#038;P Associations

In 2007, representatives of the American Orthotic & Prosthetic Association (AOPA) and the American Academy of Orthotists and Prosthetists (the Academy) visited the same Senate office on the same day but presented different positions on a legislative issue pending at the time. The Senate staff responded by urging the two groups to work out their differences before urging members of Congress to act on an issue impacting a relatively small profession. Congress, understandably, does not like to get in the middle of intraprofession disagreements. That occurrence sparked a dialogue within the O&P community that ultimately led to the creation of the O&P Alliance, a coalition of five O&P provider associations designed to coordinate the profession’s policy and advocacy agenda and to speak with one voice, a critical precursor of effective advocacy. Fifteen years later, the O&P Alliance is going strong and validating the vision of its founding members. The Alliance is a working coalition of five of the professional associations representing the O&P field, including the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), AOPA, the Academy, the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC), and the Board of Certification/Accreditation (BOC). If you have not heard of the Alliance, that is likely because it is not meant to be an entity unto itself. It is a coordinating coalition to ensure the profession proactively addresses regulatory and legislative threats and opportunities, speaks with one voice, ensures awareness and understanding of key policy issues through routine communication, and presents a united front on behalf of the profession, while deferring to the member organizations to continue to fulfill their individual missions and purposes. Furthermore, the Alliance only addresses issues on which the five groups can agree. It functions under a rule of unanimity that helps forge consensus. An example of this rule is demonstrated by the 2008 agreement ABC and BOC entered into to establish uniform standards for O&P certification and accreditation. A more recent example is illustrated by the issuance of a joint statement on direct-to-consumer O&P delivery models (opedge.com/op-alliance-opposes-direct-to-consumer-op). In contrast, in the rare circumstance when the five organizations cannot agree, each individual organization has the discretion to develop and publicize its own position. The Alliance does not supplant the efforts of its members. It supplements them while relying on each organization to continue to fulfill its own mission and achieve priorities for its membership. In this manner, the Alliance serves as an effective and efficient mechanism to ensure there is little duplication of effort across the professional associations and that the national policy agenda is coordinated and consensus based. It is the embodiment of the imperative for the O&P profession to speak with one voice. What is the role of each Alliance organization and what impact do they have in protecting and advancing the profession for the benefit of patients in need of O&P care? Below is a primer on each Alliance organization. Additional information can be found on each organization’s website. The Academy is the professional organization representing certified/state-licensed practitioners, assistants, technicians, fitters, educators, researchers, residents, students, and others affiliated with the profession of O&P. The Academy was founded in 1970 to ensure that the individual practitioner had representation independent from the voice of the manufacturer. The Academy’s mission is to promote professionalism and advance the standards of patient care through education, literature, research, advocacy, and collaboration. True to its mission, the Academy is focused on ensuring that the individual O&P practitioner and others affiliated with the profession have the tools and the representation needed to provide quality care to ensure the best patient outcomes. The Academy provides this support in many forms, including the following: ■ Resources to hone methodologies, advance the knowledge base, and ensure treatment protocols are rooted in evidence-based practice ■ Current research access, unbiased continuing education opportunities, and collaborative community groups ■ Consistent and persistent everyday advocacy efforts to ensure that the certified/licensed O&P practitioner is the only qualified provider of O&P patient care ■ A platform for the exchange of ideas, knowledge, and advocating for the best care plan for their patients ■ A network of O&P and other rehabilitation specialists in the healthcare space for the purposes of collaboration Through its flagship event, the Academy Annual Meeting & Scientific Symposium, its Journal of Prosthetics and Orthotics and patient care publications, prestigious Fellow program, scientific societies, and impactful networking opportunities, the Academy is known across the globe for its quality professional resources. The Academy is the premier source of lifelong learning, knowledge, and research for the O&P profession and is dedicated to helping members provide the highest level of professionalism and service to their patients. To learn more, visit oandp.org. AOPA was the first association to represent the O&P field. Since its founding in 1917, AOPA has sought to protect the interests of the O&P provider community and advance the field through multiple strategies. AOPA achieves its goals by providing opportunities for dialogue, education, advancement, and improvement of all aspects of the O&P industry through meetings, seminars, communications, publications, and other programs and activities. AOPA has several important strategic initiatives to anticipate challenges and barriers in the field and applies its resources to address major industry priorities. AOPA is focused on advancing equality to strengthen the O&P profession and improve the lives of patients by articulating and advocating the needs and interests of the O&P industry before legislative, administrative, and judicial branches of local, state, and national governments. AOPA has a full-service advocacy strategy to advance the field’s policy objectives, including in-house legislative and regulatory expertise, outside Washington counsel, and a political action committee known as AOPA PAC to engage in political fundraising. AOPA hosts the AOPA Policy Forum each spring where O&P leaders, practitioners, O&P students, and patients come to Washington DC to advocate on behalf of the field. AOPA advocates for federal policies that protect O&P businesses and preserve patient access to quality care. AOPA serves as a direct resource for members on issues concerning third-party payer coding and reimbursement practices. AOPA analyzes changes to Medicare, Medicaid, and private-payer policies and provides the AOPA membership with direct assistance on all aspects of reimbursement and coding. AOPA also hosts a major national meeting each fall where practitioners, manufacturers, suppliers, and O&P leaders come to learn, confer, and participate in the O&P provider community. Finally, AOPA hosts an annual leadership conference where it examines future issues confronting O&P. True to its vision, “A world where orthotic and prosthetic care transforms lives,” AOPA prioritizes communicating the importance of O&P care, increasing patient access to clinically appropriate, evidence-based care, and identifying trends that may impact O&P through collaboration and creating strategic relationships. More information on AOPA can be found on its website at aopanet.org. NAAOP, celebrating its 35th year representing the O&P community, was formed by leaders in the field who felt the federal government needed to devote more attention and funding to O&P research and development. Early advocacy efforts culminated in the National Institutes of Health (NIH) Reauthorization Act of 1990, which established the National Center for Medical Rehabilitation Research (NCMRR) at NIH. O&P research and development is listed as a priority in the center’s mission and for decades, NCMRR has funded O&P science, including the Limb Loss and Preservation Registry. NAAOP expanded its mission to encompass all policy issues impacting the profession and focuses on one main goal: policy and advocacy. NAAOP’s guiding principal is to support policies that benefit the O&P patient, and invariably, the provider will benefit as well. NAAOP is led by individuals with limb loss and seeks to cultivate the next generation of O&P leaders. NAAOP is careful not to duplicate the efforts of other O&P associations. It does not host an annual meeting, publish a national magazine, facilitate the sale of insurance to members, or cross-program against other organizations. NAAOP has a relatively small but highly committed and loyal membership and, in recent years, has taken on key projects to advance the profession. It has expanded upon its mission of awareness, policy, and advocacy by hosting virtual congressional lobbying days where its members promote O&P legislation and regulation. NAAOP proactively participates in a variety of disability, patient, and clinical coalitions on research, access to rehabilitation services, and access to rehabilitation devices and technologies. By doing so, NAAOP educates the broader rehabilitation and disability stakeholder organizations about O&P policy priorities and builds bridges with organizations whose members need O&P care, including veterans’ organizations. NAAOP seeks to identify the next generation of O&P leaders and, to help accomplish this goal, established the Breece Fellowship named after its founding and current Executive Director George W. Breece. Several Breece Fellows have found their way back to Washington representing O&P, the ultimate purpose of the fellowship. NAAOP has taken a leadership role in efforts to address diversity, inclusion, and sexual harassment. In addition, NAAOP’s board tends to be a farm team for future O&P leaders who often find themselves serving across other O&P professional organizations throughout their careers. Given its modest budget, NAAOP delivers significant value with the resources it has available. For more information on NAAOP, or to view monthly video updates on O&P policy and advocacy, visit naaop.org. [caption id="attachment_238299" align="alignright" width="422"] Studio Romantic/stock.adobe.com[/caption] ABC, established in 1948, certifies individuals and accredits practices in the areas of orthotics, prosthetics, and pedorthics. It provides the O&P profession and the general public with a recognizable emblem of competency and quality, for both individual practitioners through ABC certification and O&P practices through ABC accreditation. ABC accomplishes this by establishing certification and accreditation standards, updating those standards when appropriate, and offering competency exams for practitioners to attain and maintain their certification. ABC is a Medicare deemed authority for accrediting O&P provider businesses. ABC is recognized nationally and worldwide for its facility accreditation program, its professionalism, and its credentialing programs for orthotists, prosthetists, pedorthists, assistants, fitters, and technicians. The ABC Code of Professional Responsibility is recognized throughout the profession as the principles that govern the professional, ethical, and moral integrity of individuals and organizations engaged in the delivery of orthotic, prosthetic, and pedorthic care. The code applies to all ABC-credentialed individuals and accredited facilities and ensures that any person, facility, or organization are practicing in accordance with professional and community standards. The code and the ABC committee that enforces it serve to protect the public against unprofessional and unethical conduct by credential holders. ABC also participates in the O&P Alliance and brings expertise to the coalition’s deliberations. Many of the legislative and regulatory issues on which the Alliance is engaged address the issue of credentials, quality standards, professionalism, and the scope of practice for orthotists, prosthetists, and pedorthists. For more information on ABC, visit abcop.org. BOC is an independent, nonprofit organization dedicated to supporting quality patient care by offering valued credentials for professionals and businesses. BOC has nearly 40 years of credentialing experience and is recognized by Medicare and other third-party payers as meeting national standards. BOC assures patients, physicians, professional organizations, the public at large, and government agencies and representatives of the competence, professionalism, and safe practice environments of BOC-certified professionals and/or BOC-accredited businesses. The Center for Medicare & Medicaid Services (CMS) recognizes BOC as an accreditor of suppliers for all O&P and durable medical equipment (DME) product categories. In recent years, BOC has sunsetted its orthotist, prosthetist, and pedorthist certifications for new applicants but continues to support all existing certificants moving forward. BOC was the first to introduce certification for orthotic fitters, mastectomy fitters, and DME specialists and continues to certify new professionals in these areas. The BOC Code of Ethics establishes the principles and standards for the individuals and organizations earning its credentials. The code applies to all BOC-credentialed individuals and accredited facilities and helps ensure that any person, facility, or organization practices in accordance with its professional and community standards. BOC is an active Alliance member and major contributor to the Alliance and, like all Alliance members, supports the collective work of the field. For more information on BOC, visit bocusa.org. In addition to these organizations, the O&P Alliance routinely works with the Amputee Coalition and the National Commission on Orthotic and Prosthetic Education (NCOPE) to ensure effective communication between the Alliance organizations and other aspects of the O&P profession. The Amputee Coalition is the consumer voice of individuals with limb loss and limb difference. The organization dates back to the mid-1980s and hosts national conferences, runs innovative peer support programs, hosts congressional advocacy fly-ins and advocacy training, and has had a grant from the Department of Health and Human Services to run the Limb Loss Information Center. NCOPE is the organization that establishes the educational standards and course curriculum for the 14 O&P master’s degree programs throughout the nation. Conclusion: The national organizations of the O&P profession all play a critical role in portraying the profession to the policy world and the broader rehabilitation field. Each of the Alliance organizations work in concert to achieve consensus objectives for the betterment of O&P patients and the certified and licensed clinicians who serve them. Each organization strives to achieve its mission on behalf of its members or stakeholders while seeking to limit duplication and speak with one voice. It is critical for members of the O&P profession to recognize the importance of the organizations who represent them and not only join these organizations but actively participate and help lead the profession to move forward. O&P EDGE Peter W. Thomas, JD, is the O&P Alliance counsel and NAAOP general counsel. Nikki Grace-Strader is the 2022 NAAOP Breece Fellow and director of North American operations for Osseointegration International.

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