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TITLE 16ECONOMIC REGULATION
PART 4TEXAS DEPARTMENT OF LICENSING AND REGULATION
CHAPTER 114ORTHOTISTS AND PROSTHETISTS
RULE §114.27Assistant License

(a) Qualifications. The applicant must submit evidence satisfactory to the department of having successfully completed either (1) and (2), or (1) and (3), of the following:

  (1) Coursework from a college or university accredited by a regional accrediting organization such as the Southern Association of Colleges and Schools that included at a minimum:

    (A) eight (8) credit hours of anatomy and physiology;

    (B) three (3) credit hours of medical terminology;

    (C) three (3) credit hours of physics.

  (2) For applicants for a prosthetic assistant or orthotic assistant license, a clinical residency for assistants of not less than 1,000 hours in prosthetics or 1,000 hours in orthotics, respectively, completed in a period of not more than one year, in a facility that is accredited under §114.29, or its equivalent, as approved by the department, or in a facility to which the accreditation requirement does not apply in accordance with §605.260(e) of the Act.

  (3) For applicants for the prosthetic/orthotic assistant license, a clinical residency for assistants of not less than 1,500 hours in prosthetics and orthotics, completed in a period of not more than one year, in a facility that is accredited under §114.29, or its equivalent, as approved by the department, or in a facility to which the accreditation requirement does not apply in accordance with §605.260(e) of the Act.

(b) Clinical residency for an assistant.

  (1) Before undertaking a clinical residency for an assistant, the supervisor and clinical resident must notify the department by filing a completed supervision agreement with the department with the clinical resident's application for licensure as an assistant and the required fee.

  (2) The supervisor shall not allow the clinical residency to begin until approval from the department is received.

  (3) The supervisor shall provide the clinical resident and the department with written documentation upon beginning, terminating or completing a clinical residency.

  (4) The resident shall work under the direct supervision of a licensed practitioner. The supervisor must be licensed in the same discipline as the course of study being completed by the clinical resident.

  (5) The supervising practitioner must review and sign off on patient care notes made by the clinical resident.

  (6) The clinical residency shall primarily provide learning opportunities for the clinical resident rather than primarily providing service to the prosthetic or orthotic facility or its patients or clients.

  (7) The clinical residency shall include both observation and supervised performance of assistant level work including assisting with patient assessments, measurement, design, fabrication, assembling, fitting, adjusting or servicing prostheses or orthoses or both, as appropriate to the type of residency. Supervision shall be in the physical presence of the supervisor.

  (8) The clinical residency shall include an orientation comparing and contrasting the duties of a licensed assistant with the duties of the licensed practitioner.

  (9) The clinical resident shall not independently provide ancillary patient care services of the type performed by a licensed assistant and may not independently engage in prosthetic and orthotic care directly to the patient.

  (10) The clinical resident may be only incidentally involved in other duties including, but not limited to, scheduling, medical records, clerical, payroll and accounting, janitorial/housekeeping, transportation, or delivery.

  (11) When terminating or completing a residency, the written documentation shall indicate the number of hours satisfying the requirements of this section that were completed by the clinical resident.

  (12) Notwithstanding the supervision requirements in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

(c) Scope of practice.

  (1) When assistant patient care services are performed by a licensed assistant, the supervising licensed practitioner of that assistant must review and sign off on the clinical note written by the assistant within fifteen working days of the date the service was provided.

  (2) A licensed orthotist assistant may provide ancillary patient care services, including assistant patient care services, under the supervision of a licensed orthotist or licensed prosthetist/orthotist.

  (3) A licensed prosthetist assistant may provide ancillary patient care services, including assistant patient care services, under the supervision of a licensed prosthetist or licensed prosthetist/orthotist.

  (4) A licensed prosthetist/orthotist assistant may provide ancillary patient care services, including assistant patient care services, under the supervision of a licensed prosthetist/orthotist, or a licensed orthotist for orthotic care, or a licensed prosthetist for prosthetic care.

  (5) The supervising practitioner is responsible for the acts or omissions of the licensed assistant.

  (6) A licensed assistant may only assist in the performance of critical care events while in the physical presence of the supervising practitioner.

  (7) Except as set forth in this subsection, the supervising practitioner shall supervise and direct the licensed assistant.

  (8) The supervising practitioner shall report to the department violations of the Act or this chapter committed by the licensed assistant.

  (9) Assistants may practice only in a facility accredited under §114.29, or in a facility to which the accreditation requirement does not apply in accordance with §605.260(e) of the Act.


Source Note: The provisions of this §114.27 adopted to be effective October 1, 2016, 41 TexReg 4467; amended to be effective September 1, 2018, 43 TexReg 5362; amended to be effective May 1, 2022, 47 TexReg 2524

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