100 years of AOPA and O&P
Before the Civil War, few artificial limb companies existed in the United States. However, the carnage of the Civil War and subsequent wars dramatically increased the need for artificial limbs. Thus, limb companies were started, generally by amputees who were dissatisfied with available prostheses.
The American Orthotic and Prosthetic Association (AOPA) originated in 1917 in Washington, D.C., as the Artificial Limb Manufacturers Association of America (ALMA). Anticipating World War I casualties would require prosthetic treatment, the Council of National Defense and artificial limb companies met to prepare the profession to meet those needs.
33 members gather at the 1918 National Assembly in Indianapolis, Indiana.
Between the world wars, ALMA’s focus changed. Its members began to view themselves as clinicians and professionals caring for patients rather than as craftspeople and blacksmiths hammering on leather and metal. The rehabilitation of people with disabilities was becoming a priority.
In 1935, AOPA publishes a manual "Amputations from the Standpoint of a Sucessful Prosthesis", an instruction manual for surgeons performing amputations.
At the twenty-first annual convention, held in Chicago’s Hotel LaSalle, October 7-9, 1940, AOPA President Chester C. Haddan reported that the association had sent delegates to Washington to protest against the government encroachment on the artificial limb industry.
During 1940 the ALMAnac Advisory Committee was created. The magazine remains today as the O&P Almanac.
In 1946 leaders of the Artificial Limb Manufacturers Association, invited the orthopedic-brace fabricators to join them, resulting in the association changing its name to Orthopedic Appliance and Limb Manufacturers Association.
A National Office was established in Washington D. C. to work more effectively with the federal government.
In 1948 the OALMA recommended the formation of an organization whose responsibility would be to establish minimum requirements for the operation of a limb or brace facility to ensure that patients would receive adequate service. After informal discussions with the department of Justice, the American Board for Certification of the Prosthetic and Orthopedic Appliance Industry, Inc., was formed. In October 1959 the name was changed to the American Board for Certification in Orthotics and Prosthetics, Inc. and in 2007, the name was changed once again to incorporate the certification of Pedorthists.
The Mellon Institute established a Fellowship on Orthopedic Appliances under the auspices of the Sarah Mellon Scaife Foundation. The Mellon Institute hosted the 1948 OALMA Annual Meeting.
20 short courses for the fitting of suction-socket above-knee prostheses were presented in various parts of the US by the VA in cooperation with OALMA, in the first large scale effort for training prosthetists.
Government Encroachment was a huge concern to AOPA members.
In May of 1951, the first certification examinations were administered in New York City to twenty-one candidates. Additional examinations were conducted in 1951 in Atlanta, Los Angeles and Chicago. Overall 67 applicants took these examinations of which 51 were certified. Today over 7,500 practitioners are ABC-certified.
In 1952, the International Society for the Rehabilitation of the Disabled (now called Rehabilitation International) appointed an International Committee on Prosthetics and Orthotics (ICPO) to promote the dissemination of knowledge of prosthetics and orthotics throughout the world. The chairman was Knud Jansen, and headquarters for the committee was established in Copenhagen, where a number of very successful international seminars were conducted in the late 1950s and 1960s. The committee also sponsored courses and conferences at other locations during this period, and in 1971, with the concurrence of Rehabilitation International, the members of the committee and others formed the International Society for Prosthetics and Orthotics (ISPO) "to promote high quality prosthetics and orthotics care to all people with neuromuscular and skeletal disabilities." ISPO, an organization of all professionals associated with prosthetics and orthotics, conducts an international congress at 2-year intervals to bring together clinicians, educators, research personnel, and administrators to exchange information and ideas and to make plans for cooperative programs.
The minimum requirement of a high school diploma was established to sit for the certification examination.
Knit-Rite Takes out the first ad in the O&P Almanac.
Due to the lack of manpower in the profession, individuals with fifteen years of experience were allowed to sit for the certification examination.
The decision was made to waive requirements until facilities, colleges and universities could gear up to train an increased number of candidates.
In 1966, the Association changed its name from the OALMA to the American Orthotic and Prosthetic Association (AOPA).
Also in the 1960s, the Association, supported by the Committee for Prosthetic-Orthotic Education of the National Research Council, gathered the first national data on the O&P field, which helped establish guidelines for practitioner education and recruitment.
In June 1970, a number of distinguished leaders from health, education, and other professional fields met in Ponte Vedra, Florida, under the chairmanship of Dr. Warren Perry of the National Academy of Science to evaluate the status of prosthetic and orthotic education in the U.S. and to plan future training for practitioners in those two disciplines. Results concluded that a four-year baccalaureate should be required. The results became known as the ten-year plan. In 1976, ABC, AOPA and the Academy held Ponte Vedra II at the five year mark of the plan.
On July 27, Ronney Snell and Sam Hamontree called a meeting to order (Commadore Hotel, New York) to discuss the possibility of starting an educational society to later become the American Academy of Orthotists and Prosthetists. On November 16, the Certificate of Incorporation was granted for American Academy of Orthotists and Prosthetists.
This photo is from the 1978 Past President Luncheon.
First national meeting of AAOP was held in conjunction with the AOPA National Assembly at the Hotel Sahara, Las Vegas, Nevada.
Because of the increased need for advanced O&P education, the Association and the University Council of Orthotic and Prosthetic Education formed the National Association of Prosthetic and Orthotic Educators (NAPOE). Known today as the National Commission on Orthotic and Prosthetic Education (NCOPE), NCOPE now formally oversees O&P educational programs.
In the early 1970s, a guideline for the O&P education coursework essentials, universal orthotic-prosthetc terminology, and new occupational titles and job descriptions were developed. Shortly thereafter, AOPA established the Business Procedures and Liaison Committee.
AOPA VIPs cut the ribbon opening the 1975 exposition in New Orleans, LA. Pictured from left is Junior Odom, Gene Lambert, Don Hardin, and 1975 President Ronney Snell.
In 1975, AOPA launched an independent financial survey, where 50 AOPA members provided detailed financial data on their business operations.
“The results of this initial survey and continuing surveys in subsequent years should provide information … that will be of immeasurable value in the business management of an orthotic/prosthetic practice” said Sam Hamontree, Chair of the Business Procedures and Liaison Committee in June 1975.
From that forward thinking, AOPA’s annual financial benchmarking survey of O&P businesses was born. The survey continues today, as the annual Operating Performance Report and biannual Compensation & Benefits Report.
Minimum requirements for certification change to require an Associate’s Degree beginning with 1975 exam.
Bachelor’s degree is minimum requirement to sit for ABC exam beginning in 1979.
In the 1970s, AOPA worked with Blue Cross Blue Shield of South Carolina to develop the first template for the L-Code system. Blue Cross Blue Shield of South Carolina applied the pilot system in 1979; other insurance companies followed. The Health Care Financing Administration ,which is now CMS, established the Healthcare Common Procedure Coding System (HCPCS) in 1978.
The Board of Certification/Accreditation (BOC) was founded in 1984 as an independent, not-for-profit agency dedicated to meeting the demands for quality patient care by offering highly valued credentials for professionals and suppliers of comprehensive orthotic and prosthetic (O&P) care and durable medical equipment (DME) services
10 year phase out to accept individuals with associates degree complete.
October 1986 AOPA publishes the Pictorial Reference Manual of Orthotics and Prosthetics (currently known as the Illustrated Guide.)
The following volunteers played a huge role in the creation and development of this valuable tool: Tom Bart, CO; Larry Bradshaw; Carl Brenner, CPO; Joseph M. Cestaro, CPO; John Eschen, CPO; Gene Jones; Jon Leimkuehler, CPO, Joe Lydon, CO; Brad Rosenberger, CPO; and Ted Thranhardt, CPO
Legislative efforts paid off in 1990 when an amendment to the Social Security Act classified O&P as a unique category of provider, separate from DME for reimbursement purposes. The advocacy effort has continued since that time to further seek recognition for O&P clinicians as allied healthcare providers whose expertise should also be part of the patient’s medical record.
BOC introduced facility accreditation to help facilities independently prove their competency in patient care and sound business practices.
The National Commission on Orthotic and Prosthetic Education (NCOPE) became an independent organization under the National Office structure.
The National Easter Seal Society presented the O&P Almanac with an EDI (Equality, Dignity, Independence) Award for the article “Disability in America: A Transition in Awareness,” which appeared in the May 1992 issue. Other winners included Newsweek, The Washington Post, People Magazine, ABC’s World News Tonight, NBC’s Today Show, AT&T and McDonalds Corp.
Legislative efforts on Capitol Hill resulted in the signing of HR 3839, which increased funding for O&P schools.
In 1992, a taskforce was formed to research the economic impact of merging AOPA-ABC-AAOP-NCOPE and the O&P National Office. Many longstanding O&P Professionals can remember the acronym ACPORS. A second attempt at merging the organizations was made in 2000 which resulted in the disolution of the O&P National Office.
In 1992, as AOPA celebrated its 75th anniversary, the first legislative conference was held to educate members about O&P legislative concerns and lobbying efforts.
The O&P Athletic Fund was established in 1995 by the O&P National Office to provide financial support for the 1996 Paralympic Games. Its goal was to raise money so athletes would be cared for by orthotic and prosthetic certificants. After the games, the fund changed its name to the O&P Activities Fund and changed its mission to promoting health and fitness for disabled individuals. In August 2005, the fund developed First Volley, a tennis program for players with prosthetic limbs. It fills the gap between able-bodied tennis and wheelchair tennis.
J.E. Hanger Inc. establishes the O&P Education Fund in memoriam of Howard R. Thranhardt. The purpose of this fund is to support quality education at AOPA and AAOP national meetings by creating incentive and the means to attract high quality educational programming. The fund supports the Thranhardt lecture series, which has become the most popular and well-attended education session at the national meetings.
AOPA persuaded the Senate Judiciary Committee to shelve the Prosthetic Limb Access Act of 1996, which would have increased manufacturers’ liability and allowed the recycling of used prostheses, a practice which AOPA does not believe is in the best interest of proper clinical care.
AOPA unveiled its first website on the Internet—www.theaopa.org.
In 2001, AOPA members voted to change the association bylaws regarding membership eligibility to recognize BOC certification. This change allowed AOPA to expand its membership and be more representative of the entire O&P profession. The broader membership has led to AOPA having an even stronger, more effective voice on Capitol Hill for O&P companies and professionals.
Georgia Tech applies for accreditation as the first masters O&P program .
Orthotic Distance education piloted at Newington Certificate Program.
In April 2005, AOPA launched the Profitability Seminar, which taught the impact of discounting and how cost accounting can boost the bottom line. It also covered antitrust laws that affect O&P businesses. Along with the seminar, a new product was created, the O&P Profitability Guide: Managing Threats to Your Bottom Line.
In 2005, AOPA, ABC, the Academy and NAAOP put together a coalition, the O&P Alliance, to work on issues of mutual concern to the various groups and to help ensure that all of the stakeholders in the O&P profession spoke with a united voice, especially on government relations issues. The Alliance has worked on a number of issues including convincing CMS to make the new Medicare quality standards more reasonable for O&P, advocating for removal of O&P from competitive bidding, and pushing CMS to enforce qualified provider regulations.
AOPA hosted a Leadership Conference in 2006 with the theme of "Developing a Shared Vision"
Executive Director Tom Fise joined AOPA in 2007 and celebrates his 10 year anniversary at AOPA during AOPA's Centennial. He came to AOPA after serving as owner and principal of an association management company. In that capacity he worked simultaneously as executive director of ten different physician organizations in the fields of cardiovascular surgery, general surgery and plastic surgery, as well as the executive director of the American College of Gastroenterology.
AOPA celebrated its 90th Anniversary during the National Assembly in Las Vegas.
AOPA members changed the association’s bylaws to allow all members to participate in the voting process via an electronic ballot.
AOPA led the effort to convince the Treasury Department to exempt O&P from the 2.3% medical device tax that was implemented to help offset costs of the Affordable Care Act. AOPA met with the IRS and Treasury Department over two years to convince that O&P should be exempt under the retail exemption that applies to eye glasses and hearing aids.
Successful World Congress is held in Orlando, Florida
AOPA organizes successful leadership conference for leaders in the O&P profession in Palm Beach, Florida.
AOPA organizes patient rally outside of HHS Headquarters. Over 120 participants to include amputees, practitioners, news media and AOPA staff protest the proposed LCD prosthetic policy that would have rolled back clinical and technology advancements to a 1970's standard of care.
AOPA celebrates its 100th anniversary
AOPA hosts its Second World Congress in Las Vegas, Nevada from September 6-9th.