Occupational Therapy Licensing Rules
Courtesy of the Wisconsin Department of Public Instruction
Information
Update, April 2003
Changes in occupational therapy licensing rules
The Wisconsin Administrative Code that implements state licensure for
occupational therapists (OTs) and occupational therapy assistants (OTAs)
changed recently. Effective January 1, 2003, § OT 1 through OT 5
of the Wisconsin Administrative Code replaced the repealed § MED
19. All OTs and OTAs who practice in Wisconsin, regardless of the type
of setting, must be licensed by the Department of Regulation and Licensing,
Occupational Therapy Affiliated Credentialing Board, and practice in accordance
with these rules. Changes of significance to school occupational therapy
services include an increase in continuing education requirements, an
increase in occupational therapy assistant supervision requirements, confirmation
that a medical referral is not required, and guidance for delegation of
occupational therapy services to personnel who are not licensed under
this chapter.
Continuing education requirements
An OT or OTA who is granted a license must maintain current registration
of that license. Registration occurs every two years on November 1 of
odd-numbered years. To keep registration current, OTs must complete 18
points of continuing education and OTAs must complete 12 points of continuing
education between November 1, 2001, and November 1, 2003. Between November
1, 2003, and November 1, 2005, all licensed OTs and OTAs are required
to complete 24 points of continuing education. The new requirement will
continue in subsequent years. At least 12 of the points must be professional
development activities related to occupational therapy. § OT 3 includes
a table of acceptable activities and their point values. OTs and OTAs
must certify that they have completed this requirement and must keep evidence
of activities, such as certificates of completion, in case of audit.
Occupational therapy assistant supervision requirements
Prior to January 1, 2003, OTA supervision requirements in special education
rules were more restrictive than rules in § Med 19 and provided appropriate
guidance for school occupational therapy services (see § PI 11.24
of the Wisconsin Administrative Code). § OT 4.04 includes some provisions
that now are more restrictive and must be followed by school systems.
- Close supervision is required for school system services provided
by an entry-level OTA. Entry-level means a new graduate, a person new
to the position, or a person with no previous experience in school system
practice. Close supervision means the OT shall have daily, direct contact
on the premises with the OTA. No specific duration of close supervision
is required.
- When providing general supervision, the supervising OT now is required
to have direct contact on the premises with the OTA and the client every
two weeks. Under § PI 11.24 the biweekly meeting between the OT
and OTA did not have to be on the premises or with the client. Instead
of onsite re-evaluation of the child's therapy once every calendar month,
the OT must now have onsite contact with the child and the OTA every
two weeks.
- The OT must base the delegation of occupational therapy services
on the establishment of service competence. Service competence is defined
as determining that two people performing the same or equivalent procedures
will obtain the same or equivalent results.
Physician or other health care provider referral not required
DPI
Information Update Bulletin No. 00.05 included information that a
medical referral from a licensed physician no longer is required for school
occupational therapy. The new rules clarify that position.
Physician order or referral from another health care provider is not
required for evaluation or intervention if an occupational therapist
or occupational therapy assistant provides services in an educational
environment, including the child's home, for children and youth with
disabilities pursuant to rules promulgated by the federal individuals
with disabilities education act, the department of public instruction
and the department of health and family services, or provides services
in an educational environment for children and youth with disabilities
pursuant to the code of federal regulations. (§ OT 4.03 (1)(e))
Supervision of non-licensed personnel and therapy aides
Requirements for delegating occupational therapy services to non-licensed
personnel were not addressed previously in state law. In § OT 4.05,
"non-licensed personnel" refers to personnel who are not licensed
as occupational therapists or occupational therapy assistants.
- § OT 4.05 restricts the occupational therapy services that an
OT or an OTA may delegate to non-licensed personnel.
- In all instances of delegation to non-licensed personnel, the OT
or OTA must be on premises and available to assist.
- If the services are maintenance or restorative services, the OT or
OTA must be in the immediate area and within audible and visual range
of the client and the non-licensed personnel.
- Only non-skilled, specific tasks may be delegated to non-licensed
personnel following appropriate training and with on-premises supervision.
- Delegated tasks may not be evaluative, assessive, task selective,
or recommending in nature and may not include development, planning,
adjusting, or modification of treatment procedures.
- Non-licensed personnel may not act on behalf of the OT or OTA in
any matter related to direct client care which requires judgment or
decision making.
These requirements for delegation of occupational therapy may be contrasted
with the revised definition of "Consultation" in § OT 1.02.
"Consultation" means a work-centered, problem-solving helping
relationship in which knowledge, experience, abilities, and skills are
shared with client, family, caregivers, and other professionals, including
physicians, in the process of helping to habilitate or rehabilitate
through the use of occupational therapy.
Many of the provisions that were in § MED 19 have not changed. School
OTs, OTA, and their supervisors are advised to read the full text of the
rules. Copies of § OT 1 through OT 5 of the Wisconsin Administrative
Code can be downloaded from the Wisconsin
Legislature Web site.
For more information about school occupational therapy, see: http://www.dpi.state.wi.us/dpi/dlsea/een/occ_ther.html
Questions regarding this information update can be addressed to Patricia
Bober at 608-266-5194.
Posted May 6, 2003