TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 18. NURSING FACILITY ADMINISTRATORS

40 TAC §§18.1, 18.8, 18.9

The Texas Department of Human Services (DHS) adopts amendments to §18.1, concerning introduction, §18.8, concerning provisional licensure, and §18.9, concerning licensure renewal and inactive status, in its Nursing Facility Administrators chapter. The amendments are adopted without changes to the proposed text in the May 25, 2001, issue of the Texas Register (26 TexReg 3697) and will not be republished.

Justification for the amendments is to ensure that nursing facility administrators licensed in the State of Texas have the necessary licensure qualifications to provide greater protection of the health and safety of residents and consumers of nursing facilities DHS regulates.

The department received no comments regarding adoption of the amendments.

The amendments are adopted under the Health and Safety Code, Chapter 242, which authorizes the department to license and regulate nursing facilities.

The amendment implements the Health and Safety Code, §§242.001-242.268.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 9, 2001.

TRD-200103885

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: August 1, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 438-3108


Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 362. DEFINITIONS

40 TAC §362.1

The Texas Board of Occupational Therapy Examiners adopts amendments to §362.1 concerning Definitions, without change to the proposed text as published in the May 25, 2001 issue of Texas Register (26 TexReg 3717) and will not be republished.

The section was amended to remove supervision definitions which have been added to the Supervision Chapter, and to add definitions for non-licensed personnel, and Occupational Therapy Practitioners. It also deletes a definition for Temporary License which was not in agreement with the Act.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103801

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 364. REQUIREMENT FOR LICENSURE

40 TAC §§364.1 - 364.4

The Texas Board of Occupational Therapy Examiners adopts amendments to §§364.1 - 364.4 concerning Requirements for Licensure. Section 364.1 is being adopted with changes to the proposed text as published in the May 25, 2001 issue of Texas Register (26 TexReg 3720). Sections 364.2 - 364.4 are being adopted without change and will not be republished.

The sections are amended to add the re-exam form and procedure. It also adds a time frame for license application after passing the certification exam.

No comments were received regarding adoption of the amendments.

The amendments are adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by these sections.

§364.1.Requirements for Licensure.

(a) All applicants shall:

(1) submit a complete, notarized application form with a recent passport-type color photograph of the applicant;

(2) submit a non-refundable application fee as set by the Executive Council;

(3) submit a successfully completed board jurisprudence examination on the Texas Occupational Therapy Practice Act and board rules;

(4) Have completed an accredited OT/OTA program;

(5) Have completed supervised fieldwork experience, a minimum of 6 months for OT and 2 months for OTA.

(b) If the applicant has not passed the national licensure examination, the applicant must also meet the requirement in §364..2 of this title (relating to License by Examination).

(c) If the applicant is licensed as an OTR or COTA in another state or jurisdiction of the U.S., the applicant must also meet the requirements as stated in §364.4 of this title (relating to Licensure by Endorsement).

(d) An application for license is valid for one year after the date it is received by the board.

(e) An applicant who submits an application containing false information may be denied a license by the board.

(f) Should the board reject an application for license, the reasons for the rejection will be communicated in writing to the applicant. The applicant may submit additional information and request reconsideration by the Board. If the applicant remains dissatisfied, a hearing may be requested as specified in the Act.

(g) Applicants and licensees must notify the board in writing of changes in name, residential address, and work address within 30 days of the change.

(h) The Board will issue a replacement copy of a license to replace one lost or destroyed upon receipt of a written request and the appropriate fee from the licensee. For a name change, the appropriate fee and a copy of the legal document (marriage certificate, divorce decree) enacting the name change must accompany the request.

(i) The first regular license is valid from the date of issuance until the last day of the applicant's next birth month. If the applicant's birth month is within 90 days after the license is issued, the license will be valid until the last day of the birth month in the following year. An initial regular license will be valid no less than 3 months, no longer than 15 months.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103802

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 367. CONTINUING EDUCATION

40 TAC §§367.1 - 367.3

The Texas Board of Occupational Therapy Examiners adopts amendments to §367.1 and new §367.2, §367.3 concerning Continuing Education. Section 367.1 is be adopted with changes to the proposed text as published in the May 25, 2001 issue of Texas Register (26 TexReg 3721). Section 367.2 and §367.3 are being adopted without change and will not be republished.

Section 367.1 was amended to reorganize the chapter and clarify its intent.

Comments were received regarding these sections from AOTA and Tana Hadlock, licensee.

The amendment and new sections are being adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by these sections.

§367.1.Continuing Education.

(a) The Act mandates licensee participation in a continuing education program for license renewal. All continuing education must be directly relevant to the profession of occupational therapy. The licensee is solely responsible for keeping accurate documentation of all continuing education requirements.

(b) Continuing education documentation includes, but is not limited to, a final official transcript, AOTA self-study completion certificates, copies of official sign-in or attendance sheets, course certificates of attendance, certificates of completion, and official correspondence from the board approving requesting credits.

(c) The first regular license, which has a duration of less than 2 years, does not have a continuing education requirement.

(d) All licensees, except those addressed in (subsection c of this section must complete 30 hours of continuing education every two years during the period of time the license is current in order to renew the license. Those renewing a license more than 90 days late must submit proof of continuing education for the renewal.

(1) General information hereafter referred to as Type 1 continuing education is relevant to the profession of occupational therapy. Examples include by are not limited to: supervision, education, documentation, quality improvement, administration, reimbursement and other occupational therapy related subjects.

(2) A minimum of 15 hours of continuing education must be in skills relevant to occupational therapy practice with patients or clients hereafter referred to as Type 2.

(A) Type 2 courses teach occupational therapy treatment and intervention with patients or clients.

(B) All continuing education hours may be in Type 2.

(e) Any continuing education submissions may be counted only one time.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103803

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 370. LICENSE RENEWAL

40 TAC §370.1

The Texas Board of Occupational Therapy Examiners adopts amendments to §370.1 concerning License Renewal, without change to the proposed text as published in the May 25, 2001 issue of Texas Register (26 TexReg 3723) and will not be republished.

The section was amended to added the a requirement to submit continuing education material if submitting for renewal more than 90 days late.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103804

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 372. PROVISION OF SERVICES

40 TAC §372.1

The Texas Board of Occupational Therapy Examiners adopts amendments to §372.1 concerning Provision of Services, with changes to the proposed text as published in the May 25, 2001 issue of Texas Register (26 TexReg 3723). No language was changed, but an item was moved from (e)(6) to (d)(4).

The section was amended to clarify the chapter. The reorganization separates medical and non-medical care, differentiates between screening, evaluation and plan of care, and more clearly defines the responsibilities of the licensees.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

§372.1.Provision of Services.

(a) Medical Conditions

(1) Treatment for a medical condition by an occupational therapy practitioner requires a referral from a licensed referral source.

(2) The referral may be an oral or singed written order. If oral, it must be followed by a signed written order.

(3) If a written referral signed by the referral source is not received by the third treatment or within two weeks from the receipt of the oral referral, whichever is later, the therapist must have documented evidence of attempt(s) to contact the referral source for the written referral (e.g., registered letter, fax, certified letter, email, return receipt, etc.). The therapist must exercise professional judgement to determine cessation or continuation of treatment with a receipt of the written referral.

(b) Non-Medical Conditions

(1) Consultation, monitored services, and evaluation for need of services may be provided without a referral.

(2) Non-medical conditions do not require a referral. However, a referral must be requested at any time during the evaluation or treatment process when necessary to insure the safety and welfare of the consumer.

(c) Screening. A screening may be performed by an occupational therapist or an occupational therapy assistant.

(d) Evaluation.

(1) Only an occupational therapist may perform the evaluation.

(2) An occupational therapy plan of care must be based on an occupational therapy evaluation.

(3) The occupational therapist must have face-to-face, real time interaction with the patient or client during the evaluation process.

(4) The occupational therapist may delegate to an occupational therapy assistant the collection of data for the assessment. The occupational therapist is responsible for the accuracy of the data collected by the assistant.

(e) Plan of Care

(1) Only an occupational therapist may initiate, develop, modify or complete an occupational therapy plan of care.

(2) The occupational therapist and occupational therapy assistant may work jointly to revise the short-term goals, but the final determination resides with the occupational therapist.

(3) An occupational therapy plan of care may be integrated into an interdisciplinary plan of care, but the occupational therapy goals or objectives must be easily identifiable in the plan of care.

(4) Only occupational therapy practitioners licensed by the Texas Board of Occupational Therapy Examiners (TBOTE) may implement the plan of care.

(5) Only the occupational therapist or occupational therapist assistant may train non-licensed personnel or family members to carry out specific tasks that support the occupational therapy plan of care.

(6) The occupational therapist is responsible for determining whether intervention is needed and if a referral is required for occupational therapy intervention.

(7) The occupational therapist or the occupational therapy assistant must have face-to-face, real time interaction with the patient or client during the intervention process.

(8) It is the occupational therapist's responsibility to ensure that all documentation which becomes part of the patient's/client's permanent record is approved and co-signed by the occupational therapist and signed on the bottom of each page.

(f) Discharge.

(1) Only an occupational therapist has the authority to discharge patients from occupational therapy services. The discharge is based on whether the patient or client has achieved predetermined goals, has achieved maximum benefit from occupational therapy services; or when other circumstances warrant discontinuation of occupational therapy services.

(2) The occupational therapist is responsible for the content and validity of the discharge summary and must sign the discharge summary.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103806

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 373. SUPERVISION

40 TAC §§373.1 - 373.3

The Texas Board of Occupational Therapy Examiners adopts an amendment to §373.1 and new §373.2 and §373.3 concerning Supervision, with changes to the proposed text as published in the May 25, 2001, issue of Texas Register (26 TexReg 3725)

The amendment and new sections will differentiate the supervision of non-licensed personnel, temporary licensees and occupational therapy assistants.

No comments were received regarding adoption of the amendment and new sections.

The amendment and new sections are adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by these sections.

§373.1.Supervision of Non-Licensed Personnel.

(a) Licensed occupational therapists are fully responsible for the planning and delivery of occupational therapy services. They may use non-licensed personnel to extend their services; however, the non-licensed personnel must be under the supervision of the licensed occupational therapist or licensed occupational therapy assistant.

(b) Close Personnel Supervision implies direct, on-site contact whereby the supervising occupational therapy licensee is able to respond immediately to the needs of the patient. This type of supervision is required for non-licensed personnel providing support services to the occupational therapist and occupational therapy assistant.

(c) When occupational therapy licensees delegate occupational therapy tasks to non-licensed personnel, the licensee is responsible for ensuring that this person is adequately trained in the tasks delegated.

(d) The licensee providing the treatment must interact with the patient regarding the patient's condition, progress, and/or achievement of goals during each treatment session.

(e) Delegation of tasks to non-licensed personnel includes but is not limited to:

(1) routine department maintenance;

(2) transportation of patients/clients;

(3) preparation or set up of treatment equipment and work area;

(4) assisting patients/clients with their personal needs during treatment;

(5) assisting in the construction of adaptive/assistive equipment and splints. The licensee must be on-site and attending for any initial applications to the patient;

(6) carrying out a predetermined segment or task in the patient's care for which the patient has demonstrated some previous performance ability in executing the task;

(f) The non-licensed personnel may not:

(1) perform occupational therapy evaluative procedures

(2) initiate, plan, adjust, or modify occupational therapy procedures.

(3) act on behalf of the occupational therapist in any matter relating to occupational therapy which requires decision making or professional judgements.

§373.2.Supervision of a Temporary Licensee.

(a) Supervision of an occupational therapist with a temporary license includes:

(1) frequent communication between the supervising occupational therapist and the temporary licensee by telephone, written report or conference, including the review of progress of patients/clients assigned, plus

(2) encounters twice a month where the occupational therapist directly observes the temporary licensee providing services to one or more patients/clients with face-to-face, real time interaction.

(b) Supervision of an occupational therapy assistant with a temporary license includes;

(1) sixteen hours of supervision a month of which at least twelve hours are through telephone, written report or conference, including the review of progress of patients/clients assigned; plus

(2) four or more hours of supervision a month which are face-to-face, real time supervision with the temporary licensee providing services to one or more patients/clients.

(c) Temporary licensees may not supervise anyone.

(d) All documentation completed by an individual holding a temporary license which becomes part of the patient's/client's permanent file, must be approved and co-signed by the supervising occupational therapist.

(e) A temporary licensee works under the supervision of a regular licensed occupational therapist, whose name and license number are on file on the board's "Supervision of a Temporary Licensee" form.

(f) A temporary licensee does not become a regular licensee with those privileges until the regular license is in hand.

§373.3.Supervision of a Licensed Occupational Therapy Assistant.

(a) Supervision per month of eight hours includes:

(1) A minimum of six hours a month of frequent communication with the supervising occupational therapist(s) and the occupational therapy assistant by telephone, written report, email, conference etc., including review of progress of patient's/client's assigned.

(2) A minimum of two hours of supervision a month of face-to-face, real time interaction observing the occupational therapy assistant providing services with patients/clients.

(b) Part-time licensees may pro-rate these hours, but shall document no less than four hours of supervision per month, one hour of which includes face-to-face, real time interaction observing the occupational therapy assistant providing services with patients/clients.

(c) Occupational Therapy Assistants with more than one employer must have a supervisor at each job.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103807

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900


Chapter 374. DISCIPLINARY ACTIONS/DETRIMENTAL PRACTICE/COMPLAINT PROCESS/CODE OF ETHICS

40 TAC §§374.1 - 374.3

The Texas Board of Occupational Therapy Examiners adopts amendments to §§374.1 - 374.3- DISCIPLINARY ACTIONS/DETRIMENTAL PRACTICE/COMPLAINT PROCESS/CODE OF ETHICS. Section 374.1 is being adopted with changes to the proposed text as published in the May 25, 2001 issue of the Texas Register (26 TexReg 3728). Sections 374.2 and 374.3 are adopted without change and will not be republished. The amendments will reorganize the chapter and make current reference to the OT Practice Act.

No comments were received regarding these amendments.

The rules are adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 454, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subtitle H, Chapter 454 of the Occupational Code are affected by these amended sections.

§374.1.Disciplinary Actions.

(a) The Board, in accordance with the Administrative Procedure Act, may deny, revoke, suspend, or refuse to renew or issue a license, or may reprimand or impose probationary conditions, if the licensee or applicant for licensure has been found in violation of the rules or the Act. The board will adhere to procedures for such action as stated in the Act, 454.301, 454.302, 454.303, and 454.304.

(b) The board recognizes four levels of disciplinary action for its licensees.

(1) Level I: Order and/or Letter of Reprimand or Other Appropriate Disciplinary Action (including but not limited to community service hours)

(2) Level II: Probation--The licensee may continue to practice while on probation. The board orders the probationary status which may include but is not limited to restrictions on practice and continued monitoring by the board during the specified time period.

(3) Level III: Suspension--A specified period of time that the licensee may not practice as an occupational therapist or occupational therapy assistant. Upon the successful completion of the suspension period, the license will be reinstated upon the licensee successfully meeting all requirements.

(4) Level IV: Revocation-A determination that the licensee may not practice as an occupational therapist or occupational therapy assistant. Upon passage of 180 days, from the date the revocation order becomes final, the former licensee may petition the board for re-issuance of a license. The former licensee may be required to re-take the Examination.

(c) Licensees and facilities which provide occupational therapy services are responsible for understanding and complying with Chapter 454 of the Occupational Code (the Occupational Therapy Practice Act), and the Texas Board of Occupational Therapy Examiners' rules.

(d) Final disciplinary actions taken by the board will be routinely published as to the names and offenses of the licensees or facilities.

(e) A licensee who is ordered by the board to perform certain act(s) will be monitored by the board to ensure that the required act(s) are completed per the order of the board.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 2, 2001.

TRD-200103808

John Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: July 22, 2001

Proposal publication date: May 25, 2001

For further information, please call: (512) 305-6900