TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 362. DEFINITIONS

40 TAC §362.1

The Texas Board of Occupational Therapy Examiners (TBOTE) proposes amendments to §362.1, concerning Definitions.

The section is being amended to change terms which are no longer current. The proposed new definitions will recognize the current OT practice framework, which includes practice settings that are in the community, schools, business and other non-medical settings.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the rule is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Maline also has determined that for each year of the first five years the rule is in effect, the pubic benefit anticipated as a result of enforcing the rule will be the improved definitions to help practitioners. There will be no effect on small businesses and no economic cost to persons having to comply is anticipated.

Comments on the proposed amendments may be submitted to Augusta Gelfand, OT Coordinator, at (512) 305-6900, 333 Guadalupe St., #2-510, Austin, TX 78701 or augusta.gelfand@mail.capnet.state.tx.us.

The amendment is proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, 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 proposal.

§362.1.Definitions.

The following words, terms, and phrases, when used in this part shall have the following meaning, unless the context clearly indicates otherwise.

(1) - (5) (No change.)

(6) Class A Misdemeanor--An individual adjudged guilty of a Class A misdemeanor shall be punished by:

(A) A fine not to exceed $4,000 [ $3,000 ];

(B) - (C) (No change.)

(7) Client--The entity that receives occupational therapy. Clients may be individuals (including others involved in the individual's life who may also help or be served indirectly such as caregiver, teacher, parent, employer, spouse), groups, or populations (i.e., organizations, communities).

(8) [ (7) ] Complete Application--Notarized application form with photograph, license fee, jurisprudence examination with at least 70% of questions answered correctly and all other required documents.

(9) [ (8) ] Complete Renewal--Contains renewal fee, renewal form with signed continuing education affidavit, home/work address(es) and phone number(s), and jurisprudence examination with at least 70% of questions answered correctly.

[ (9) Consultation--The provision of occupational therapy expertise to an individual or institution. This service may be provided on a one time only basis or on an ongoing basis.]

(10) - (11) (No change.)

(12) Direct Contact--Refers to contact with the client and includes face-to-face in person or via visual telecommunications. [ Direct Service--Refers to the provision of occupational therapy services to individuals to develop, improve, and/or restore occupational functioning. ]

(13) Endorsement--The process by which the board issues a license to a person currently licensed in another state, the District of Columbia, or territory of the United States that maintains professional standards considered by the board to be substantially equivalent to those set forth in the Act, and is applying [ apply ] for a Texas license for the first time.

(14) Evaluation-- The process of planning, obtaining, documenting and interpreting data necessary for intervention. This process is focused on finding out what the client wants and needs to do and on identifying those factors that act as supports or barriers to performance. [ Refers to a process of determining an individual's status for the purpose of determining the need for occupational therapy services or for implementing a treatment program. ]

(15) - (17) (No change.)

[ (18) Face-to-face, real time--Refers to live interactions either in person or via visual telecommunications.]

(18) [ (19) ] First Available Examination--Refers to the first scheduled Examination after successful completion of all educational requirements.

(19) [ (20) ] Health Care Condition--See Medical Condition .

(20) Intervention--The process of planning and implementing specific strategies based on the client's desired outcome, evaluation data and evidence, to effect change in the client's occupational performance leading to engagement in occupation to support participation.

(21) - (27) (No change.)

[ (28) Monitored Services--The checking on the status/condition of students, patients, clients, equipment, programs, services, and staff in order to make appropriate adjustments and recommendations. Minimum contact for the purpose of monitoring will be one time a month.]

(28) [ (29) ] NBCOT [ (formerly AOTCB) ]--National Board for Certification in Occupational Therapy [ (formerly American Occupational Therapy Certification Board) ].

(29) [ (30) ] Non-licensed Personnel--OT Aide or OT Orderly or other person not licensed by this board who provides support services to occupational therapy practitioners and whose activities require on-the-job training and close personal supervision.

(30) [ (31) ] Non-Medical Condition--A condition where the ability to perform occupational roles is impaired by developmental disabilities, learning disabilities, the aging process, sensory impairment, psychosocial dysfunction, or other such conditions which does not require the routine intervention of a physician.

(31) Occupation--Activities of everyday life, named, organized, and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves, including looking after themselves, enjoying life and contributing to the social and economic fabric of their communities.

(32) - (33) (No change.)

(34) Occupational Therapy Practice--includes:

(A) Methods or strategies selected to direct the process of interventions such as:

(i) Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired.

(ii) Compensation, modification, or adaptation of activity or environment to enhance performance.

(iii) Maintenance and enhancement of capabilities without which performance in everyday life activities would decline.

(iv) Health promotion and wellness to enable or enhance performance in everyday life activities.

(v) Prevention of barriers to performance, including disability prevention.

(B) Evaluation of factors affecting activities of daily living (ADL) instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:

(i) Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinaray systems).

(ii) Habits, routines, roles and behavior patterns.

(iii) Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance.

(iv) Performance skills, including motor, process, and communication/interaction skills.

(C) Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including.

(i) Therapeutic use of occupations, exercises, and activities.

(ii) Training in self-care, self-management, home management and community/work reintegration.

(iii) Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills.

(iv) Therapeutic use of self, including one's personality, insights, perceptions, and judgments, as part of the therapeutic process.

(v) Education and training of individuals, including family members, caregivers, and others.

(vi) Care coordination, case management and transition services.

(vii) Consultative services to groups, programs, organizations, or communities.

(viii) Modification of environments (home, work, school, or community) and adaptation of processes, including the application of ergonomic principles.

(ix) Assessment, design, fabrication, application, fitting and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices.

(x) Assessment, recommendation, and training in techniques to enhance functional mobility including wheelchair management.

(xi) Driver rehabilitation and community mobility.

(xii) Management of feeding, eating, and swallowing to enable eating and feeding performance.

(xiii) Application of physical agent modalities, and use of a range of specific therapeutic procedures (such as wound care management; techniques to enhance sensory, perceptual, and cognitive processing; manual therapy techniques) to enhance performance skills.

[ (34) Occupational Therapy--The use of purposeful activity or intervention to achieve functional outcomes. Achieving functional outcomes means to develop or facilitate restoration of the highest possible level of independence in interaction with the environment. Occupational Therapy provides services to individuals limited by physical injury or illness, a dysfunctional condition, cognitive impairment, psychosocial dysfunction, mental illness, a developmental or learning disability or an adverse environmental condition, whether due to trauma, illness or condition present at birth. Occupational therapy services include but are not limited to:]

[(A) The evaluation/assessment, treatment and education of or consultation with the individual, family or other persons;]

[(B) interventions directed toward developing, improving or restoring daily living skills, work readiness or work performance, play skills or leisure capacities;]

[(C) intervention methodologies to develop restore or maintain sensorimotor, oral-motor, perceptual or neuromuscular functioning; joint range of motion; emotional, motivational, cognitive or psychosocial components of performance.]

(35) - (37) (No change.)

(38) Outcome--The focus and targeted end objective of occupational therapy intervention. The overarching outcome of occupational therapy is engagement in occupation to support participation in context(s).

(39) [ (38) ] Place(s) of Business--Any facility in which a licensee practices.

(40) [ (39) ] Practice--Providing occupational therapy as a clinician, practitioner, educator, or consultant. Only a person holding a license from TBOTE may practice occupational therapy in Texas.

(41) [ (40) ] Accredited Educational Program [ Recognized Educational Institution ]--An educational institution offering a course of study in occupational therapy that has been accredited or approved by the American Occupational Therapy Association.

(42) [ (41) ] Regular License--A license issued by TBOTE to an applicant who has met the academic requirements and who has passed the Examination.

(43) [ (42) ] Rules--Refers to the TBOTE Rules.

(44) [ (43) ] Screening-- A process used to determine a potential need for occupational therapy interventions, educational and/or other client needs. Screening information may be compiled using observation, client records, the interview process, self-reporting, and/or other documentation. [ A process or tool used to determine a potential need for occupational therapy interventions. This information may be compiled using observation, medical or other records, the interview process, self-reporting, and/or other documentation. ]

(45) [ (44) ] Supervision--See Chapter 373 of this title (relating to Supervision) .

(46) [ (45) ] Temporary License--A license issued by TBOTE to an applicant who meets all the qualifications for a license except taking the first available Examination after completion of all education requirements.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on March 2, 2007.

TRD-200700826

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: April 15, 2007

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


Chapter 364. REQUIREMENTS FOR LICENSURE

40 TAC §364.1

The Texas Board of Occupational Therapy Examiners, (TBOTE) proposes amendments to §364.1, concerning Requirements for Licensure, to be published in the Texas Register for public comment.

The section is being amended to change the duration of the first license to at least two years ending at the last day of the licensee's birth month. First time licensees will have the same continuing education requirement as all regular licensees.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendments are in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the amended section.

Mr. Maline also has determined that for each year of the first five years the amendment is in effect the public benefit anticipated as a result of enforcing the amended rule will the consistency of all licenses and continuing education requirements, eliminating the confusion of the exceptions for the first license. There will be no effect on small businesses, and no economic cost to persons having to comply is anticipated.

Comments on the proposed amendments may be submitted to Augusta Gelfand, OT Coordinator, at (512) 305-6900, 333 Guadalupe Street, Suite 2-510, Austin, Texas 78701 or augusta.gelfand@mail.capnet.state.tx.us.

The amendments are proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, 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.

§364.1.Requirements for Licensure.

(a) All applicants shall:

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

(2) - (3) (No change.)

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

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

(b) - (h) (No change.)

(i) The first regular license is valid from the date of issuance until the last day of the applicant's [ next ] birth month , with a duration of at least two years . [ 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. ]

(j) Licensees will follow the rules for continuing education, as described in Chapter 367 of this title (relating to Continuing Education).

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on March 2, 2007.

TRD-200700827

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: April 15, 2007

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


Chapter 367. CONTINUING EDUCATION

40 TAC §367.1, §367.2

The Texas Board of Occupational Therapy Examiners (TBOTE) proposes amendments to §367.1, concerning Continuing Education, and §367.2, concerning Categories of Continuing Education, to be published in the Texas Register for public comment.

The sections are being amended to change the continuing education requirement for the first regular license to be consistent with all regular licensees' continuing educational requirements.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the amendments are in effect there will be no fiscal implication for state or local government as a result of enforcing or administering the amended sections.

Mr. Maline also has determined that for the each year of the first five years the amendments are in effect the public benefit anticipated as a result of enforcing the amended rules will be the consistency of continuing educational requirements for all licensees. There will be no effect on small businesses, and no economic cost to persons having to comply is anticipated.

Comments on the proposed amendments may be submitted to Augusta Gelfand, OT Coordinator, at (512) 305-6900, 333 Guadalupe Street, Suite 2-510, Austin, Texas 78701 or augusta.gelfand@mail.capnet.state.tx.us.

The amendments are proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, 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 the amended sections.

§367.1.Continuing Education.

(a) (No change.)

[(b) New licensees holding a regular license, issued for a period of less than two years, do not have a continuing education requirement until they receive a regular two-year license.]

(b) [ (c) ] All licensees[ , except those addressed in subsection (b) of this section ] must complete a minimum of 30 hours of continuing education every two years during the period of time the license is current in order to renew the license, and provide this information as requested.

(c) [ (d) ] Those renewing a license more than 90 days late must submit proof of continuing education for the renewal.

(d) [ (e) ] Types of Continuing Education.

(1) A minimum of 15 hours of continuing education must be in skills specific to occupational therapy practice with patients or clients hereafter referred to as Type 2. (AOTA's Category 1 or 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, but no less than 15 hours of Type 2 is acceptable.

(2) General information hereafter referred to as Type 1 continuing education is relevant to the profession of occupational therapy. Examples include but are not limited to: supervision, education, documentation, quality improvement, administration, reimbursement and other occupational therapy related subjects. (AOTA's Category 3)

(e) [ (f) ] A specific continuing educational activities may be counted only one time in the licensee's career unless content has been updated or revised.

(f) [ (g) ] Effective January 1, 2003, Type 1 and Type 2 educational activities approved or offered by the American Occupational Therapy Association or the Texas Occupational Therapy Association are pre-approved by the board. The board will review its approval process and continuation thereof for educational activities by January 2005 and at least once each five-year period thereafter.

§367.2.Categories of Continuing Education.

(a) (No change.)

(b) Unacceptable Continuing Education Activities include but are not limited to:

(1) - (5) (No change.)

(6) Facility-based annual required courses such as, but not limited to patient abuse, disposal of hazardous waste, patient privacy, HIPAA [ HIPPA ] & FERPA, blood borne pathogens, and other annual facility required repetitive courses do not count toward continuing education.

(7) (No change.)

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on March 2, 2007.

TRD-200700828

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: April 15, 2007

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


Chapter 370. LICENSE RENEWAL

40 TAC §370.1, §370.2

The Texas Board of Occupational Therapy Examiners, (TBOTE) proposes amendments to §370.1, concerning License Renewal and proposes new §370.2, concerning Late Renewals.

Section 370.1 is being amended to change the restored license duration to at least two years duration and to include the continuing education requirements. New language was added to recognize the online renewal process. Late renewals are proposed in new §370.2.

John P. Maline, Executive Director of the Executive Council of Physical Therapy and Occupational Therapy Examiners, has determined that for the first five-year period the sections are in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the sections.

Mr. Maline also has determined that for each year of the first five years the sections are in effect the public benefit anticipated as a result of enforcing the sections will be consistency in license duration and continuing education requirements. There will be no effect on small businesses. There are no anticipated economic costs to persons who are required to comply with the sections as proposed.

Comments on the proposed amendments may be submitted to Augusta Gelfand, OT Coordinator, at (512) 305-6900, 333 Guadalupe St. #2-510, Austin, TX 78701 or augusta.gelfand@mail.capnet.state.tx.us.

The amendment and new section are proposed under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, 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 proposal.

§370.1.License Renewal.

(a) Licensee Renewal: Licensees [ Except for those renewing their first license, licensees ] are required to renew their licenses every two years by the end of their birth month. A licensee may not provide occupational therapy services without a current license or renewal certificate in hand. If a license expired after all required items are submitted but before the licensee received the renewal certificate, the licensee may not provide occupational therapy services until the renewal certificate is in hand.

(1) General Requirements. The renewal application is not complete until the board receives all required items. The components required for license renewals are:

(A) signed renewal application form, or online equivalent verifying completion of 30 hours of continuing education, as per [ see ] Chapter 367 of this title (relating to Continuing Education);

(B) the renewal fee and any late fees which may be due;

(C) a passing score on the Jurisprudence exam; and [ . ]

(D) any additional forms the board may require.

(2) The licensee is responsible for ensuring that the license is renewed, whether receiving a renewal notice or not.

(3) Online Renewal. Licensees may complete their renewal online and continue to practice with their online receipt for up to 30 days or until they receive their renewal certificate.

(A) Licensees who do not have a Social Security Number on file will be unable to renew online.

(B) Licensees who are inactive status, or who wish to change their current status must renew with a paper application before the expiration date.

(C) Licensees who want to change their name on their license must submit a copy of court documents with the new name before the renewal process so that the renewal card reflects the new name. Changing the wall license requires a replacement license fee. Should the change occur out of the renewal process sequence, the licensee must pay for a duplicate renewal card and/or wall license.

[ (2) Notification of license expiration. The Board will send notification to each licensee at least 30 days prior to the license expiration date. However, the licensee is responsible for ensuring that the license is renewed.]

[ (3) Late Renewals. A renewal application is late if all required materials are not postmarked prior to the expiration date of the license. Licensees who do not complete the renewal process prior to the expiration date are subject to late fees as described.]

[ (A) If the license has been expired for 90 days or less, the late fee is one-half the examination fee for the license.]

[ (B) If the license has been expired for more than 90 days, the late fee is equal to the examination fee for the license. Those renewing a license more than 90 days late must submit the documentation for the required continuing education with the renewal.]

[ (C) If the license has been expired for one year or longer, the person may not renew the license. To obtain a new license, the applicant must retake and pass the national examination and comply with the requirements and procedure for obtaining an original license set by Chapter 364 of this title (relating to Requirements for Licensure).]

[ (D) If a reserve status licensee is called into active military service, and his or her license expires during service, the licensee may follow the requirements for renewal with no penalty if the licensee:]

[ (i) submits the renewal within 90 days after return to reserve status; and]

[ (ii) submits evidence of active service and its inclusive dates.]

[ (E) A reserve status licensee who is called into active military service will have 6 additional months after release from active military service to submit proof of completion of the 30 required CE hours.]

[ (b) Restoration of a Texas License]

[ (1) Eligibility. A person whose license has been expired for one year or more may restore the license without reexamination if the applicant holds a current license in another state, and has been in practice in the other state for the two years preceding application for restoration.]

[ (2) Duration. When a license is restored, the expiration date will be calculated using the nearest past birth month. The restored license will be valid for no less than one year and no more than two years.]

[ (3) Requirements. The components required for restoration of a license are:]

[ (A) Notarized restoration application;]

[ (B) A passing score on the Jurisprudence exam;]

[ (C) A fee equal to the cost of the examination fee for licensure;]

[ (D) Verification of Licensure from the current licensed state;]

[ (E) History of Employment form for the two years proceeding application; and]

[ (F) Other application information as needed by the board.]

(b) [ (c) ] Restrictions to Renewal/Restoration

(1) The board will not renew a license if a licensee has defaulted with the Student Loan Corporation (TGSLC). Upon notice from TGSLC that a repayment agreement has been established, the license shall be renewed.

(2) The board will not renew a license if the licensee has defaulted on a court or attorney general's notice of child support. Upon receipt that repayment has been established, the license shall be renewed.

§370.2.Late Renewals.

(a) A renewal application is late if all required materials are not postmarked prior to the expiration date of the license. Licensees who do not complete the renewal process prior to the expiration date are subject to late fees as described.

(1) If the license has been expired for 90 days or less, the person may renew the license by:

(A) submitting the renewal fee and the board approved late fee; and

(B) reporting completion of the required number of contact hours of continuing education.

(2) If the license has been expired for more than 90 days, but less than one year, the person may renew the license by:

(A) submitting the renewal fee and the board approved late fee; and

(B) reporting completion of the required number of contact hours of continuing education.

(b) If the license has been expired for one year or longer, the person may not renew the license. To obtain a new license, the applicant must retake and pass the national examination and comply with the requirements and procedure for obtaining an original license set by Chapter 364 of this title (relating to Requirements for Licensure).

(c) Restoration: Persons holding a license in another state, previously licensed in Texas:

(1) The board may issue a license to a person who was licensed in Texas, moved to another state, is currently licensed in the other state, and has been engaged in the practice of occupational therapy in the other state for the two years preceding the application if the person meets the following requirements:

(A) makes the application for licensure to the board on a form prescribed by the board;

(B) submits to the board verification of the current license in good standing from the other state;

(C) submits the board form documenting continuous employment in occupational therapy in another state for the two years preceding the application;

(D) passes the jurisprudence exam; and

(E) pays the board approved fee.

(2) The license shall expire at the last day of the month of the licensee's birth. The duration shall be at least two years, and licensees shall obtain the continuing education as per Chapter 367 of this title (relating to Continuing Education).

(d) Military Service

(1) If a reserve status licensee is called into active military service, and his or her license expires during service, the licensee may follow the requirements for renewal with no penalty if the licensee:

(A) submits the renewal within 90 days after return to reserve status;

(B) submits evidence of active service and its inclusive dates.

(2) A reserve status licensee who is called into active military service will have 6 additional months after release from active military service to submit proof of completion of the 30 required CE hours as per Chapter 367 of this title.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on March 2, 2007.

TRD-200700829

John Maline

Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners

Texas Board of Occupational Therapy Examiners

Earliest possible date of adoption: April 15, 2007

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