Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS
Chapter 367. CONTINUING EDUCATION
The Texas Board of Occupational Therapy Examiners adopts the amendments to §367.1, concerning Continuing Education, with changes to the proposed text as published in the December 14, 2007, issue of the Texas Register (32 TexReg 9313). Section 367.1 is adopted with changes to correct a typographical error. In the proposed rule text the section number was incorrectly submitted as §376.1. The only change to the rule is to correct the section number.
The amended section is adopted, in part, to clarify the continuing education requirements for occupational therapists. The amended section removed the reference to AOTA's categories and added the requirement for licensees to choose continuing education according to the Type 1 and Type 2 definitions.
Five comments were received from individuals.
One suggested adding OT theory, OT ethics, and OT practice framework to Type 2 when presented by an OT practitioner. This item will be on the agenda for the April Rules Committee. No change was made in response to this comment.
One of the comments concerned taking the same course twice, which is not allowed by rule if it's the exact same course. No change was made in response to this comment.
The other comments were in favor of the rule as proposed.
The amendments are adopted under the Occupational Therapy Act, Title 3, Chapter 454, Subchapter H of the Texas Occupations Code, which provides 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, Chapter 454, Subchapter H of the Texas Occupations Code is affected by this amended section.
§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 and meet the definition of Type 1 or Type 2 as outlined in this section. The licensee is solely responsible for keeping accurate documentation of all continuing education requirements.
(b) All licensees 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) Those renewing a license more than 90 days late must submit proof of continuing education for the renewal.
(d) 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.
(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.
(e) Specific continuing educational activities may be counted only one time in the licensee's career unless content has been updated or revised.
(f) 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.
(g) Licensees are responsible for choosing Type 1 or Type 2 CE according to the definitions in this 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 February 5, 2008.
TRD-200800685
John Maline
Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners
Texas Board of Occupational Therapy Examiners
Effective date: February 25, 2008
Proposal publication date: December 14, 2007
For further information, please call: (512) 305-6900
The Texas Board of Occupational Therapy Examiners adopts the amendments to §372.1, concerning Provision of Services, with changes to the proposed text as published in the December 14, 2007, issue of the Texas Register (32 TexReg 9314).
The amended section is adopted, in part, to delineate the role distinctions between the OTR/LOT and the COTA/LOTA. It also recognizes that a COTA/LOTA may hold a supervisory role, but cannot determine occupational therapy services.
Five comments were received from individuals.
One comment suggested giving COTAs the ability to determine initiation, continuation and discharge of therapy. The Board disagrees. The Board thinks it is inappropriate to give this additional authority to COTAs. The Board thinks that it is in the best interest of a patient's health and safety to allow only OTRs and LOTs to determine the initiation, continuation and discharge of therapy.
The second comment suggested adding LOTA where COTA was written. The Board agrees with this comment and amends the section to add LOTA where COTA appeared in the rule.
The third comment suggested adding "time intensity" to the language. The time intensity question will be charged to the next rules committee.
The fourth comment felt the additional verbage was unnecessary. The Board disagrees. The additional language is necessary to delineate the role distinctions between the OTR/LOT and the COTA/LOTA.
The fifth comment agreed with the board's proposed amendments.
The amendments are adopted under the Occupational Therapy Act, Title 3, Chapter 454, Subchapter H of the Texas Occupations Code, which provides 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, Chapter 454, Subchapter H of the Texas 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 signed 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 judgment 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 therapy practitioner.
(d) Evaluation.
(1) Only an OTR or LOT may perform the evaluation.
(2) An occupational therapy plan of care must be based on an occupational therapy evaluation.
(3) The OTR or LOT must have face-to-face, real time interaction with the patient or client during the evaluation process.
(4) The OTR or LOT may delegate to a COTA, LOTA or temporary licensee the collection of data for the assessment. The OTR or LOT is responsible for the accuracy of the data collected by the assistant.
(e) Plan of Care.
(1) Only an OTR, LOT or OT may initiate, develop, modify or complete an occupational therapy plan of care. It is a violation of the OT Practice Act for a COTA/LOTA to dictate, or attempt to dictate, when occupational therapy services should or should not be provided, the nature and frequency of services that are provided, when the patient should be discharged, or any other aspect of the provision of occupational therapy as set out in the OT Act and Rules.
(2) The OTR, LOT or OT and COTA, LOTA or OTA may work jointly to revise the short-term goals, but the final determination resides with the OTR or LOT. Revisions to the plan of care and goals must be documented by the OTR/LOT and/or COTA/LOTA to reflect revisions at the time of the change.
(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 once it is established.
(5) Only the occupational therapy practitioner may train non-licensed personnel or family members to carry out specific tasks that support the occupational therapy plan of care.
(6) The OTR or LOT is responsible for determining whether intervention is needed and if a referral is required for occupational therapy intervention.
(7) The occupational therapy practitioners must have face-to-face, real time interaction with the patient or client during the intervention process.
(8) Except where otherwise restricted by rule, the supervising OTR or LOT may only delegate to a COTA, LOTA or temporary licensee tasks that they both agree are within the competency level of that COTA, LOTA or temporary licensee.
(9) The COTA or LOTA must include the name of his or her supervising OTR or LOT in each treatment note. If there is not a current supervising OTR or LOT, the COTA or LOTA cannot treat.
(f) Discharge.
(1) Only an OTR or LOT 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 OTR or LOT 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 February 5, 2008.
TRD-200800687
John Maline
Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners
Texas Board of Occupational Therapy Examiners
Effective date: February 25, 2008
Proposal publication date: December 14, 2007
For further information, please call: (512) 305-6900
The Texas Board of Occupational Therapy Examiners adopts the amendments to §373.3, concerning Supervision of a Licensed Occupational Therapy Assistant, without changes to the proposed text as published in the December 14, 2007, issue of the Texas Register (32 TexReg 9314) and will not be republished.
The amended section is adopted, in part, to clarify the manner in which a COTA/LOTA shall be supervised by a licensed occupational therapist. The amended section requires that the COTA/LOTA's hours be documented in a supervision log.
Two comments were received from individuals.
One comment contended that the supervisory regulations for COTAs were getting too extreme, and suggested that the Board only require a supervisory visit every 30 days. The Board disagrees. The Board thinks that the amendments to this section are not burdensome and will improve the supervision of COTAs and LOTAs. No changes were made in response to this comment.
The other comment supported the changes.
The amendments are adopted under the Occupational Therapy Act, Title 3, Chapter 454, Subchapter H of the Texas Occupations Code, which provides 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, Chapter 454, Subchapter H of the Texas 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 February 5, 2008.
TRD-200800688
John Maline
Executive Director, Executive Council of Physical Therapy and Occupational Therapy Examiners
Texas Board of Occupational Therapy Examiners
Effective date: February 25, 2008
Proposal publication date: December 14, 2007
For further information, please call: (512) 305-6900