1     
OCCUPATIONAL THERAPISTS AMENDMENTS

2     
2015 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Gene Davis

5     
House Sponsor: Carol Spackman Moss

6     av

7     LONG TITLE
8     General Description:
9          This bill modifies the Occupational Therapy Practice Act and related provisions.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms, including the "practice of occupational therapy";
13          ▸     modifies the qualifications for an individual to get a license as an occupational
14     therapist or as an occupational therapy assistant;
15          ▸     modifies the supervision requirements of an occupational therapist when
16     supervising an occupational therapy assistant;
17          ▸     modifies who may engage in the practice of occupational therapy without a license;
18          ▸     describes what is unlawful and unprofessional conduct under the act;
19          ▸     extends the sunset date of the Occupational Therapy Practice Act; and
20          ▸     makes technical changes.
21     Money Appropriated in this Bill:
22          None
23     Other Special Clauses:
24          None
25     Utah Code Sections Affected:
26     AMENDS:
27          58-42a-102, as last amended by Laws of Utah 2005, Chapter 71
28          58-42a-201, as enacted by Laws of Utah 1994, Chapter 240
29          58-42a-302, as last amended by Laws of Utah 2009, Chapter 183
30          58-42a-303, as enacted by Laws of Utah 1994, Chapter 240
31          58-42a-304, as enacted by Laws of Utah 1994, Chapter 240
32          58-42a-305, as enacted by Laws of Utah 1994, Chapter 240
33          58-42a-306, as enacted by Laws of Utah 1994, Chapter 240
34          63I-1-258, as last amended by Laws of Utah 2014, Chapters 25, 72, and 181
35     ENACTS:
36          58-42A-103, Utah Code Annotated 1953
37          58-42a-303.5, Utah Code Annotated 1953
38          58-42a-502, Utah Code Annotated 1953
39     REPEALS AND REENACTS:
40          58-42a-501, as enacted by Laws of Utah 1994, Chapter 240
41     

42     Be it enacted by the Legislature of the state of Utah:
43          Section 1. Section 58-42a-102 is amended to read:
44          58-42a-102. Definitions.
45          In addition to the definitions in Section 58-1-102, as used in this chapter:
46          [(1) "Assessment" means the use of skilled observation or evaluation by administering
47     and interpreting standardized or nonstandardized tests and measurements to identify areas for
48     occupational therapy services.]
49          [(2)] (1) "Board" means the [Occupational Therapy] Board of Occupational Therapy
50     created in Section 58-42a-201.
51          [(3) "Certified occupational therapy assistant" or "COTA" means a person certified as a
52     certified occupational therapy assistant by the National Board for Certification in Occupational
53     Therapy.]
54          (2) (a) "Individual treatment plan" means a written record composed for each client by
55     a person licensed under this chapter to engage in the practice of occupational therapy.
56          [(4)] (b) "Individual treatment plan" includes:
57          [(a)] (i) planning and directing specific exercises and programs to improve sensory
58     integration and motor functioning at the level of performance neurologically appropriate for the
59     individual's stage of development;
60          [(b)] (ii) establishing a program of instruction to teach a [patient in] client skills,
61     behaviors, and attitudes necessary for the [patient's] client's independent productive, emotional,
62     and social functioning;
63          [(c)] (iii) analyzing, selecting, and adapting functional exercises to achieve and
64     maintain the [patient's] client's optimal functioning in activities of daily living [tasks] and to
65     prevent further disability; and
66          [(d)] (iv) planning and directing specific programs to evaluate and enhance perceptual,
67     motor, and cognitive skills.
68          [(5)] (3) "Occupational therapist" [or "OT"] means a person licensed [in the state]
69     under this chapter to practice occupational therapy.
70          [(6) "Occupational therapist registered" or "OTR" means a person certified as an
71     occupational therapist registered by the National Board for Certification in Occupational
72     Therapy.]
73          [(7) "Occupational therapy" means the use of purposeful activity or occupational
74     therapy interventions to develop or restore the highest possible level of independence of an
75     individual who is limited by a physical injury or illness, a dysfunctional condition, a cognitive
76     impairment, a psychosocial dysfunction, a mental illness, a developmental or learning
77     disability, or an adverse environmental condition.]
78          (4) "Occupational therapy aide" means a person who is not licensed under this chapter
79     but who provides supportive services under the supervision of an occupational therapist or
80     occupational therapy assistant.
81          [(8)] (5) "Occupational therapy assistant" [or "OTA"] means a person licensed [in the
82     state] under this chapter to practice occupational therapy under the supervision of an
83     occupational therapist as [set forth] described in [Section] Sections 58-42a-305 and
84     58-42a-306.
85          [(9) "Occupational therapy services" include:]
86          [(a) assessing, treating, educating, or consulting with an individual, family, or other
87     persons;]
88          [(b) developing, improving, or restoring an individual's daily living skills, work
89     readiness, work performance, play skills, or leisure capacities, or enhancing an individual's
90     educational performance skills;]
91          [(c) developing, improving, or restoring an individual's sensory-motor, oral-motor,
92     perceptual, or neuromuscular functioning, or the individual's range of motion;]
93          [(d) developing, improving, or restoring the individual's emotional, motivational,
94     cognitive, or psychosocial components of performance;]
95          [(e) assessing the need for and recommending, developing, adapting, designing, or
96     fabricating splints or assistive technology devices for individuals;]
97          [(f) training individuals in the use of rehabilitative or assistive technology devices such
98     as selected orthotic or prosthetic devices;]
99          [(g) applying physical agent modalities as an adjunct to or in preparation for purposeful
100     activity;]
101          [(h) applying the use of ergonomic principles; and]
102          [(i) adapting or modifying environments and processes to enhance or promote the
103     functional performance, health, and wellness of individuals.]
104          [(10) "Practice of occupational therapy" means rendering or offering to render
105     occupational therapy services to individuals, groups, agencies, organizations, industries, or the
106     public.]
107          (6) (a) "Practice of occupational therapy" means the therapeutic use of everyday life
108     activities with an individual:
109          (i) that has or is at risk of developing an illness, injury, disease, disorder, condition,
110     impairment, disability, activity limitation, or participation restriction; and
111          (ii) to develop or restore the individual's ability to engage in everyday life activities by
112     addressing physical, cognitive, psychosocial, sensory, or other aspects of the individual's
113     performance.
114          (b) "Practice of occupational therapy" includes:
115          (i) establishing, remediating, or restoring an undeveloped or impaired skill or ability of
116     an individual;
117          (ii) modifying or adapting an activity or environment to enhance an individual's
118     performance;
119          (iii) maintaining and improving an individual's capabilities to avoid declining
120     performance in everyday life activities;
121          (iv) promoting health and wellness to develop or improve an individual's performance
122     in everyday life activities;
123          (v) performance-barrier prevention for an individual, including disability prevention;
124          (vi) evaluating factors that affect an individual's activities of daily living in
125     educational, work, play, leisure, and social situations, including:
126          (A) body functions and structures;
127          (B) habits, routines, roles, and behavioral patterns;
128          (C) cultural, physical, environmental, social, virtual, and spiritual contexts and activity
129     demands that affect performance; and
130          (D) motor, process, communication, interaction, and other performance skills;
131          (vii) providing interventions and procedures to promote or enhance an individual's
132     safety and performance in activities of daily living in educational, work, and social situations,
133     including:
134          (A) the therapeutic use of occupations and exercises;
135          (B) training in self-care, self-management, home-management, and community and
136     work reintegration;
137          (C) the development, remediation, or compensation of behavioral skills and physical,
138     cognitive, neuromuscular, and sensory functions;
139          (D) the education and training of an individual's family members and caregivers;
140          (E) care coordination, case management, and transition services;
141          (F) providing consulting services to groups, programs, organizations, or communities,
142          (G) modifying the environment and adapting processes, including the application of
143     ergonomic principles;
144          (H) assessing, designing, fabricating, applying, fitting, and providing training in
145     assistive technology, adaptive devices, orthotic devices, and prosthetic devices;
146          (I) assessing, recommending, and training an individual in techniques to enhance
147     functional mobility, including wheelchair management;
148          (J) driver rehabilitation and community mobility;
149          (K) enhancing eating and feeding performance; and
150          (L) applying physical agent modalities, managing wound care, and using manual
151     therapy techniques to enhance an individual's performance skills, if the occupational therapist
152     has received the necessary training as determined by division rule in collaboration with the
153     board.
154          (7) "Unlawful conduct" means the same as that term is defined in Sections 58-1-501
155     and 58-42a-501.
156          [(11)] (8) "Unprofessional conduct" [is as defined in Section 58-42a-501] means the
157     same as that term is defined in Sections 58-1-501 and 58-42a-502.
158          Section 2. Section 58-42A-103 is enacted to read:
159          58-42A-103. Rulemaking.
160          When exercising rulemaking authority under this chapter, the division shall comply
161     with the requirements of Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
162          Section 3. Section 58-42a-201 is amended to read:
163          58-42a-201. Board.
164          (1) There is created the [Occupational Therapy Licensing] Board of Occupational
165     Therapy consisting of three licensed occupational therapists, one licensed occupational therapy
166     assistant, and one member of the general public.
167          (2) The board shall be appointed and serve in accordance with Section 58-1-201.
168          (3) The duties and responsibilities of the board shall be in accordance with Sections
169     58-1-202 and 58-1-203[, and in addition, the].
170          (4) The board shall[: (a)] designate one of its members on a permanent or rotating basis
171     to:
172          (a) assist the division in reviewing complaints concerning the unlawful or
173     unprofessional practice of [occupational therapy] a licensee; and [to]
174          (b) advise the division [with respect to] in its investigation of these complaints[; and].
175          [(b) disqualify any member of the board from participating as a member of the board in
176     its capacity as a presiding officer in any administrative procedure in which that member has
177     reviewed the complaint or advised the division.]
178          (5) A board member who has, under Subsection (4), reviewed a complaint or advised
179     in its investigation may not participate with the board while the board serves as a presiding
180     officer of an administrative proceeding concerning the complaint.
181          Section 4. Section 58-42a-302 is amended to read:
182          58-42a-302. Qualifications for licensure.
183          (1) [All applicants] An applicant for licensure as an occupational therapist shall:
184          (a) submit an application in a form as prescribed by the division;
185          (b) pay a fee as determined by the department under Section 63J-1-504;
186          (c) be of good moral character as it relates to the functions and responsibilities of the
187     practice of occupational therapy;
188          (d) graduate with a [bachelors] bachelor's or graduate degree [in] for the practice of
189     occupational therapy from [a] an education program accredited by the [Accreditation Council
190     for Occupational Therapy Education; and] American Occupational Therapy Association's
191     Accreditation Council for Occupational Therapy Education, a predecessor organization, or an
192     equivalent organization as determined by division rule;
193          (e) [be certified by the National Board for Certification in Occupational Therapy as an
194     occupational therapist registered.] if applying for licensure on or after July 1, 2015, complete a
195     minimum of 24 weeks of supervised fieldwork experience; and
196          (f) pass an examination approved by the division in consultation with the board and
197     administered by the National Board for Certification in Occupational Therapy, or by another
198     nationally recognized credentialing body as approved by division rule, to demonstrate
199     knowledge of the practice, skills, theory, and professional ethics related to occupational
200     therapy.
201          (2) All applicants for licensure as an occupational [therapist] therapy assistant shall:
202          (a) submit an application in a form as prescribed by the division;
203          (b) pay a fee as determined by the department under Section 63J-1-504;
204          (c) be of good moral character as it relates to the functions and responsibilities of the
205     practice of occupational therapy;
206          (d) [graduate with a two-year associate degree in occupational therapy from a program
207     accredited by the Accreditation Council for Occupational Therapy Education; and] graduate
208     from an educational program for the practice of occupational therapy as an occupational
209     therapy assistant that is accredited by the American Occupational Therapy Association's
210     Accreditation Council for Occupational Therapy Education, a predecessor organization, or an
211     equivalent organization as determined by division rule;
212          [(e) be certified by the National Board for Certification in Occupational Therapy as a
213     certified occupational therapist assistant.]
214          (e) if applying for licensure on or after July 1, 2015, complete a minimum of 16 weeks
215     of supervised fieldwork experience; and
216          (f) pass an examination approved by the division in consultation with the board and
217     administered by the National Board for Certification in Occupational Therapy, or by another
218     nationally recognized credentialing body as approved by division rule, to demonstrate
219     knowledge of the practice, skills, theory, and professional ethics related to occupational
220     therapy.
221          (3) Notwithstanding the other requirements of this section, the division may issue a
222     license as an occupational therapist or as an occupational therapy assistant to an applicant who:
223          (a) meets the requirements of receiving a license by endorsement under Section
224     58-1-302; or
225          (b) has been licensed in a state, district, or territory of the United States, or in a foreign
226     country, where the education, experience, or examination requirements are not substantially
227     equal to the requirements of this state, if the applicant passes the applicable examination
228     described in Subsection (1)(f) or (2)(f).
229          Section 5. Section 58-42a-303 is amended to read:
230          58-42a-303. Term of license -- Expiration -- Renewal.
231          (1) The division shall issue each license under this chapter in accordance with a
232     two-year renewal cycle established by division rule.
233          (2) The division may by rule extend or shorten a renewal period by as much as one year
234     to stagger the renewal cycles it administers.
235          [(2)] (3) Each license automatically expires on the expiration date shown on the license
236     unless the licensee renews it in accordance with Section 58-1-308.
237          Section 6. Section 58-42a-303.5 is enacted to read:
238          58-42a-303.5. Continuing education.
239          (1) As a condition for renewal of a license under this chapter, a licensee shall complete
240     24 hours of qualified continuing professional education, in accordance with standards defined
241     by division rule in collaboration with the board, during each two-year licensure cycle.
242          (2) If a renewal cycle is extended or shortened under Subsection (1), the continuing
243     education hours required for license renewal under this section shall be increased or decreased
244     proportionally.
245          Section 7. Section 58-42a-304 is amended to read:
246          58-42a-304. Exemptions from licensure.
247          In addition to the exemptions from licensure in Section 58-1-307, [a person who
248     performs activities that are repetitive and routine in nature and that do not require specific
249     skills or knowledge may engage in acts or practices included within the definition of the
250     practice of occupational therapy under general supervision of an occupational therapist as
251     defined by rule, without being licensed under this chapter.] the following may engage in the
252     stated limited acts or practices without being licensed under this chapter:
253          (1) a person licensed in the state who is engaging in the practice of the person's
254     profession or occupation as defined in statute under which the person is licensed;
255          (2) a person pursuing a course of study leading to a degree for the practice of
256     occupational therapy at an accredited education program, if that person is acting under
257     appropriate supervision and is designated by a title that clearly indicates the person's status as a
258     student; and
259          (3) a person fulfilling the supervised fieldwork experience requirements for licensure
260     described in Section 58-42a-302, if the person is acting under appropriate supervision and is
261     designated by a title that clearly indicates the person is performing supervised fieldwork
262     experience to qualify for a license under this chapter.
263          Section 8. Section 58-42a-305 is amended to read:
264          58-42a-305. Limitation upon occupational therapy services provided by an
265     occupational therapy assistant.
266          (1) An occupational [therapist] therapy assistant [shall]:
267          (a) may only perform occupational therapy services under the supervision of an
268     occupational therapist as [set forth] described in Section 58-42a-306[.];
269          [(2) (a) An occupational therapist assistant]
270          (b) may not write an individual treatment plan [or];
271          (c) may not approve or cosign modifications to [a] an individual treatment plan[.]; and
272          [(b) An occupational therapist assistant] (d) may contribute to and maintain [a] an
273     individual treatment plan.
274          (2) An occupational therapy aide:
275          (a) may only perform occupational therapy services under the direct supervision of an
276     occupational therapist or an occupational therapy assistant;
277          (b) may not write, modify, contribute, or maintain an individual treatment plan; and
278          (c) may only perform tasks that are repetitive and routine for which the aide has been
279     trained and has demonstrated competence.
280          Section 9. Section 58-42a-306 is amended to read:
281          58-42a-306. Supervision requirements.
282          [The supervising] An occupational therapist who is supervising an occupational therapy
283     assistant shall [perform the following functions]:
284          (1) write or contribute to an individual treatment plan before referring a client to a
285     supervised occupational therapy assistant for treatment;
286          (2) approve and cosign on all modifications to the individual treatment plan;
287          [(3) perform an assessment of the patient before referring the patient to a supervised
288     occupational therapist assistant for treatment;]
289          [(4)] (3) meet face to face with the supervised occupational [therapist] therapy assistant
290     as often as necessary but at least once every two weeks in person or by video conference, and at
291     least one time every month in person, to adequately provide consultation, advice, training, and
292     direction to the occupational therapy assistant;
293          [(5)] (4) meet with each [patient] client who has been referred to a supervised
294     occupational [therapist] therapy assistant at least once each month, [unless otherwise approved
295     by the division in collaboration with the board,] to further assess the patient, evaluate the
296     treatment, and modify the individual's treatment plan, except that if the interval of client care
297     occurs one time per month or less, the occupational therapist shall meet with the client at least
298     once every four visits;
299          [(6)] (5) [limit supervision to not] supervise no more than two full-time occupational
300     [therapist] therapy assistants at one time, or four part-time occupational therapy assistants if the
301     combined work hours of the assistants do not exceed 40 hours per week, unless otherwise
302     approved by the division in collaboration with the board; [and]
303          [(7)] (6) remain responsible for [patient] client treatment provided by the occupational
304     [therapist] therapy assistant[.]; and
305          (7) fulfill any other supervisory responsibilities as determined by division rule.
306          Section 10. Section 58-42a-501 is repealed and reenacted to read:
307     
Part 5. Unlawful and Unprofessional Conduct

308          58-42a-501. Unlawful conduct.
309          "Unlawful conduct," as defined in Section 58-1-501 and as may be further defined by
310     division rule, includes:
311          (1) engaging or offering to engage in the practice of occupational therapy unless
312     licensed under this chapter or exempted from licensure under Section 58-1-307 or 58-42a-304;
313          (2) using the title occupational therapist or occupational therapy assistant unless
314     licensed under this chapter;
315          (3) employing or aiding and abetting an unqualified or unlicensed person to engage or
316     offer to engage in the practice of occupational therapy unless the person is exempted from
317     licensure under Section 58-1-307 or 58-42a-304; and
318          (4) obtaining a license under this chapter by means of fraud, misrepresentation, or
319     concealment of a material fact.
320          Section 11. Section 58-42a-502 is enacted to read:
321          58-42a-502. Unprofessional conduct.
322          "Unprofessional conduct," as defined in Section 58-1-501 and as may be further defined
323     by division rule, includes:
324          (1) being convicted of a crime in any court except for minor offenses;
325          (2) violating a lawful order, rule, or regulation adopted by the division in consultation
326     with the board;
327          (3) providing substandard care as an occupational therapist due to a deliberate or
328     negligent act or failure to act regardless of whether actual injury to the client is established;
329          (4) providing substandard care as an occupational therapy assistant, including
330     exceeding the authority to perform components of intervention selected and delegated by the
331     supervising occupational therapist, regardless of whether actual injury to the client is
332     established;
333          (5) knowingly delegating responsibilities related to the practice of occupational therapy
334     to an individual, including an occupational therapy aide, who does not have the knowledge,
335     skills, or abilities to perform those responsibilities;
336          (6) failing to provide appropriate supervision in accordance with this chapter to an
337     occupational therapy assistant or occupational therapy aide;
338          (7) practicing as an occupational therapist or occupational therapy assistant when
339     physical or mental impairment of the occupational therapist or occupational therapy assistant
340     prevents the provision of competent services to clients;
341          (8) having had an occupational therapist, occupational therapy assistant, or equivalent
342     license or application refused, revoked, suspended, or other disciplinary action taken in another
343     state, United States territory, or country;
344          (9) engaging in sexual misconduct, including:
345          (a) engaging in or soliciting a sexual relationship with a client;
346          (b) making a sexual advance, requesting a sexual favor, or engaging in physical contact
347     of a sexual nature with a client; and
348          (c) engaging in verbal or physical conduct of a sexual nature in the presence of a client;
349     and
350          (10) abandoning or neglecting a client in need of immediate professional care without
351     making reasonable arrangements for the continuation of care.
352          Section 12. Section 63I-1-258 is amended to read:
353          63I-1-258. Repeal dates, Title 58.
354          (1) Title 58, Chapter 13, Health Care Providers Immunity from Liability Act, is
355     repealed July 1, 2016.
356          (2) Title 58, Chapter 15, Health Facility Administrator Act, is repealed July 1, 2015.
357          (3) Title 58, Chapter 20a, Environmental Health Scientist Act, is repealed July 1, 2018.
358          (4) Section 58-37-4.3 is repealed July 1, 2016.
359          (5) Title 58, Chapter 40, Recreational Therapy Practice Act, is repealed July 1, 2023.
360          (6) Title 58, Chapter 41, Speech-Language Pathology and Audiology Licensing Act, is
361     repealed July 1, 2019.
362          (7) Title 58, Chapter 42a, Occupational Therapy Practice Act, is repealed July 1,
363     [2015] 2025.
364          (8) Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act, is repealed July
365     1, 2023.
366          (9) Title 58, Chapter 47b, Massage Therapy Practice Act, is repealed July 1, 2024.
367          (10) Section 58-69-302.5 is repealed on July 1, 2015.
368          (11) Title 58, Chapter 72, Acupuncture Licensing Act, is repealed July 1, 2017.




Legislative Review Note
     as of 1-27-15 6:55 PM

Office of Legislative Research and General Counsel