AB 2221: Occupational therapy.
- Session Year: 2017-2018
- House: Assembly
- Latest Version Date: 2018-09-18
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law specifies that the Occupational Therapy Act does not authorize an occupational therapist to practice, among other things, physical therapy or psychology, as those terms are defined under specified law.
This bill would additionally specify that the Occupational Therapy Act does not authorize an occupational therapist to practice marriage and family therapy, as that term is defined for purposes of the Licensed Marriage and Family Therapist Act, professional clinical counseling, as that term is defined for purposes of the Licensed Professional Clinical Counselor Act, clinical social work, as that term is defined for purposes of the Clinical Social Worker Practice Act, or educational psychology, as that term is defined for purposes of the Educational Psychologist Practice Act.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law specifies that the Occupational Therapy Act does not authorize an occupational therapist to practice, among other things, physical therapy or psychology, as those terms are defined under specified law.
This bill would additionally specify that the Occupational Therapy Act does not authorize an occupational therapist to practice marriage and family therapy, as that term is defined for purposes of the Licensed Marriage and Family Therapist Act, professional clinical counseling, as that term is defined for purposes of the Licensed Professional Clinical Counselor Act, clinical social work, as that term is defined for purposes of the Clinical Social Worker Practice Act, or educational psychology, as that term is defined for purposes of the Educational Psychologist Practice Act.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law specifies that the Occupational Therapy Act does not authorize an occupational therapist to practice, among other things, physical therapy or psychology, as those terms are defined under specified law.
This bill would additionally specify that the Occupational Therapy Act does not authorize an occupational therapist to practice marriage and family therapy, as that term is defined for purposes of the Licensed Marriage and Family Therapist Act, professional clinical counseling, as that term is defined for purposes of the Licensed Professional Clinical Counselor Act, clinical social work, as that term is defined for purposes of the Clinical Social Worker Practice Act, and or educational psychology, as that term is defined for purposes of the Educational Psychologist Practice Act.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law specifies that the Occupational Therapy Act does not authorize an occupational therapist to practice, among other things, physical therapy or psychology, as those terms are defined under specified law.
This bill would additionally specify that the Occupational Therapy Act does not authorize an occupational therapist to practice marriage and family therapy, as that term is defined for purposes of the Licensed Marriage and Family Therapist Act. Act, professional clinical counseling, as that term is defined for purposes of the Licensed Professional Clinical Counselor Act, clinical social work, as that term is defined for purposes of the Clinical Social Worker Practice Act, and educational psychology, as that term is defined for purposes of the Educational Psychologist Practice Act.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law specifies that the Occupational Therapy Act does not authorize an occupational therapist to practice, among other things, physical therapy or psychology, as those terms are defined under specified law.
This bill would additionally specify that the Occupational Therapy Act does not authorize an occupational therapist to practice marriage and family therapy, as that term is defined for purposes of the Licensed Marriage and Family Therapist Act.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law authorizes an occupational therapist to provide advanced practices if the therapist, among other things, has demonstrated to the board that he or she has met educational training and competency requirements.This bill would require the therapist to attest to the board under penalty of perjury, rather than demonstrate to the satisfaction of the board, that he or she has met educational training and competency requirements. The bill would authorize periodic compliance audits of attestations submitted to the board. By expanding the crime of perjury, the bill would impose a state-mandated local program.Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. This bill would provide that an occupational therapist, or an occupational therapy assistant, that is serving as an educator in an education program for occupational therapists in California must be licensed.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would eliminate that limitation and instead specify that the occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law authorizes an occupational therapist to provide advanced practices if the therapist, among other things, has demonstrated to the board that he or she has met educational training and competency requirements.
This bill would require the therapist to attest to the board under penalty of perjury, rather than demonstrate to the satisfaction of the board, that he or she has met educational training and competency requirements. The bill would authorize periodic compliance audits of attestations submitted to the board. By expanding the crime of perjury, the bill would impose a state-mandated local program.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. The bill would also delete provisions authorizing terms and abbreviations that may be used by a licensee who has earned a doctoral degree in occupational therapy or in a related area of practice or study.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would eliminate that limitation and instead specify that the occupational therapist directs the evaluation process and develops the intervention plan.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law authorizes an occupational therapist to provide advanced practices if the therapist, among other things, has demonstrated to the board that he or she has met educational training and competency requirements.
This bill would require the therapist to attest to the board under penalty of perjury, rather than demonstrate to the satisfaction of the board, that he or she has met educational training and competency requirements. The bill would authorize periodic compliance audits of attestations submitted to the board. By expanding the crime of perjury, the bill would impose a state-mandated local program.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also delete the requirement that authorize, rather than require, the board to approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. The bill would also delete provisions authorizing terms and abbreviations that may be used by a licensee who has earned a doctoral degree in occupational therapy or in a related area of practice or study.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Occupational Therapy Practice Act, provides for the licensure and regulation of the practice of occupational therapy by the California Board of Occupational Therapy. Existing law defines the practice of occupational therapy and specifies that occupational therapy services encompass occupation therapy, assessment, treatment, education, and consultation with individuals referred for those services after diagnosis of a disease or disorder. Existing law prohibits a person from practicing occupational therapy without being licensed under the act and makes a violation of that prohibition a crime.
This bill would instead define occupational therapy for purposes of the act, and would make conforming changes. The bill would also eliminate the reference to a referral after diagnosis in the description of occupational therapy services. By expanding the scope of a crime, the bill would impose a state-mandated local program.
Existing law defines the term occupational therapist and specifies that only the occupational therapist is responsible for the occupational therapy assessment of a client and the development of an occupational therapy plan of treatment.
This bill would eliminate that limitation and instead specify that the occupational therapist directs the evaluation process and develops the intervention plan.
Existing law requires the occupational therapy board to ensure proper supervision of occupational therapy assistants and aides and allows an occupational therapist to supervise no more than 2 occupational therapy assistants at any one time. Existing law provides for aides to be supervised by occupational therapists or occupational therapy assistants and defines the term aide for purposes of the act to mean an individual who provides supportive services to an occupational therapist.
This bill would increase the number of occupational therapy assistants an occupational therapist may supervise to 3. This bill would also revise the definition of aide to conform to the authority for an aide to also be supervised by an occupational therapy assistant. The bill would specify that the occupational therapist is responsible for the overall use and actions of the aide.
Existing law authorizes an occupational therapist to provide advanced practices if the therapist, among other things, has demonstrated to the board that he or she has met educational training and competency requirements.
This bill would require the therapist to attest to the board under penalty of perjury, rather than demonstrate to the satisfaction of the board, that he or she has met educational training and competency requirements. By expanding the crime of perjury, the bill would impose a state-mandated local program.
Existing law requires an occupational therapist providing hand therapy services or using physical agent modalities to demonstrate to the satisfaction of the board that he or she has completed post professional education and training in specified areas.
This bill would eliminate the post professional limitation.
Existing law requires an applicant for an occupational therapist license to, among other things, complete a specified educational program and pass a specified examination. Existing law requires the board to approve the examinations for licensure and also authorizes the board to adopt rules relating to professional conduct to carry out the purposes of the act. Existing law requires the curriculum for an educational program for occupational therapists to contain the content required or approved by specified organizations, and specifies a list of subjects that must be included in the program.
This bill would delete that list of subjects. The bill would also delete the requirement that the board approve licensure examinations and would authorize the board to adopt rules necessary to effectuate the purpose of the act.
Existing law authorizes the board to establish and require the satisfactory completion of continuing competency requirements as a condition of renewal of a license.
The bill would instead require the board to do so, and would authorize only a portion of continuing competence requirements to be fulfilled through competency assessment activities performed in the context of a broader professional development plan. The bill would also provide a definition for the term continuing competence.
Existing law prohibits a person from using specified professional abbreviations and terms intended to represent that the person is authorized to practice occupational therapy or assist in the practice of occupational therapy unless the person is licensed to practice as an occupational therapist or occupational therapy assistant.
This bill would revise the list of abbreviations and terms that may not be used without a license. The bill would also delete provisions authorizing terms and abbreviations that may be used by a licensee who has earned a doctoral degree in occupational therapy or in a related area of practice or study.
The bill would replace references to patient with client throughout the act and would enact other related provisions.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
The Occupational Therapy Practice Act provides for the licensure and regulation of occupational therapists and occupational therapy assistants by the California Board of Occupational Therapy. This bill would make a nonsubstantive change to this act.The Occupational Therapy Practice Act provides for the licensure and regulation of occupational therapists and occupational therapy assistants by the California Board of Occupational Therapy.
This bill would make a nonsubstantive change to this act.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health by supporting occupational performance in people with, or at risk of experiencing, a range of physical and mental health disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; marriage and family therapy, as defined in Section 4980.02; clinical social work, as defined in Section 4996.9; professional clinical counseling, as defined in Section 4999.20, educational psychology, as defined in Section 4989.14; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health by supporting occupational performance in people with, or at risk of experiencing, a range of physical and mental health disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; marriage and family therapy, as defined in Section 4980.02; clinical social work, as defined in Section 4996.9; professional clinical counseling, as defined in Section 4999.20, educational psychology, as defined in Section 4989.14; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning by supporting occupational performance in people with, or at risk of experiencing, a range of physical and mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; marriage and family therapy, as defined in Section 4980.02; clinical social work, as defined in Section 4996.9; professional clinical counseling, as defined in Section 4999.20, educational psychology, as defined in Section 4989.14; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; marriage and family therapy, as defined in Section 4980.02; clinical social work, as defined in Section 4996.9; professional clinical counseling, as defined in Section 4999.20, educational psychology, as defined in Section 4989.14; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; marriage and family therapy, as defined in Section 4980.02; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has attested, under penalty of perjury, to the board that he or she has met educational training and competency requirements. All attestations submitted to the board may be subject to periodic compliance audits, as determined by the board. demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h)An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i)An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to practice occupational therapy or to assist in the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in the practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist is responsible for and directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness for clients with disability- and nondisability-related needs or to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 3.SEC. 2.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall provide practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to provide practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has attested, under penalty of perjury, to the board that he or she has met educational training and competency requirements. All attestations submitted to the board may be subject to periodic compliance audits, as determined by the board. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 4.SEC. 3.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 5.SEC. 4.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 6.SEC. 5.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 7.SEC. 6.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 8.SEC. 7.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T./L., or O.T.D., Occupational Therapist, Occupational Therapist Licensed, Occupational Therapist Doctorate, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name.
(2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(c)(f)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(d)(g)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
SEC. 9.SEC. 8.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 10.SEC. 9.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, evaluate the qualifications for licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to provide practice occupational therapy or to assist in providing the practice of occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 11.SEC. 10.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 12.SEC. 11.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 13.SEC. 12.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 14.SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
The Legislature finds and declares that the profession of occupational therapy in California affects the public health, safety, and welfare and there is a necessity for that profession to be subject to regulation and control.
SEC. 2.Section 2570.2 of the Business and Professions Code is amended to read:2570.2.As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in client-related tasks to assist the occupational therapist or occupational therapy assistant in occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(f)Examination means an entry level examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional licensing or standard-setting body within five years prior to application or renewal of the persons license.
(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. The occupational therapist directs the evaluation process and develops the intervention plan.
(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(k)Person means an individual, partnership, unincorporated organization, or corporation.
(l)Occupational therapy means the therapeutic use of occupations, including everyday life purposeful and meaningful goal-directed activities (occupations) with individuals, groups, populations, or organizations, to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness to those who have, or are at risk of developing, an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. health conditions that limit activity or cause participation restrictions. Occupational therapy services encompass occupational therapy assessment, treatment, education, and consultation. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perceptual, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or populations.
(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 3.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall provide occupational therapy or hold himself or herself out as an occupational therapist or as being able to provide occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has attested, under penalty of perjury, to the board that he or she has met educational training and competency requirements. All attestations submitted to the board may be subject to periodic compliance audits, as determined by the board. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each client, provide direct care to the client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 4.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program.
(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 5.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 6.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board shall by rule establish and require the satisfactory completion of continuing competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 7.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 8.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.D.T., O.T.D., Occupational Therapist, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(d)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
SEC. 9.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the client record.
(b)An occupational therapy assistant shall document the services provided in the client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the client record legibly.
(d)Client records shall be maintained for a period of no less than seven years following the discharge of the client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 10.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter and chapter, evaluate the qualifications for licensure licensure, and may approve the examinations for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act necessary to effectuate the purpose of this chapter for persons holding a license to provide occupational therapy or to assist in providing occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 11.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual client harm.
(m)Failing to maintain confidentiality of client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 12.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 13.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 14.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
The Legislature finds and declares that the practice profession of occupational therapy in California affects the public health, safety, and welfare and there is a necessity for that practice profession to be subject to regulation and control.
SEC. 2.Section 2570.2 of the Business and Professions Code is amended to read:2570.2.As used in this chapter, unless the context requires otherwise:
(a)Appropriate supervision of an aide means that the responsible occupational therapist or occupational therapy assistant shall provide direct in-sight supervision when the aide is providing delegated client-related tasks and shall be readily available at all times to provide advice or instruction to the aide. The occupational therapist or occupational therapy assistant is responsible for documenting the clients record concerning the delegated client-related tasks performed by the aide.
(b)Aide means an individual who provides supportive services to an occupational therapist or occupational therapy assistant and who is trained by an occupational therapist or occupational therapy assistant to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist or occupational therapy assistant licensed pursuant to this chapter may utilize the services of one aide engaged in patient-related client-related tasks to assist the occupational therapist or occupational therapy assistant in his or her practice of occupational therapy. The occupational therapist shall be responsible for the overall use and actions of the aide.
(c)Association means the Occupational Therapy Association of California or a similarly constituted organization representing occupational therapists in this state.
(d)Board means the California Board of Occupational Therapy.
(e)Continuing competence means a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
(e)(f)Examination means an entry level certification examination for occupational therapists and occupational therapy assistants administered by the National Board for Certification in Occupational Therapy or by another nationally recognized credentialing body.
(f)(g)Good standing means that the person has a current, valid license to practice occupational therapy or assist in the practice of occupational therapy and has not been disciplined by the recognized professional certifying licensing or standard-setting body within five years prior to application or renewal of the persons license.
(g)(h)Occupational therapist means an individual who meets the minimum education requirements specified in Section 2570.6 and is licensed pursuant to the provisions of this chapter and whose license is in good standing as determined by the board to practice occupational therapy under this chapter. Only the The occupational therapist is responsible for directs the occupational therapy assessment of a client, evaluation process and develops the development of an occupational therapy plan of treatment. intervention plan.
(h)(i)Occupational therapy assistant means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy under this chapter, and who works under the appropriate supervision of a licensed occupational therapist.
(i)(j)Occupational therapy services means the services of an occupational therapist or the services of an occupational therapy assistant under the appropriate supervision of an occupational therapist.
(j)(k)Person means an individual, partnership, unincorporated organization, or corporation.
(k)(l)Practice of occupational Occupational therapy means the therapeutic use of purposeful occupations, including everyday life activities with individuals, groups, populations, or organizations, to support participation, performance, and meaningful goal-directed activities (occupations) which engage function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the individuals body promotion of health and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize wellness to those who have, or are at risk of developing, an illness, injury, disease, disorder, condition, impairment, disability, and maintain health. activity limitation, or participation restriction. Occupational therapy services encompass occupational therapy assessment, treatment, education of, education, and consultation with, individuals who have been referred for occupational consultation. Occupational therapy services subsequent to diagnosis addresses the physical, cognitive, psychosocial, sensory-perceptual, and other aspects of disease or disorder (or who are receiving occupational therapy services as part performance in a variety of an Individualized Education Plan (IEP) pursuant contexts and environments to the federal Individuals with Disabilities Education Act (IDEA)). support engagement in occupations that affect physical and mental health, well-being, and quality of life. Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities. Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability. Through engagement in everyday activities, occupational therapy promotes mental health and supports functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders. Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating selective temporary orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training). Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence. Services are provided individually, in groups, or through social groups. populations.
(l)(m)Hand therapy is the art and science of rehabilitation of the hand, wrist, and forearm requiring comprehensive knowledge of the upper extremity and specialized skills in assessment and treatment to prevent dysfunction, restore function, or reverse the advancement of pathology. This definition is not intended to prevent an occupational therapist practicing hand therapy from providing other occupational therapy services authorized under this act in conjunction with hand therapy.
(m)(n)Physical agent modalities means techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity. These techniques are used as adjunctive methods in conjunction with, or in immediate preparation for, occupational therapy services.
SEC. 3.Section 2570.3 of the Business and Professions Code is amended to read:2570.3.(a)No person shall practice provide occupational therapy or hold himself or herself out as an occupational therapist or as being able to practice provide occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b)Only an individual may be licensed under this chapter.
(c)Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; or spinal manipulation or other forms of healing, except as authorized by this section.
(d)An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the attested, under penalty of perjury, to the board that he or she has met educational training and competency requirements. These advanced practices include the following:
(1)Hand therapy.
(2)The use of physical agent modalities.
(3)Swallowing assessment, evaluation, or intervention.
(e)An occupational therapist providing hand therapy services shall demonstrate to the satisfaction of the board that he or she has completed post professional education and training in all of the following areas:
(1)Anatomy of the upper extremity and how it is altered by pathology.
(2)Histology as it relates to tissue healing and the effects of immobilization and mobilization on connective tissue.
(3)Muscle, sensory, vascular, and connective tissue physiology.
(4)Kinesiology of the upper extremity, such as biomechanical principles of pulleys, intrinsic and extrinsic muscle function, internal forces of muscles, and the effects of external forces.
(5)The effects of temperature and electrical currents on nerve and connective tissue.
(6)Surgical procedures of the upper extremity and their postoperative course.
(f)An occupational therapist using physical agent modalities shall demonstrate to the satisfaction of the board that he or she has completed post professional education and training in all of the following areas:
(1)Anatomy and physiology of muscle, sensory, vascular, and connective tissue in response to the application of physical agent modalities.
(2)Principles of chemistry and physics related to the selected modality.
(3)Physiological, neurophysiological, and electrophysiological changes that occur as a result of the application of a modality.
(4)Guidelines for the preparation of the patient, client, including education about the process and possible outcomes of treatment.
(5)Safety rules and precautions related to the selected modality.
(6)Methods for documenting immediate and long-term effects of treatment.
(7)Characteristics of the equipment, including safe operation, adjustment, indications of malfunction, and care.
(g)An occupational therapist in the process of achieving the education, training, and competency requirements established by the board for providing hand therapy or using physical agent modalities may practice these techniques under the supervision of an occupational therapist who has already met the requirements established by the board, a physical therapist, or a physician and surgeon.
(h)The board shall develop and adopt regulations regarding the educational training and competency requirements for advanced practices in collaboration with the Speech-Language Pathology and Audiology Board, the Board of Registered Nursing, and the Physical Therapy Board of California.
(i)Nothing in this chapter shall be construed as authorizing an occupational therapist to seek reimbursement for services other than for the practice of occupational therapy as defined in this chapter.
(j)Supervision of an occupational therapy assistant means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client. The occupational therapist who is responsible for appropriate supervision shall formulate and document in each clients record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapists appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.
(1)The supervising occupational therapist has the continuing responsibility to follow the progress of each patient, client, provide direct care to the patient, client, and to assure that the occupational therapy assistant does not function autonomously.
(2)An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Two Three occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the publics health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.
(k)The amendments to subdivisions (d), (e), (f), and (g) relating to advanced practices, that are made by the act adding this subdivision, shall become operative no later than January 1, 2004, or on the date the board adopts regulations pursuant to subdivision (h), whichever first occurs.
SEC. 4.Section 2570.6 of the Business and Professions Code is amended to read:2570.6.An applicant applying for a license as an occupational therapist or as an occupational therapy assistant shall file with the board a written application provided by the board, showing to the satisfaction of the board that he or she meets all of the following requirements:
(a)That the applicant is in good standing and has not committed acts or crimes constituting grounds for denial of a license under Section 480.
(b)(1)That the applicant has successfully completed the academic requirements of an educational program for occupational therapists or occupational therapy assistants that is approved by the board and accredited by the American Occupational Therapy Associations Accreditation Council for Occupational Therapy Education (ACOTE), or accredited or approved by the American Occupational Therapy Associations (AOTA) predecessor organization, or approved by AOTAs Career Mobility Program.
(2)The curriculum of an educational program for occupational therapists shall contain the content required by the ACOTE accreditation standards, or as approved by AOTAs predecessor organization, or as approved by AOTAs Career Mobility Program, including all of the following subjects: Program.
(A)Biological, behavioral, and health sciences. (B)Structure and function of the human body, including anatomy, kinesiology, physiology, and the neurosciences. (C)Human development throughout the lifespan. (D)Human behavior in the context of sociocultural systems. (E)Etiology, clinical course, management, and prognosis of disease processes and traumatic injuries, and the effects of those conditions on human functioning. (F)Occupational therapy theory, practice, and processes. (3)The curriculum of an educational program for occupational therapy assistants shall contain the content required by the ACOTE accreditation standards, or as approved or accredited by AOTAs predecessor organization, including all of the following subjects: (A)Biological, behavioral, and health sciences. (B)Structure and function of the normal human body. (C)Human development. (D)Conditions commonly referred to occupational therapists. (E)Occupational therapy principles and skills.(c)(1)For an applicant who is a graduate of an occupational therapy or occupational therapy assistant educational program who is unable to provide evidence of having met the requirements of paragraph (2) or (3) of subdivision (b), he or she may demonstrate passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraph (2) or (3) of subdivision (b).
(2)For an applicant who completed AOTAs Career Mobility Program, he or she shall demonstrate participation in the program and passage of the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association, as evidence of having successfully satisfied the requirements of paragraphs (1) and (2) of subdivision (b).
(d)That the applicant has successfully completed a period of supervised fieldwork experience approved by the board and arranged by a recognized educational institution where he or she met the academic requirements of subdivision (b) or (c) or arranged by a nationally recognized professional association. The fieldwork requirements for applicants applying for licensure as an occupational therapist or certification as an occupational therapy assistant shall be consistent with the requirements of the ACOTE accreditation standards, or AOTAs predecessor organization, or AOTAs Career Mobility Program, that were in effect when the applicant completed his or her educational program.
(e)That the applicant has passed an examination as provided in Section 2570.7.
(f)That the applicant, at the time of application, is a person over 18 years of age, is not addicted to alcohol or any controlled substance, and has not committed acts or crimes constituting grounds for denial of licensure under Section 480.
SEC. 5.Section 2570.7 of the Business and Professions Code is amended to read:2570.7.(a)An applicant who has satisfied the requirements of Section 2570.6 may apply for examination for licensure in a manner prescribed by the board. Subject to the provisions of this chapter, an applicant who fails an examination may apply for reexamination.
(b)Each applicant for licensure shall successfully complete the entry level certification examination for occupational therapists or occupational therapy assistants, such as the examination administered by the National Board for Certification in Occupational Therapy, the American Occupational Therapy Certification Board, or the American Occupational Therapy Association. The examination shall be appropriately validated. Each applicant shall be examined by written examination to test his or her knowledge of the basic and clinical sciences relating to occupational therapy, occupational therapy techniques and methods, and any other subjects that the board may require to determine the applicants fitness to practice under this chapter.
(c)Applicants for licensure shall be examined at a time and place and under that supervision as the board may require.
SEC. 6.Section 2570.10 of the Business and Professions Code is amended to read:2570.10.(a)Any license issued under this chapter shall be subject to renewal as prescribed by the board and shall expire unless renewed in that manner. The board may provide for the late renewal of a license as provided for in Section 163.5.
(b)In addition to any other qualifications and requirements for licensure renewal, the board may shall by rule establish and require the satisfactory completion of continuing competency competence requirements as a condition of renewal of a license. Only a portion of continuing competence requirements, as determined by the board to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
SEC. 7.Section 2570.14 of the Business and Professions Code is amended to read:2570.14.An initial applicant who has not been actively engaged in the practice of occupational therapy within the past five years shall provide to the board, in addition to the requirements for licensure under Section 2570.6, any of the following:
(a)Evidence of continued competency as referred to in subdivision (b) of Section 2570.10 for the previous two-year period.
(b)Evidence of having completed the certification entry-level examination as described in subdivision (b) of Section 2570.7 within the previous two-year period.
SEC. 8.Section 2570.18 of the Business and Professions Code is amended to read:2570.18.(a)A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b)Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations O.T., O.T.R., or O.T.R./L., or O.D.T., Occupational Therapist, or Occupational Therapist Registered, or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c)A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following: (1)In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensees name. (2)In a written communication, use the title Doctor or the abbreviation Dr. preceding the licensees name, if the licensees name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (3)In a spoken communication while engaged in the practice of occupational therapy, use the title Doctor preceding the licensees name, if the licensee specifies that he or she is an occupational therapy practitioner. (d)A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges. (e)The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c). (f)(c)Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations O.T.A., O.T.A/L., C.O.T.A., C.O.T.A./L., or Occupational Therapy Assistant, Licensed Occupational Therapy Assistant, or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(g)(d)The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
SEC. 9.Section 2570.185 of the Business and Professions Code is amended to read:2570.185.(a)An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the patient client record.
(b)An occupational therapy assistant shall document the services provided in the patient client record.
(c)Occupational therapists and occupational therapy assistants shall document and sign the patient client record legibly.
(d)Patient Client records shall be maintained for a period of no less than seven years following the discharge of the patient, client, except that the records of unemancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years.
SEC. 10.Section 2570.20 of the Business and Professions Code is amended to read:2570.20.(a)The board shall administer, coordinate, and enforce the provisions of this chapter, chapter and evaluate the qualifications, and approve the examinations qualifications for licensure under this chapter.
(b)The board shall adopt rules in accordance with the Administrative Procedure Act relating necessary to professional conduct to carry out effectuate the purpose of this chapter, including, but not limited to, rules relating to professional licensure and to the establishment of ethical standards of practice chapter for persons holding a license to practice provide occupational therapy or to assist in the practice of providing occupational therapy in this state.
(c)Proceedings under this chapter shall be conducted in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.
SEC. 11.Section 2570.28 of the Business and Professions Code is amended to read:2570.28.The board may deny or discipline a licensee for any of the following:
(a)Unprofessional conduct, including, but not limited to, the following:
(1)Incompetence or gross negligence in carrying out usual occupational therapy functions.
(2)Repeated similar negligent acts in carrying out usual occupational therapy functions.
(3)A conviction of for practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(4)The use of advertising relating to occupational therapy which that violates Section 17500.
(5)Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a licensee by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision, order, or judgment shall be conclusive evidence thereof.
(b)Procuring a license by fraud, misrepresentation, or mistake.
(c)Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision or term of this chapter or any regulation adopted pursuant to this chapter.
(d)Making or giving any false statement or information in connection with the application for issuance or renewal of a license.
(e)Conviction of a crime or of any offense substantially related to the qualifications, functions, or duties of a licensee, in which event the record of the conviction shall be conclusive evidence thereof.
(f)Impersonating an applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a license.
(g)Impersonating a licensed practitioner, or permitting or allowing another unlicensed person to use a license.
(h)Committing any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee.
(i)Committing any act punishable as a sexually related crime, if that act is substantially related to the qualifications, functions, or duties of a licensee, in which event a certified copy of the record of conviction shall be conclusive evidence thereof.
(j)Using excessive force upon or mistreating or abusing any patient. client. For the purposes of this subdivision, excessive force means force clearly in excess of that which would normally be applied in similar clinical circumstances.
(k)Falsifying or making grossly incorrect, grossly inconsistent, or unintelligible entries in a patient client or hospital record or any other record.
(l)Changing the prescription of a physician and surgeon or falsifying verbal or written orders for treatment or a diagnostic regime received, whether or not that action resulted in actual patient client harm.
(m)Failing to maintain confidentiality of patient client medical information, except as disclosure is otherwise permitted or required by law.
(n)Delegating to an unlicensed employee or person a service that requires the knowledge, skills, abilities, or judgment of a licensee.
(o)Committing any act that would be grounds for denial of a license under Section 480.
(p)Except for good cause, the knowing failure to protect patients clients by failing to follow infection control guidelines of the board, thereby risking transmission of infectious diseases from licensee to patient, from patient to patient, or from patient client, from client to client, or from client to licensee.
(1)In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Public Health developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 63001) of Division 5 of the Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary to encourage appropriate consistency in the implementation of this subdivision, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, the Board of Registered Nursing, and the Board of Vocational Nursing and Psychiatric Technicians.
(2)The board shall seek to ensure that licensees are informed of their responsibility to minimize the risk of transmission of infectious diseases from health care provider to patient, from patient to patient, and from patient client, from client to client, and from client to health care provider, and are informed of the most recent scientifically recognized safeguards for minimizing the risks of transmission.
SEC. 12.Section 2570.29 of the Business and Professions Code is amended to read:2570.29.In addition to other acts constituting unprofessional conduct within the meaning of this chapter, it is unprofessional conduct for a person licensed under this chapter to do any of the following:
(a)Obtain or possess in violation of law, or prescribe, or, except as directed by a licensed physician and surgeon, dentist, optometrist, or podiatrist, to administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
(b)Use to an extent or in a manner dangerous or injurious to himself or herself, to any other person, or to the public, or that impairs his or her ability to conduct with safety to the public the practice authorized by his or her license, of any of the following:
(1)A controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code.
(2)A dangerous drug or dangerous device as defined in Section 4022.
(3)Alcoholic beverages.
(c)Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
(d)Be committed or confined by a court of competent jurisdiction for intemperate use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of the commitment or confinement.
(e)Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital or patient client record, or any other record, pertaining to the substances described in subdivision (a) of this section.
SEC. 13.Section 2571 of the Business and Professions Code is amended to read:2571.(a)An occupational therapist licensed pursuant to this chapter and approved by the board in the use of physical agent modalities may apply topical medications prescribed by the patients clients physician and surgeon, certified nurse-midwife pursuant to Section 2746.51, nurse practitioner pursuant to Section 2836.1, or physician assistant pursuant to Section 3502.1, if the licensee complies with regulations adopted by the board pursuant to this section.
(b)The board shall adopt regulations implementing this section, after meeting and conferring with the Medical Board of California, the California State Board of Pharmacy, and the Physical Therapy Board of California, specifying those topical medications applicable to the practice of occupational therapy and protocols for their use.
(c)Nothing in this section shall be construed to authorize an occupational therapist to prescribe medications.
SEC. 14.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
SECTION 1.Section 2570 of the Business and Professions Code is amended to read:2570.This chapter is known and may be cited as the Occupational Therapy Practice Act.This chapter is known and may be cited as the Occupational Therapy Practice Act.
|
Date
|
Status
|
|---|---|
| Sep 18, 2018 | Chaptered by Secretary of State - Chapter 490, Statutes of 2018. |
| Sep 18, 2018 | Approved by the Governor. |
| Sep 10, 2018 | Enrolled and presented to the Governor at 3:30 p.m. |
| Aug 30, 2018 | Senate amendments concurred in. To Engrossing and Enrolling. |
| Aug 29, 2018 | In Assembly. Concurrence in Senate amendments pending. |
| Aug 29, 2018 | Read third time. Passed. Ordered to the Assembly. |
| Aug 27, 2018 | Read second time. Ordered to third reading. |
| Aug 24, 2018 | Read third time and amended. Ordered to second reading. |
| Aug 21, 2018 | Read second time. Ordered to third reading. |
| Aug 20, 2018 | Read third time and amended. Ordered to second reading. |
| Aug 15, 2018 | Read second time. Ordered to third reading. |
| Aug 14, 2018 | Read third time and amended. Ordered to second reading. |
| Aug 7, 2018 | Read second time. Ordered to third reading. |
| Aug 6, 2018 | From committee: Be ordered to second reading pursuant to Senate Rule 28.8. |
| Jul 2, 2018 | Read second time and amended. Re-referred to Com. on APPR. |
| Jun 28, 2018 | From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 9. Noes 0.) (June 25). |
| Jun 11, 2018 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on B., P. & E.D. |
| Jun 7, 2018 | Referred to Com. on B., P. & E.D. |
| May 30, 2018 | In Senate. Read first time. To Com. on RLS. for assignment. |
| May 29, 2018 | Read third time. Passed. Ordered to the Senate. |
| May 25, 2018 | From committee: Do pass. (Ayes 16. Noes 0.) (May 25). |
| Apr 25, 2018 | In committee: Set, first hearing. Referred to APPR. suspense file. |
| Apr 10, 2018 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (April 10). Re-referred to Com. on APPR. |
| Apr 9, 2018 | Re-referred to Com. on B. & P. |
| Apr 5, 2018 | From committee chair, with author's amendments: Amend, and re-refer to Com. on B. & P. Read second time and amended. |
| Apr 2, 2018 | Re-referred to Com. on B. & P. |
| Mar 23, 2018 | From committee chair, with author's amendments: Amend, and re-refer to Com. on B. & P. Read second time and amended. |
| Mar 22, 2018 | Referred to Com. on B. & P. |
| Feb 13, 2018 | From printer. May be heard in committee March 15. |
| Feb 12, 2018 | Read first time. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Aug 30, 2018 | AB 2221 BLOOM Concurrence in Senate Amendments | Assembly Floor |
Passed |
|
| Aug 29, 2018 | Assembly 3rd Reading AB2221 Bloom By Dodd | Senate Floor |
Passed |
|
| Jun 25, 2018 | Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] | Senate Standing Committee on Business, Professions and Economic Development |
Passed |
|
| May 29, 2018 | AB 2221 BLOOM Assembly Third Reading | Assembly Floor |
Passed |
|
| May 25, 2018 | Do pass. | Assembly Standing Committee on Appropriations |
Passed |
|
| Apr 10, 2018 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Business and Professions |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| 21 Individuals | ** Support | Aug 27, 2018 |
| American Occupational Therapy Association | ** Support | Aug 27, 2018 |
| Occupational Therapy Association Of California | ** Support | Aug 27, 2018 |
| Union of Health Care Professionals | ** Support | Aug 27, 2018 |
| United Nurses Association of California | ** Support | Aug 27, 2018 |
CONCURRENCE IN SENATE AMENDMENTS
CSA1 Bill Id:AB 2221
Author:(Bloom)
As Amended Ver:August 24, 2018
Majority vote
ASSEMBLY: | 77-0 | (May 29, 2018) | SENATE: | 39-0 | (August 29, 2018) |
Original Committee Reference: B. & P.
SUMMARY: Makes numerous changes to the Occupational Therapy Practice Act, including definitions relating to scope of practice of occupational therapists (OTs) and occupational therapy assistants (OTAs), supervision ratios and duties, methods the California Board of Occupational Therapy (CBOT) may verify advanced practice requirements, and requirements related to the use of doctoral degree titles. Specifically, this bill:
- Replaces the term "patient" with "client."
- Authorizes an "aide" to provide occupational therapy support services to OTAs in addition to OTs, but provides that the OT is responsible for the overall use and actions of the aide, increases the number of OTAs an OT may supervise from two to three, and replaces the requirement that an OT being the only person responsible for the assessment of a client and the development of an occupational therapy plan with the requirement that an OT directs the evaluation process and develops the intervention plan.
- Defines "continuing competence" as a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
- Redefines the "practice of occupational therapy" as "occupational therapy" and makes numerous changes, including deleting references to individuals with medical referrals and individuals receiving occupational therapy services under an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA) as the individuals who receive occupational therapy services; describing occupational therapy as the engagement in everyday activities to promote mental health by supporting occupational performance in people with, or at risk of experiencing, a range of physical and mental health disorders; and expanding the definition of "occupational therapy techniques" by deleting the "selective temporary" limitation on designing and fabricating orthotics.
- Deletes the term "post professional" from the advanced practice education requirements.
- Deletes the list of subjects required as part of the curriculum for accredited OT educational programs and deletes the curriculum requirements for accredited OTA programs.
- Deletes the option for an OT or OTA applicant who is a graduate from an OT or OTA educational program who is unable to provide evidence of meeting the OTA educational requirements deleted under this bill to demonstrate passage of specified examination national examinations.
- Requires, rather than authorizes, the CBOT to establish continuing competence requirements.
- Provides that only a portion of continuing competence requirements, as determined by the CBOT to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
- Deletes title protection for, and references to, the titles "Occupational Therapist Registered," "O.T.R.," "O.T.R./L.," "C.O.T.A.," and "C.O.T.A./L." and instead refers to the titles "O.T./L.," "Occupational Therapist Licensed," "O.T.D.," and "Occupational Therapist Doctorate."
- Requires an OT that is serving as an educator in an education program for OTs or OTAs in California to be licensed.
- Requires an OTA that is serving as an educator in an education program for OTAs in California to be licensed.
- Revises the CBOT's authority to adopt regulations to include those "necessary to effectuate the purpose of" the practice act instead of just those "relating to professional conduct to carry out the purpose of" the practice act.
- Makes other technical, updating, and conforming changes.
The Senate amendments:
- Reinstate the term "practice" in place of the term "profession" where it is used as a noun and the term "provide" where it is used as a verb, consistent with existing law.
- Specify that occupational therapy promotes mental health by supporting occupational performance in people with a range of physical and mental health instead of promoting mental health and supporting functioning in in people with a range of mental health disorders, including psychiatric, behavioral, and substance abuse.
- Clarify that the OT Practice Act does not authorize an OT to practice marriage and family therapy, clinical social work, professional clinical counseling, or educational psychology.
- Reinstate the requirement that an OT demonstrate competence in advanced practices to the satisfaction of the CBOT rather than require an OT to attest, under penalty of perjury, that the OT has met the educational training and competency requirements.
- Reinstate the requirements relating to the use of the title "O.T.D."
- Reinstate the requirement that the CBOT approve the examination for licensure permissive, consistent with existing law.
- Insert the requirement that OTs and OTAs working as educators be licensed.
- Make conforming and technical changes.
FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS:
Purpose. This bill is co-sponsored by the Occupational Therapy Association of California and the American Occupational Therapy Association. According to the author, "[o]ccupational therapists work with individuals from a wide range of backgrounds, experiencing physical and mental health conditions or disabilities, helping to improve and develop daily skills necessary on a routine basis. [This bill] ensures that [OTs] will be able to practice the full extent of their training to provide quality care for those in need."
Background. According to the California Occupational Guides published by the Labor Market Information Division within the Employment Development Department (EDD), OTs and OTAs are healthcare providers who help patients with mental, emotional, or physical disabilities become self-sufficient. They may also work with other healthcare providers to develop therapy plans, which may include educational, vocational, and rehabilitative activities. The goal of occupational therapy is to enable patients to gain confidence, to adapt to or overcome their particular disability, and to use their time in rewarding ways.
Occupational Therapy Regulation. The current iteration of the Occupational Therapy Practice Act passed in 2000. According to the author, changes in healthcare since the year 2000 have caused the practice act to become outdated. To address this issue, this bill "proposes to amend the Act to include the revision of outdated definitions, clarification of provisions related to advance practices, revision of continuing competence and coursework requirements, and language to clarify that occupational therapy supports functioning in people with or at risk of experiencing a range of mental health disorders."
CBOT. The CBOT is a licensing board under the DCA. The purpose of the CBOT is to protect consumers through state regulation of the practice of occupational therapy. According to the DCA's 2017 Annual Report, the CBOT reported a total of 15,553 licensees, including 13,380 OTs and 2,977 OTAs.
Definition of Occupational Therapy. This bill makes significant changes to the definition of occupational therapy. The changes are based on the sponsors' Standards of Practice for Occupational Therapy. The changes include, among others, referencing the relationship of occupational therapy to: rehabilitation, habilitation, cognitive, psychosocial, sensory-perception, and physical and mental health. It also adds references to the roles of occupational therapy in the promotion of functioning in those with mental health disorders, including, psychiatric, behavioral, and substance-use disorders.
According to the sponsors, these changes are intended to reflect that OTs and OTAs have a role in these services. Specifically, the sponsors note that this bill is intended "to clarify the role of occupational therapy in mental health and behavioral health services, which they are currently providing to patients in California."
Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301 FN: 0005100
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB |
THIRD READING
Bill No: AB 2221
: 8/24/18
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/25/18
AYES: Hill, Fuller, Allen, Dodd, Galgiani, Glazer, Hernandez, Pan, Wilk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 5/29/18 - See last page for vote
DIGEST:
This bill makes numerous changes to the Occupational Therapy Practice Act.
Senate Floor Amendments of 8/24/18 make clarifying changes intended to ensure that the bill does not impact the practice of psychology.
Senate Floor Amendments of 8/20/18 clarify that nothing in the Occupational Therapy Practice Act shall be construed to as authorizing an occupational therapist to practice clinical social work, professional clinical counseling and educational psychology.
Senate Floor Amendments of 8/14/18 make technical changes.
Existing law:
- Provides for the licensure and regulation of the practice of occupational therapy under the Occupational Therapy Practice Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy (CBOT or Board) within the Department of Consumer Affairs until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner.
(BPC § 2570.18(c)(3))
- Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
This bill makes various changes to the Occupational Therapy Practice Act.
Background
The Board administers the licensing and enforcement programs for OTs, OTAs, and occupational therapy aides. The Board also establishes and clarifies state-specific process and practice standards through administrative rulemaking. In California, regulation of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the first iteration of the Occupational Therapy Practice Act. The Practice Act establishes the CBOT and specifies the scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice. Under the Practice Act, it is a misdemeanor to practice occupational therapy or hold oneself out as being able to practice occupational therapy, via titles or other methods, unless licensed or otherwise authorized by law. The Practice Act provides, among others, the following definitions relating to the breadth and scope of occupational therapy as regulated in California.
The Act requires that an applicant seeking an OT or OTA license must meet the following competencies:
- Complete the academic requirements of an approved and accredited educational program for OTs or OTAs;
- Complete two years of postgraduate training;
- Complete a period of supervised fieldwork experience; and
- Pass an entry-level certification examination.
Applicants for an OT or OTA license must complete the academic requirements of an approved and accredited educational program. Specifically, BPC § 2570.6(b) requires the educational program to be approved by the CBOT; be accredited by the American Occupational Therapy Association (AOTA)’s Accreditation Council for Occupational Therapy Education (ACOTE), be accredited or approved by the AOTA’s predecessor organization, or approved by AOTA’s Career Mobility Program. The curriculum must meet the content standards required by the ACOTE or the relevant AOTA accreditation agency, including specified course subjects (BPC § 2570.6(b)(2)-(3)).
While the Act requires that educational programs be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education and approved by the CBOT, the CBOT does not separately approve, review, or remove schools. In practice, the CBOT approves accredited schools by default.
The Board requires both OTs and OTAs licensees to complete 24 professional development units prior to renewal which can be earned through a variety of means, such as academic course work, attending board meetings and activities, or mentorship. The CBOT also accepts programs and activities sponsored by the OTAC or AOTA, including continuing education courses. Rather than require licensees to submit certificates of completion at the time of renewal, the CBOT audits a random sample of renewing licensees to determine compliance with the requirement. However, the CBOT does not approve, audit, or review the individual course providers.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
American Occupational Therapy Association
Occupational Therapy Association of California
United Nurses Association of California/Union of Health Care Professionals
21 Individuals
OPPOSITION: (Verified 8/17/18)
None received
ARGUMENTS IN SUPPORT: The Occupational Therapy Association of California and the American Occupational Therapy Association believe this bill will update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.
According to the United Nurses Associations of California/Union of Health Care Professionals, this bill will enable occupational therapists to provide greater care and service to their patients by revising and updating various provisions of the Act.
ASSEMBLY FLOOR: 77-0, 5/29/18
AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Chu
8/27/18 20:37:54
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB |
THIRD READING
Bill No: AB 2221
: 8/20/18
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/25/18
AYES: Hill, Fuller, Allen, Dodd, Galgiani, Glazer, Hernandez, Pan, Wilk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 5/29/18 - See last page for vote
DIGEST:
This bill makes numerous changes to the Occupational Therapy Practice Act.
Senate Floor Amendments of 8/20/18 clarify that nothing in the Occupational Therapy Practice Act shall be construed to as authorizing an occupational therapist to practice clinical social work, professional clinical counseling and educational psychology.
Senate Floor Amendments of 8/14/18 make technical changes in order to avoid chaptering conflicts.
Existing law:
- Provides for the licensure and regulation of the practice of occupational therapy under the Occupational Therapy Practice Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy (CBOT or Board) within the Department of Consumer Affairs until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner.
(BPC § 2570.18(c)(3))
- Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
This bill makes various changes to the Occupational Therapy Practice Act.
Background
The Board administers the licensing and enforcement programs for OTs, OTAs, and occupational therapy aides. The Board also establishes and clarifies state-specific process and practice standards through administrative rulemaking. In California, regulation of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the first iteration of the Occupational Therapy Practice Act. The Practice Act establishes the CBOT and specifies the scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice. Under the Practice Act, it is a misdemeanor to practice occupational therapy or hold oneself out as being able to practice occupational therapy, via titles or other methods, unless licensed or otherwise authorized by law. The Practice Act provides, among others, the following definitions relating to the breadth and scope of occupational therapy as regulated in California.
The Act requires that an applicant seeking an OT or OTA license must meet the following competencies:
- Complete the academic requirements of an approved and accredited educational program for OTs or OTAs;
- Complete two years of postgraduate training;
- Complete a period of supervised fieldwork experience; and
- Pass an entry-level certification examination.
Applicants for an OT or OTA license must complete the academic requirements of an approved and accredited educational program. Specifically, BPC § 2570.6(b) requires the educational program to be approved by the CBOT; be accredited by the American Occupational Therapy Association (AOTA)’s Accreditation Council for Occupational Therapy Education (ACOTE), be accredited or approved by the AOTA’s predecessor organization, or approved by AOTA’s Career Mobility Program. The curriculum must meet the content standards required by the ACOTE or the relevant AOTA accreditation agency, including specified course subjects (BPC § 2570.6(b)(2)-(3)).
While the Act requires that educational programs be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education and approved by the CBOT, the CBOT does not separately approve, review, or remove schools. In practice, the CBOT approves accredited schools by default.
The Board requires both OTs and OTAs licensees to complete 24 professional development units prior to renewal which can be earned through a variety of means, such as academic course work, attending board meetings and activities, or mentorship. The CBOT also accepts programs and activities sponsored by the OTAC or AOTA, including continuing education courses. Rather than require licensees to submit certificates of completion at the time of renewal, the CBOT audits a random sample of renewing licensees to determine compliance with the requirement. However, the CBOT does not approve, audit, or review the individual course providers.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
American Occupational Therapy Association
Occupational Therapy Association of California
United Nurses Association of California/Union of Health Care Professionals
21 Individuals
OPPOSITION: (Verified 8/17/18)
None received
ARGUMENTS IN SUPPORT: The Occupational Therapy Association of California and the American Occupational Therapy Association believe this bill will update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.
According to the United Nurses Associations of California/Union of Health Care Professionals, this bill will enable occupational therapists to provide greater care and service to their patients by revising and updating various provisions of the Act.
ASSEMBLY FLOOR: 77-0, 5/29/18
AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Chu
8/21/18 18:57:48
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB |
THIRD READING
Bill No: AB 2221
: 8/14/18
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/25/18
AYES: Hill, Fuller, Allen, Dodd, Galgiani, Glazer, Hernandez, Pan, Wilk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 5/29/18 - See last page for vote
DIGEST:
This bill makes numerous changes to the Occupational Therapy Practice Act.
Senate Floor Amendments of 8/14/18 make technical changes in order to avoid chaptering conflicts.
Existing law:
- Provides for the licensure and regulation of the practice of occupational therapy under the Occupational Therapy Practice Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy (CBOT or Board) within the Department of Consumer Affairs until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner.
(BPC § 2570.18(c)(3))
- Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
This bill makes various changes to the Occupational Therapy Practice Act.
Background
The Board administers the licensing and enforcement programs for OTs, OTAs, and occupational therapy aides. The Board also establishes and clarifies state-specific process and practice standards through administrative rulemaking. In California, regulation of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the first iteration of the Occupational Therapy Practice Act. The Practice Act establishes the CBOT and specifies the scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice. Under the Practice Act, it is a misdemeanor to practice occupational therapy or hold oneself out as being able to practice occupational therapy, via titles or other methods, unless licensed or otherwise authorized by law. The Practice Act provides, among others, the following definitions relating to the breadth and scope of occupational therapy as regulated in California.
The Act requires that an applicant seeking an OT or OTA license must meet the following competencies:
- Complete the academic requirements of an approved and accredited educational program for OTs or OTAs;
- Complete two years of postgraduate training;
- Complete a period of supervised fieldwork experience; and
- Pass an entry-level certification examination.
Applicants for an OT or OTA license must complete the academic requirements of an approved and accredited educational program. Specifically, BPC § 2570.6(b) requires the educational program to be approved by the CBOT; be accredited by the American Occupational Therapy Association (AOTA)’s Accreditation Council for Occupational Therapy Education (ACOTE), be accredited or approved by the AOTA’s predecessor organization, or approved by AOTA’s Career Mobility Program. The curriculum must meet the content standards required by the ACOTE or the relevant AOTA accreditation agency, including specified course subjects (BPC § 2570.6(b)(2)-(3)).
While the Act requires that educational programs be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education and approved by the CBOT, the CBOT does not separately approve, review, or remove schools. In practice, the CBOT approves accredited schools by default.
The Board requires both OTs and OTAs licensees to complete 24 professional development units prior to renewal which can be earned through a variety of means, such as academic course work, attending board meetings and activities, or mentorship. The CBOT also accepts programs and activities sponsored by the OTAC or AOTA, including continuing education courses. Rather than require licensees to submit certificates of completion at the time of renewal, the CBOT audits a random sample of renewing licensees to determine compliance with the requirement. However, the CBOT does not approve, audit, or review the individual course providers.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
American Occupational Therapy Association
Occupational Therapy Association of California
United Nurses Association of California/Union of Health Care Professionals
21 Individuals
None received
ARGUMENTS IN SUPPORT: The Occupational Therapy Association of California and the American Occupational Therapy Association believe this bill will update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.
According to the United Nurses Associations of California/Union of Health Care Professionals, this bill will enable occupational therapists to provide greater care and service to their patients by revising and updating various provisions of the Act.
ASSEMBLY FLOOR: 77-0, 5/29/18
AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Chu
8/15/18 15:47:54
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB |
THIRD READING
Bill No: AB 2221
:
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/25/18
AYES: Hill, Fuller, Allen, Dodd, Galgiani, Glazer, Hernandez, Pan, Wilk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 5/29/18 - See last page for vote
DIGEST:
This bill makes numerous changes to the Occupational Therapy Practice Act.
Existing law:
- Provides for the licensure and regulation of the practice of occupational therapy under the Occupational Therapy Practice Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy (CBOT or Board) within the Department of Consumer Affairs until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner.
(BPC § 2570.18(c)(3))
- Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
This bill makes various changes to the Occupational Therapy Practice Act.
Background
The Board administers the licensing and enforcement programs for OTs, OTAs, and occupational therapy aides. The Board also establishes and clarifies state-specific process and practice standards through administrative rulemaking. In California, regulation of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the first iteration of the Occupational Therapy Practice Act. The Practice Act establishes the CBOT and specifies the scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice. Under the Practice Act, it is a misdemeanor to practice occupational therapy or hold oneself out as being able to practice occupational therapy, via titles or other methods, unless licensed or otherwise authorized by law. The Practice Act provides, among others, the following definitions relating to the breadth and scope of occupational therapy as regulated in California.
The Act requires that an applicant seeking an OT or OTA license must meet the following competencies:
- Complete the academic requirements of an approved and accredited educational program for OTs or OTAs;
- Complete two years of postgraduate training;
- Complete a period of supervised fieldwork experience; and
- Pass an entry-level certification examination.
Applicants for an OT or OTA license must complete the academic requirements of an approved and accredited educational program. Specifically, BPC § 2570.6(b) requires the educational program to be approved by the CBOT; be accredited by the American Occupational Therapy Association (AOTA)’s Accreditation Council for Occupational Therapy Education (ACOTE), be accredited or approved by the AOTA’s predecessor organization, or approved by AOTA’s Career Mobility Program. The curriculum must meet the content standards required by the ACOTE or the relevant AOTA accreditation agency, including specified course subjects (BPC § 2570.6(b)(2)-(3)).
While the Act requires that educational programs be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education and approved by the CBOT, the CBOT does not separately approve, review, or remove schools. In practice, the CBOT approves accredited schools by default.
The Board requires both OTs and OTAs licensees to complete 24 professional development units prior to renewal which can be earned through a variety of means, such as academic course work, attending board meetings and activities, or mentorship. The CBOT also accepts programs and activities sponsored by the OTAC or AOTA, including continuing education courses. Rather than require licensees to submit certificates of completion at the time of renewal, the CBOT audits a random sample of renewing licensees to determine compliance with the requirement. However, the CBOT does not approve, audit, or review the individual course providers.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
American Occupational Therapy Association
Occupational Therapy Association of California
United Nurses Association of California/Union of Health Care Professionals
21 Individuals
None received
ARGUMENTS IN SUPPORT: The Occupational Therapy Association of California and the American Occupational Therapy Association believe this bill will update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.
According to the United Nurses Associations of California/Union of Health Care Professionals, this bill will enable occupational therapists to provide greater care and service to their patients by revising and updating various provisions of the Act.
ASSEMBLY FLOOR: 77-0, 5/29/18
AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Chu
8/8/18 16:00:33
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2017 - 2018 Regular
Bill No: Hearing Date: June 25, 2018
Author: | |||
Version: | June 11, 2018 | ||
Urgency: | No | Fiscal: | Yes |
Consultant: | Sarah Mason | ||
Subject:
SUMMARY: Makes numerous changes to the Occupational Therapy Practice Act (Act).
Existing law:
- Provides for the licensure and regulation of the practice of occupational therapy under the Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy (CBOT or Board) within the Department of Consumer Affairs (DCA) until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Defines “aide” as an individual who provides supportive services to OT and who is trained by an OT to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. A licensed OT may utilize the services of one aide engaged in patient-related tasks to assist the OT in his or her practice. (BPC § 2570.2(b))
- Defines “occupational therapist” as an individual who meets specified minimum education requirements and is licensed pursuant to the practice act, and provides that only the OT is responsible for the occupational therapy treatment.
(BPC § 2570.2(g)) - Defines the “practice of occupational therapy” as the therapeutic use of purposeful and meaningful goal-directed activities (occupations) which engage the individual’s body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health, and states the following:
- Occupational therapy services encompass occupational therapy assessment, treatment, education of, and consultation with, individuals who have been referred for occupational therapy services subsequent to diagnosis of disease or disorder (or who are receiving occupational therapy services as part of an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA)).
- Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities.
- Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability.
- Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating selective temporary orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training).
- Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence.
- Services are provided individually, in groups, or through social groups.
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner.
(BPC § 2570.18(c)(3))
- Requires a licensee planning to use an OTD title to have a doctoral degree that is granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(BPC § 2570.18(d)) - Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
This bill:
- Replaces the term “patient” with “client” throughout the practice act.
- Authorizes an aide to provide occupational therapy support services to OTAs in addition to OTs, but provides that the OT is responsible for the overall use and actions of the aide.
- Defines “continuing competence” as a dynamic and multidimensional process in which the OT or OTA develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
- Replaces the requirement that an OT be the only person responsible for the assessment of a client and the development of an occupational therapy plan with the requirement that an OT directs the evaluation process and develops the intervention plan.
- Repurposes and amends the definition and descriptions of “practice of occupational therapy” into a definition and descriptions of “occupational therapy” as follows:
- Replaces the description of "occupations" stating that occupations "engage the individual’s body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health" with a description of the target populations and settings where occupational therapy is used.
- Describes "occupational therapy services" as being "provided for habilitation, rehabilitation, and the promotion of health and wellness to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions."
- Deletes from the description of "occupational therapy services" the references to individuals with medical referrals and individuals receiving occupational therapy services under an IEP pursuant to the federal IDEA.
- Describes occupational therapy as addressing "the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life."
- Describes occupational therapy as promoting, through engagement in everyday activities, mental health and supporting functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders
- Expands the definition of "occupational therapy techniques" by deleting the "selective temporary" limitation on designing and fabricating orthotics.
- Replaces the term "social groups" with "populations."
- Replaces the requirement that an OT demonstrate competence in advanced practices to the satisfaction of the CBOT with the requirement that an OT attest, under penalty of perjury, that the OT has met the educational training and competency requirements.
- Authorizes the CBOT to periodically audit the advanced practices attestations for compliance.
- Deletes the term "post professional" from the advanced practice education requirements.
- Increases the number of OTAs an OT may supervise from two to three.
- Deletes the list of subjects required as part of the curriculum for accredited OT educational programs.
- Deletes the curriculum requirements for accredited OTA programs.
- Deletes the option allowing an applicant who is a graduate from an OTA educational program who is unable to provide evidence of meeting educational requirements to instead demonstrate passage of specified examination national examinations.
- Changes the CBOT's authority to establish continuing competence requirements into a requirement on the CBOT and provides that only a portion of continuing competence requirements, as determined by the CBOT to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
- Makes permissive the requirement that the CBOT approve the examination for licensure.
- Revises the CBOT's authority to adopt regulations to include those "necessary to effectuate the purpose of" the practice act and deletes the limitation to those "relating to professional conduct to carry out the purpose of" the practice act.
- Makes other technical, updating, and conforming changes.
FISCAL EFFECT: This bill is keyed fiscal by Legislative Counsel. According to the Assembly Committee on Appropriations analysis dated April 25, 2018, this bill will result in ongoing administrative costs to the CBOT, not likely to exceed $100,000, for personnel to review attestations and verify compliance; uncertain, potentially significant ongoing enforcement costs if individuals are found in violation of new rules governing advanced practice; and uncertain, potentially significant one-time regulatory and legal workload to respond to and interpret various definitional changes.
COMMENTS:
- Purpose. This bill is sponsored by the Occupational Therapy Association of California (OTAC) and the American Occupational Therapy Association (AOTA). According to the Author, “The Occupational Therapy Practice Act was written 18 years ago. Since that time, the practice of occupational therapy has matured, patient needs have become more diverse, and healthcare reform has changed and broadened the services that are provided. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.”
- Background. The Board administers the licensing and enforcement programs for OTs, occupational therapy assistants OTAs, and occupational therapy aides. The CBOT also establishes and clarifies state-specific process and practice standards through administrative rulemaking. In California, regulation of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the first iteration of the Occupational Therapy Practice Act. The Practice Act establishes the CBOT and specifies the scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice. Under the Practice Act, it is a misdemeanor to practice occupational therapy or hold oneself out as being able to practice occupational therapy, via titles or other methods, unless licensed or otherwise authorized by law. The Practice Act provides, among others, the following definitions relating to the breadth and scope of occupational therapy as regulated in California.
The Act requires that an applicant seeking an OT or OTA license must meet the
following competencies:
- Complete the academic requirements of an approved and accredited educational program for OTs or OTAs;
- Complete two years of postgraduate training;
- Complete a period of supervised fieldwork experience; and
- Pass an entry-level certification examination.
Applicants for an OT or OTA license must complete the academic requirements of an approved and accredited educational program. Specifically, BPC §
2570.6(b) requires the educational program to be approved by the CBOT; be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education (ACOTE), be accredited or approved by the AOTA’s predecessor organization, or approved by AOTA’s Career Mobility Program. The curriculum must meet the content standards required by the ACOTE or the relevant AOTA accreditation agency, including specified course subjects (BPC § 2570.6(b)(2)-(3)).
While the Act requires that educational programs be accredited by the AOTA’s Accreditation Council for Occupational Therapy Education and approved by the CBOT, the CBOT does not separately approve, review, or remove schools. In practice, the CBOT approves accredited schools by default.
The Board requires both OTs and OTAs licensees to complete 24 professional development units prior to renewal which can be earned through a variety of means, such as academic course work, attending board meetings and activities, or mentorship. The CBOT also accepts programs and activities sponsored by the OTAC or AOTA, including continuing education courses. Rather than require licensees to submit certificates of completion at the time of renewal, the CBOT audits a random sample of renewing licensees to determine compliance with the requirement. However, the CBOT does not approve, audit, or review the individual course providers.
- Arguments in Support. The Occupational Therapy Association of California (OTAC) and the American Occupational Therapy Association (AOTA) believe this bill would update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act.
According to the United Nurses Associations of California/Union of Health Care Professionals, this bill will enable occupational therapists to provide greater care and service to their patients by revising and updating various provisions of the Act.
- Proposed Author’s Amendments. The Board supports this bill if amendments are taken to address outstanding issues. In response, the Author has proposed the following changes (as outlined in the mockup below):
- Add provisions to clearly state that OTs and OTAs in OT/OTA education programs in California must be licensed.
- Delete language that allows licenses to “attest” that they possess the knowledge, skill and ability to provide advanced practices and instead revert back to current law requiring “demonstration to the satisfaction of the board”.
SUPPORT AND OPPOSITION:
Support:
American Occupational Therapy Association (AOTA)
Occupational Therapy Association of California (OTAC)
United Nurses Association of California/Union of Health Care Professionals
Opposition: None on file as of June 20, 2018.
-- END --
Mockup of AB 2221 as proposed to be amended:
SEC. 7.
Section 2570.18 of the Business and Professions Code is amended to read:
2570.18.
(a) A person shall not represent to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter.
(b) Unless licensed to practice as an occupational therapist under this chapter, a person may not use the professional abbreviations “O.T.,” “O.T./L.,” or “O.T.D.,” “Occupational Therapist,” “Occupational Therapist Licensed,” Occupational Therapist Doctorate,” or any other words, letters, or symbols with the intent to represent that the person practices or is authorized to practice occupational therapy.
(c) A licensee who has earned a doctoral degree in occupational therapy (OTD) or, after adoption of the regulations described in subdivision (e), a doctoral degree in a related area of practice or study may do the following:
(1) In a written communication, use the initials OTD, DrPH, PhD, or EdD, as applicable, following the licensee’s name.
(2) In a written communication, use the title “Doctor” or the abbreviation “Dr.” preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee.
(3) In a spoken communication while engaged in the practice of occupational therapy, use the title “Doctor” preceding the licensee’s name, if the licensee specifies that he or she is an occupational therapy practitioner.
(d) A doctoral degree described in subdivision (c) shall be granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges.
(e) The board shall define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of subdivision (c).
(c)
(f) Unless licensed to assist in the practice of occupational therapy as an occupational therapy assistant under this chapter, a person may not use the professional abbreviations “O.T.A.,” “O.T.A/L.,” or “Occupational Therapy Assistant,” “Licensed Occupational Therapy Assistant,” or any other words, letters, or symbols, with the intent to represent that the person assists in, or is authorized to assist in, the practice of occupational therapy as an occupational therapy assistant.
(d)
(g) The unauthorized practice or representation as an occupational therapist or as an occupational therapy assistant constitutes an unfair business practice under Section 17200 and false and misleading advertising under Section 17500.
(h) An occupational therapist that is serving as an educator in an education program for occupational therapists in California must be licensed. The licensure requirement also applies to an occupational therapist that is serving as an educator in an education program for occupational therapy assistants in California.
(i) An occupational therapy assistant that is serving as an educator in an education program for occupational therapy assistants in California must be licensed.
SEC. 3.
Section 2570.3 of the Business and Professions Code is amended to read:
2570.3.
(a) No person shall provide practice occupational therapy or hold himself or herself out as an occupational therapist or as being able to provide practice occupational therapy, or to render occupational therapy services in this state unless he or she is licensed as an occupational therapist under the provisions of this chapter. No person shall hold himself or herself out as an occupational therapy assistant or work as an occupational therapy assistant under the supervision of an occupational therapist unless he or she is licensed as an occupational therapy assistant under the provisions of this chapter.
(b) Only an individual may be licensed under this chapter.
(c) Nothing in this chapter shall be construed as authorizing an occupational therapist to practice physical therapy, as defined in Section 2620; speech-language pathology or audiology, as defined in Section 2530.2; nursing, as defined in Section 2725; psychology, as defined in Section 2903; or spinal manipulation or other forms of healing, except as authorized by this section.
(d) An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has attested, under penalty of perjury, to the board that he or she has met educational training and competency requirements. All attestations submitted to the board may be subject to periodic compliance audits, as determined by the board. These advanced practices include the following:
(d) An occupational therapist may provide advanced practices if the therapist has the knowledge, skill, and ability to do so and has demonstrated to the satisfaction of the board that he or she has met educational training and competency requirements. These advanced practices include the following:
ASSEMBLY THIRD READING
ATR Bill Id:AB 2221
Author:(Bloom)
As Amended Ver:April 5, 2018
Majority vote
Committee | Votes | Ayes | Noes |
Business & Professions | 16-0 | Low, Brough, Arambula, Baker, Bloom, Chen, Chiu, Cunningham, Eggman, Fong, Gipson, Grayson, Holden, Irwin, Mullin, Ting | |
Appropriations | 16-0 | Gonzalez Fletcher, Bigelow, Bloom, Bonta, Calderon, Carrillo, Chau, Eggman, Fong, Friedman, Gallagher, Eduardo Garcia, Nazarian, Obernolte, Quirk, Reyes |
|
SUMMARY: Makes numerous changes to the Occupational Therapy Practice Act, including definitions relating to scope of practice of occupational therapists (OTs) and occupational therapy assistants (OTAs), supervision ratios and duties, methods the California Board of Occupational Therapy (CBOT) may verify advanced practice requirements, and requirements related to the use of doctoral degree titles. Specifically, this bill:
- Replaces the term "practice" with the term "profession" where it is used as a noun and the term "provide" where it is used as a verb.
- Replaces the term "patient" with "client."
- Authorizes an "aide" to provide occupational therapy support services to OTAs in addition to OTs, but provides that the OT is responsible for the overall use and actions of the aide, increases the number of OTAs an OT may supervise from two to three, and replaces the requirement that an OT being the only person responsible for the assessment of a client and the development of an occupational therapy plan with the requirement that an OT directs the evaluation process and develops the intervention plan.
- Defines "continuing competence" as a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
- Redefines the "practice of occupational therapy" as "occupational therapy" and makes numerous changes, including deleting references to individuals with medical referrals and individuals receiving occupational therapy services under an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA) as the individuals who receive occupational therapy services; describing occupational therapy as the engagement in everyday activities to promote mental health and support functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders; and expanding the definition of "occupational therapy techniques" by deleting the "selective temporary" limitation on designing and fabricating orthotics.
- Replaces the requirement that an OT demonstrate competence in advanced practices to the satisfaction of the CBOT with the requirement that an OT attest, under penalty of perjury, that the OT has met the educational training and competency requirements, authorizes the CBOT to periodically audit the advanced practices attestations for compliance, and deletes the term "post professional" from the advanced practice education requirements.
- Deletes the list of subjects required as part of the curriculum for accredited OT educational programs and deletes the curriculum requirements for accredited OTA programs.
- Deletes the option allowing an applicant who is a graduate from an OTA educational program who is unable to provide evidence of meeting educational requirements to instead demonstrate passage of specified examination national examinations.
- Changes the CBOT's authority to establish continuing competence requirements into a requirement on the CBOT and provides that only a portion of continuing competence requirements, as determined by the CBOT to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
- Deletes title protection for, and references to, the titles "Occupational Therapist Registered," "O.T.R.," "O.T.R./L.," "C.O.T.A.," and "C.O.T.A./L." and deletes requirements relating to the use of the title "O.T.D.," including the requirement that the licensee have earned a doctoral degree in occupational therapy; the requirement that a licensee must list the degree when using "Doctor" or "Dr." in a written communication; the requirement that the doctoral degree must be granted from an institution and program accredited by specified accrediting agencies; and the requirement that the CBOT define in regulation other authorized types of doctoral degrees.
- Makes the requirement that the CBOT approve the examination for licensure permissive.
- Revises the CBOT's authority to adopt regulations to include those "necessary to effectuate the purpose of" the practice act and deletes the limitation to those "relating to professional conduct to carry out the purpose of" the practice act.
- Makes other technical, updating, and conforming changes.
FISCAL EFFECT: According to the Assembly Appropriations Committee,
- Ongoing administrative costs to the CBOT within the Department of Consumer Affairs, not likely to exceed $100,000, for personnel to review attestations and verify compliance (all costs are Occupational Therapy Fund).
- Uncertain, potentially significant ongoing enforcement costs if individuals are found in violation of new rules governing advanced practice.
- Uncertain, potentially significant one-time regulatory and legal workload to respond to and interpret various definitional changes.
COMMENTS:
Purpose. This bill is co-sponsored by the Occupational Therapy Association of California and the American Occupational Therapy Association. According to the author, "[o]ccupational therapists work with individuals from a wide range of backgrounds, experiencing physical and mental health conditions or disabilities, helping to improve and develop daily skills necessary on a routine basis. [This bill] ensures that [OTs] will be able to practice the full extent of their training to provide quality care for those in need."
Background. According to the California Occupational Guides published by the Labor Market Information Division within the Employment Development Department (EDD), OTs and OTAs are healthcare providers who help patients with mental, emotional, or physical disabilities become self-sufficient. They may also work with other healthcare providers to develop therapy plans, which may include educational, vocational, and rehabilitative activities. The goal of occupational therapy is to enable patients to gain confidence, to adapt to or overcome their particular disability, and to use their time in rewarding ways.
Occupational Therapy Regulation. The current iteration of the Occupational Therapy Practice Act passed in 2000. According to the author, changes in healthcare since the year 2000 have caused the practice act to become outdated. To address this issue, this bill "proposes to amend the Act to include the revision of outdated definitions, clarification of provisions related to advance practices, revision of continuing competence and coursework requirements, and language to clarify that occupational therapy supports functioning in people with or at risk of experiencing a range of mental health disorders."
CBOT. The CBOT is a licensing board under the DCA. The purpose of the CBOT is to protect consumers through state regulation of the practice of occupational therapy. According to the DCA's 2017 Annual Report, the CBOT reported a total of 15,553 licensees, including 13,380 OTs and 2,977 OTAs.
Definition of Occupational Therapy. This bill makes significant changes to the definition of occupational therapy. The changes are based on the sponsors' Standards of Practice for Occupational Therapy. The changes include, among others, referencing the relationship of occupational therapy to: rehabilitation, habilitation, cognitive, psychosocial, sensory-perception, and physical and mental health. It also adds references to the roles of occupational therapy in the promotion of functioning in those with mental health disorders, including, psychiatric, behavioral, and substance-use disorders.
According to the sponsors, these changes are intended to reflect that OTs and OTAs have a role in these services. Specifically, the sponsors note that this bill is intended "to clarify the role of occupational therapy in mental health and behavioral health services, which they are currently providing to patients in California."
Advanced Practice Requirements. Currently, additional education and training is required before a licensee can perform advanced practices, including hand therapy, the use of physical agent modalities, and swallowing assessment, evaluation, and intervention. The CBOT is authorized to determine the method for demonstrating the completion of the advanced practice requirements.
This bill removes the CBOT's authority to determine how licensees demonstrate completion of the educational and training requirements for advanced practice. Instead, it will require the licensees to attest to completion of the requirements and authorize the CBOT to audit the attestations for compliance, similar to the requirements for continuing competence. The sponsors and the CBOT disagree on the necessity of the advanced practice requirements and the sufficiency of pre-licensure education.
POLICY ISSUE FOR CONSIDERATION:
Practice vs. Profession. This bill replaces the term "practice" with "profession" where the term "practice" is used as a noun. This is inconsistent with the other practice acts and may narrow the scope of the state's regulation of occupational therapy. In general, the term "profession" means occupations or vocations that involve the use of specialized skills and knowledge requiring specific training, education, or experience. The term "practice" means the application or use of the specialized skills and knowledge, whether as part of a profession or otherwise.
For example, it is not the "profession of occupational therapy" itself that affects the health, safety, and welfare of the public. Rather, it is the risk of harms resulting from the unqualified practice of occupational therapy by the profession and others, including non-professionals and unlicensed practitioners.
Further, it is unclear that the "profession of occupational therapy" should to be the sole subject of state regulation and control, as state licensing schemes often involve regulation of much more than the profession itself, including OT and OTA students and applicants, education and test providers, health plans, health facilities, and other licensees authorized to practice occupational therapy. Therefore, the use of profession in place of practice may not achieve the goals of state regulation of occupational therapy.
IMPLEMENTATION ISSUES:
Definitions vs. Descriptions. This bill revises the definition of "occupational therapy" by adding and amending the descriptions of various aspects of occupational therapy, including codifying the declaration that occupational therapy promotes mental health in people with, or who are at risk of, mental health disorders. In general, practice act definitions can help delineate specific services or actions that make up a practitioners scope of practice. In contrast, broad, open-ended descriptions may raise more questions. While the current practice act language is similarly descriptive, it is unclear how the changes may impact the scope of practice for OTs and OTAs.
Doctorate of Occupational Therapy (OTD) Degree. At the CBOT's request, the last sunset review bill, AB 1706 (Committee on Business and Professions), Chapter 454, Statutes of 2017, authorized licensees who have earned an OTD to use the title "Dr." or "Doctor" under specified conditions, including requiring written communications to also clarify the type of doctoral degree by listing the degree after the licensee's name.
This bill deletes most of the new provisions, instead adding "O.T.D." to the list of protected titles. However, "O.T.D." is no longer spelled out. If this bill passes as written, it would be unclear from the practice act what "O.T.D." stands for. Further, this bill adds the title "O.T.D." to the list of titles that a licensed OT may use, but it does not specify which licensed OTs may use it.
Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301 FN: 0003070
Date of Hearing: April 25, 2018
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez Fletcher, Chair
ABPCA Bill Id:AB 2221
Author:(Bloom) – As Amended Ver:April 5, 2018
Policy Committee: | Business and Professions | Vote: | 16 - 0 |
Urgency: No State Mandated Local Program: Yes Reimbursable: No
SUMMARY:
This bill makes numerous changes to code governing the California Board of Occupational Therapy's (CBOT's) regulation of occupational therapy. Specifically, this bill, among other provisions:
- Changes and adds definitions, including inserting additional language related to occupational therapy for mental health disorders into the definition of occupational therapy and changing the responsibilities of occupational therapists (OTs) with respect to assessment and development of a treatment plan.
- Strikes provisions specifying educational requirements and provisions specifying requirements a person must meet to use the term O.T.D., or doctor of occupational therapy.
- Allows an OT to provide advanced practices based on an attestation to the board that they possess the training and competence, rather than being required to demonstrate to the board that he or she has met the training and competence requirements.
- Limits the board's oversight authority to the profession, rather than the practice, of occupational therapy.
FISCAL EFFECT:
- Ongoing administrative costs to the CBOT within the Department of Consumer Affairs, not likely to exceed $100,000, for personnel to review attestations and verify compliance (all costs are Occupational Therapy Fund).
- Uncertain, potentially significant ongoing enforcement costs if individuals are found in violation of new rules governing advanced practice.
- Uncertain, potentially significant one-time regulatory and legal workload to respond to and interpret various definitional changes.
COMMENTS:
- Purpose. According to co-sponsors, the American Occupational Therapy Association and the Occupational Therapy Association of California, this bill updates statute governing regulation of occupational therapy to allow OTs to practice to the full extent of their training.
- Background. Current law defines the practice of occupational therapy as the therapeutic use of purposeful and meaningful goal-directed activities (occupations) that engage the individual’s body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health. For instance, an OT may teach a stroke victim how to get dressed or demonstrate how to stretch joints for arthritis pain relief. According to the federal Occupational Outlook Handbook, about half of occupational therapists work in offices of occupational therapy or in hospitals, while others work in schools, nursing homes, and home health services. CBOT licenses about 13,000 OTs and 3,000 Occupational Therapy Assistants. CBOT was most recently reviewed by the Legislature last year, when the board's sunset was extended and minor statutory changes were made through AB 1706 (Low), Chapter 454, Statutes of 2017.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Date of Hearing:
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Evan Low, Chair
ABPCA Bill Id:AB 2221
Author:(Bloom) – As Amended Ver:April 5, 2018
SUBJECT: Occupational therapy.
SUMMARY: Makes numerous changes to the Occupational Therapy Practice Act, including: revising and updating several definitions, including the "practice of occupational therapy"; deleting the "selective temporary" limitation on the designing and fabricating orthotics; authorizing an aide to provide support services to an occupational therapy assistant (OTA) in addition to an occupational therapist (OT); increasing the ratio of OTs that may supervise OTAs; replacing the training requirement for advanced practices with an attestation; modifying title protection provisions relating to doctoral degrees and registrations; and making other updating, technical, and clarifying changes.
EXISTING LAW:
- Provides for the licensure and regulation of the practice of occupational therapy under the Occupational Therapy Practice Act. (Business and Professions Code (BPC) §§2570 -2571)
- Establishes the California Board of Occupational Therapy within the Department of Consumer Affairs (DCA) until January 1, 2022, to license and regulate occupational therapists (OTs) and occupational therapy assistants (OTAs). (BPC § 3716)
- Defines “aide” as an individual who provides supportive services to an occupational therapist and who is trained by an occupational therapist to perform, under appropriate supervision, delegated, selected client and nonclient-related tasks for which the aide has demonstrated competency. An occupational therapist licensed pursuant to this chapter may utilize the services of one aide engaged in patient-related tasks to assist the occupational therapist in his or her practice of occupational therapy. (BPC § 2570.2(b))
- Defines “occupational therapist” as an individual who meets specified minimum education requirements and is licensed pursuant to the practice act, and provides that only the OT is responsible for the occupational therapy assessment of a client, and the development of an occupational therapy plan of treatment. (BPC § 2570.2(g))
- Defines the “practice of occupational therapy” as the therapeutic use of purposeful and meaningful goal-directed activities (occupations) which engage the individual’s body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health, and states the following:
- Occupational therapy services encompass occupational therapy assessment, treatment, education of, and consultation with, individuals who have been referred for occupational therapy services subsequent to diagnosis of disease or disorder (or who are receiving occupational therapy services as part of an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA)).
- Occupational therapy assessment identifies performance abilities and limitations that are necessary for self-maintenance, learning, work, and other similar meaningful activities.
- Occupational therapy treatment is focused on developing, improving, or restoring functional daily living skills, compensating for and preventing dysfunction, or minimizing disability.
- Occupational therapy techniques that are used for treatment involve teaching activities of daily living (excluding speech-language skills); designing or fabricating selective temporary orthotic devices, and applying or training in the use of assistive technology or orthotic and prosthetic devices (excluding gait training).
- Occupational therapy consultation provides expert advice to enhance function and quality of life. Consultation or treatment may involve modification of tasks or environments to allow an individual to achieve maximum independence.
- Services are provided individually, in groups, or through social groups.
- Prohibits a person from representing to the public by title, education, or background, or by description of services, methods, or procedures, or otherwise, that the person is authorized to practice occupational therapy in this state, unless authorized to practice occupational therapy under this chapter. (BPC § 2570.18(a))
- Authorizes OTs who have earned a doctoral degree in occupational therapy (OTD) or, after adoption of regulations, a doctoral degree in a related area of practice or study, to:
- Use the initials OTD, DrPH, PhD, or EdD, in a written communication, following the licensee’s name. (BPC § 2570.18(c)(1))
- Use the title “Doctor” or the abbreviation “Dr.” in a written communication, preceding the licensee’s name, if the licensee’s name is immediately followed by an unabbreviated specification of the applicable doctoral degree held by the licensee. (BPC § 2570.18(c)(2))
- Use the title “Doctor” in a spoken communication, preceding the licensee’s name, if the licensee specifies that he or she is an OT practitioner. (BPC § 2570.18(c)(3))
- Requires a licensee planning to use an OTD title to have a doctoral degree that is granted by an institution and program accredited by the Western Association of Schools and Colleges, the Accreditation Council on Occupational Therapy Education, or by an accrediting agency recognized by the National Commission on Accrediting or the United States Department of Education that the board determines is equivalent to the Western Association of Schools and Colleges. (BPC § 2570.18(d))
- Requires the CBOT to define, by regulation, the doctoral degrees that are in a related area of practice or study for purposes of the use of the OTD title. (BPC § 2570.18(e))
THIS BILL:
- Replaces the term "practice" with the term "profession" where it is used as a noun and the term "provide" where it is used as a verb.
- Replaces the term "patient" with "client" throughout the practice act.
- Authorizes an "aide" to provide occupational therapy support services to OTAs in addition to OTs, but provides that the OT is responsible for the overall use and actions of the aide.
- Defines “continuing competence” as a dynamic and multidimensional process in which the occupational therapist or occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning, and ethical reasoning skills necessary to perform current and future roles and responsibilities within the profession.
- Replaces the requirement that an OT being the only person responsible for the assessment of a client and the development of an occupational therapy plan with the requirement that an OT directs the evaluation process and develops the intervention plan.
- Repurposes and amends the definition and descriptions of "practice of occupational therapy" into a definition and descriptions of "occupational therapy" as follows:
- Replaces the description of "occupations" stating that occupations "engage the individual’s body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health" with a description of the target populations and settings where occupational therapy is used.
- Describes "occupational therapy services" as being "provided for habilitation, rehabilitation, and the promotion of health and wellness to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions."
- Deletes from the description of "occupational therapy services" the references to individuals with medical referrals and individuals receiving occupational therapy services under an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA).
- Describes occupational therapy as addressing "the physical, cognitive, psychosocial, sensory-perception and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life."
- Describes occupational therapy as promoting, through engagement in everyday activities, mental health and supporting functioning in people with, or at risk of experiencing, a range of mental health disorders, including, but not limited to, psychiatric, behavioral, and substance abuse disorders
- Expands the definition of "occupational therapy techniques" by deleting the "selective temporary" limitation on designing and fabricating orthotics.
- Replaces the term "social groups" with "populations."
- Replaces the requirement that an OT demonstrate competence in advanced practices to the satisfaction of the CBOT with the requirement that an OT attest, under penalty of perjury, that the OT has met the educational training and competency requirements.
- Authorizes the CBOT to periodically audit the advanced practices attestations for compliance.
- Deletes the term "post professional" from the advanced practice education requirements.
- Increases the number of OTAs an OT may supervise from two to three.
- Deletes the list of subjects required as part of the curriculum for accredited OT educational programs.
- Deletes the curriculum requirements for accredited OTA programs.
- Deletes the option allowing an applicant who is a graduate from an OTA educational program who is unable to provide evidence of meeting educational requirements to instead demonstrate passage of specified examination national examinations.
- Changes the CBOT's authority to establish continuing competence requirements into a requirement on the CBOT and provides that only a portion of continuing competence requirements, as determined by the CBOT to protect public health, safety, and welfare, may be fulfilled through competency assessment activities performed within the context of a broader professional development plan.
- Deletes title protection for, and references to, the titles “Occupational Therapist Registered,” “O.T.R.,” “O.T.R./L.,” “C.O.T.A.,” and “C.O.T.A./L.”
- Amends title protection provisions for the title "O.T.D." as follows:
- Deletes the requirement that the licensee have earned a doctoral degree in occupational therapy.
- Deletes the reference abbreviating the term "doctoral degree in occupational therapy" into the initialism "OTD."
- Deletes the requirement that, if a licensee uses the title "Doctor" or the abbreviation "Dr." in a written communication, the licensee must also list the degree.
- Deletes the requirement that the doctoral degree must be granted from an institution and program accredited by specified accrediting agencies.
- Deletes the requirement that the CBOT define in regulation other authorized types of doctoral degrees.
- Makes permissive the requirement that the CBOT approve the examination for licensure.
- Revises the CBOT's authority to adopt regulations to include those "necessary to effectuate the purpose of" the practice act and deletes the limitation to those "relating to professional conduct to carry out the purpose of" the practice act.
- Makes other technical, updating, and conforming changes.
FISCAL EFFECT: Unknown. This bill is keyed fiscal by the Legislative Counsel.
COMMENTS:
Purpose. This bill is co-sponsored by the Occupational Therapy Association of California and the American Occupational Therapy Association. According to the author, "[o]ccupational therapists work with individuals from a wide range of backgrounds, experiencing physical and mental health conditions or disabilities, helping to improve and develop daily skills necessary on a routine basis. [This bill] ensures that [OTs] will be able to practice the full extent of their training to provide quality care for those in need."
Background. According to the California Occupational Guides published by the Labor Market Information Division within the Employment Development Department (EDD), OTs and OTAs are healthcare providers who help patients with mental, emotional, or physical disabilities become self-sufficient. They may also work with other healthcare providers to develop therapy plans, which may include educational, vocational, and rehabilitative activities. The goal of occupational therapy is to enable patients to gain confidence, to adapt to or overcome their particular disability, and to use their time in rewarding ways.
Occupational Therapy Regulation. In California, regulation of the practice of occupational therapy began in 1977. Initially, regulation was limited to a title protection statute, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting specific requirements. In 2000, the Legislature passed the current iteration of the Occupational Therapy Practice Act. The practice act specifies the OT and OTA scope, licensing requirements and fees, and penalties for violations of the Practice Act, including unlicensed practice.
According to the author, changes in healthcare since the year 2000 have caused the practice act to become outdated. To address this issue, this bill "proposes to amend the Act to include the revision of outdated definitions, clarification of provisions related to advance practices, revision of continuing competence and coursework requirements, and language to clarify that occupational therapy supports functioning in people with or at risk of experiencing a range of mental health disorders."
CBOT. The CBOT is a licensing board under the DCA. The purpose of the CBOT is to protect consumers through state regulation of the practice of occupational therapy. Specifically, the CBOT implements the Occupational Therapy Practice Act through administration and enforcement of the licensing programs for OTs, OTAs, and occupational therapy aides. The CBOT also establishes and clarifies state-specific process and practice standards through administrative rulemaking.
According to the DCA's 2017 Annual Report, the CBOT reported a total of 15,553 licensees, including 13,380 OTs and 2,977 OTAs. The CBOT's mission statement, as stated in its 2016–2019 Strategic Plan, is to "protect California consumers of occupational therapy services through effective regulation, licensing and enforcement."
Definition of occupational therapy. This bill makes significant changes to the definition of occupational therapy. The changes are based on the sponsors' Standards of Practice for Occupational Therapy. The changes include, among others, referencing the relationship of occupational therapy to: rehabilitation, habilitation, cognitive, psychosocial, sensory-perception, and physical and mental health. It also adds references to the roles of occupational therapy in the promotion of functioning in those with mental health disorders, including, psychiatric, behavioral, and substance-use disorders.
According to the sponsors, these changes are intended to reflect that OTs and OTAs have a role in these services. Specifically, the sponsors note that this bill is intended "to clarify the role of occupational therapy in mental health and behavioral health services, which they are currently providing to patients in California."
Advanced Practice Requirements. Currently, additional education and training is required before a licensee can perform advanced practices, including hand therapy, the use of physical agent modalities, and swallowing assessment, evaluation, and intervention. The CBOT is authorized to determine the method for demonstrating the completion of the advanced practice requirements.
This bill removes the CBOT's authority to determine how licensees demonstrate completion of the educational and training requirements for advanced practice. Instead, it will require the licensees to attest to completion of the requirements and authorize the CBOT to audit the attestations for compliance, similar to the requirements for continuing competence. The sponsors and the CBOT disagree on the necessity of the advanced practice requirements and the sufficiency of pre-licensure education.
Current Related Legislation. AB 2386 (Rubio), of the current Legislative Session, would require the Commission on Teacher Credentialing to, among other things, establish a specialization in occupational therapy or physical therapy services, as specified. STATUS: This bill is pending in the Assembly Committee on Education.
Prior Related Legislation. AB 1706 (Low), Chapter 454, Statutes of 2017, among other things, extended the operation of the CBOT until 2022 and several other healing arts boards and made changes to the entities’ practice acts intended to improve their efficiency and effectiveness, including authorizes licensees who have earned an OTD to use the title "Dr." or "Doctor" under specified conditions.
SB 1046 (Murray), Chapter 697, Statutes of 2000 repealed established the Occupational Therapy Practice Act and was substantially similar to SB 1287 (Murray) of 1999.
SB 1287 (Murray) of 1999 would have established the Occupational Therapy Practice Act. NOTE: This bill was vetoed by Governor Davis because the anticipated revenue would have been insufficient to repay the loan in the allotted time.
AB 1100 (Egeland), Chapter 836, Statutes of 1977 established a title protection requirement, which prohibited the use of titles such as “occupational therapist” or “O.T.” without meeting the requirements specified by regulations of the state Department of Health Services.
Arguments in Support:
The co-sponsors of this bill, the Occupational Therapy Association of California (OTAC) and the American Occupational Therapy Association (AOTA) write in support, "[this bill] would update the Occupational Therapy Practice Act to reflect the maturing practice of occupational therapy, changing patient needs which have become more diverse, and healthcare reform which has changed and broadened the services provided by occupational therapy. This evolution in healthcare and occupational therapy services has resulted in the need to update the Occupational Therapy Practice Act."
Arguments in Opposition:
None on file.
POLICY ISSUE FOR CONSIDERATION:
Practice vs. Profession. This bill replaces the term "practice" with "profession" where the term "practice" is used as a noun. This is inconsistent with the other practice acts and may narrow the scope of the state's regulation of occupational therapy. In general, the term "profession" means occupations or vocations that involve the use of specialized skills and knowledge requiring specific training, education, or experience. The term "practice" means the application or use of the specialized skills and knowledge, whether as part of a profession or otherwise.
For example, it is not the "profession of occupational therapy" itself that affects the health, safety, and welfare of the public. Rather, it is the risk of harms resulting from the unqualified practice of occupational therapy by the profession and others, including non-professionals and unlicensed practitioners.
Further, it is unclear that the "profession of occupational therapy" should to be the sole subject of state regulation and control, as state licensing schemes often involve regulation of much more than the profession itself, including OT and OTA students and applicants, education and test providers, health plans, health facilities, and other licensees authorized to practice occupational therapy. Therefore, the use of profession in place of practice may not achieve the goals of state regulation of occupational therapy.
IMPLEMENTATION ISSUES:
Definitions vs. Descriptions. This bill revises the definition of "occupational therapy" by adding and amending the descriptions of various aspects of occupational therapy, including codifying the declaration that occupational therapy promotes mental health in people with, or who are at risk of, mental health disorders. In general, practice act definitions can help delineate specific services or actions that make up a practitioners scope of practice. In contrast, broad, open-ended descriptions may raise more questions. While the current practice act language is similarly descriptive, it is unclear how the changes may impact the scope of practice for OTs and OTAs.
For example, BPC § 2570.2(i) defines “occupational therapy services” as the services of an OT or an OTA under the appropriate supervision of an occupational therapist. At the same time, the current definition of "practice of occupational therapy" under BPC § 2570.2(k) refers to "occupational therapy services" as encompassing "occupational therapy assessment, treatment, education of, and consultation with, individuals who have been referred for occupational therapy services subsequent to diagnosis of disease or disorder (or who are receiving occupational therapy services as part of an Individualized Education Plan (IEP) pursuant to the federal Individuals with Disabilities Education Act (IDEA))."
Given that there is a specific definition for "occupational therapy services," it is not clear whether the reference to "occupational therapy services" under the "practice of occupational therapy" is a general explanation with no legal effect or whether it actually limits the provision of occupational therapy services to one of two categories of patients or clients: (1) those "who have been referred… subsequent to diagnosis of disease or disorder" or (2) those "who are receiving occupational therapy services as part of an [IEP]."
The ambiguity of this specific provision was debated by the CBOT's Legislative and Regulatory Affairs Committee on November 4, 2011, under Agenda Item E. "Discussion regarding whether the Occupational Therapy Practice Act requires a physician's referral for services."
The CBOT Committee reviewed BPC § 2570.2(k) and raised several, including:
(1) The language does not state "physician's referral" or "medical diagnosis";
(2) "Referral" might not mean a specific referral or order for services;
(3) "Physician's referral" may have been left out because healthcare providers other than a physician may refer someone for occupational therapy services, such as if a social worker refers a client for home modifications or an optometrist refers a patient to an OT for low vision issues;
(4) The New York Occupational Therapy Practice Act was amended to omit the word "referral" altogether; and
(5) Requiring a physician referral could be an obstacle to care in some cases.
Ultimately, the CBOT Committee decided that, even though a referral may be required, the Committee would make no recommendation to the full board on requiring a physician's referral. On December 1, 2011, the CBOT Committee reported to the full board that the existing language was acceptable and the CBOT accepted the report.
This bill deletes the reference to referral and IEPs. It also adds a second non-definitional reference to "occupational therapy services," describing the services as being provided for habilitation, rehabilitation, and the promotion of health and wellness to those who have, or are at risk of developing, health conditions that limit activity or cause participation restrictions.
If this bill passes this Committee, the author may wish to consider clarifying the effect of deleting the reference to referrals, IEPs, and other descriptive terms. The author may also wish to consider distinguishing definitions from descriptions and declarations. One option might be consolidating the descriptions of defined terms with the definition or breaking up the definition of "occupational therapy" into discrete terms. For example, separating out terms like "occupational therapy assessment" and "occupational therapy techniques" into their own subdivisions could help clarify whether one reference relates to another.
Doctorate of Occupational Therapy (OTD) Degree. At the CBOT's request, the last sunset review bill, AB 1706 (Low), Chapter 454, Statutes of 2017, authorized licensees who have earned an OTD to use the title "Dr." or "Doctor" under specified conditions, including requiring written communications to also clarify the type of doctoral degree by listing the degree after the licensee's name.
This bill deletes most of the new provisions, instead adding "O.T.D." to the list of protected titles. However, "O.T.D." is no longer spelled out. If this bill passes as written, it would be unclear from the practice act what "O.T.D." stands for. Further, this bill adds the title "O.T.D." to the list of titles that a licensed OT may use, but it does not specify which licensed OTs may use it. If this bill passes this committee, the author may wish to clarify these issues.
REGISTERED SUPPORT:
American Occupational Therapy Association (co-sponsor)
Occupational Therapy Association of California (co-sponsor)
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301
Discussed in Hearing
1MIN
Assembly Floor
1MIN
Senate Floor
4MIN
Senate Standing Committee on Business, Professions and Economic Development
1MIN
Assembly Floor
6MIN
Assembly Standing Committee on Business and Professions
Bill Author
Bill Co-Author(s):