Current through Register Vol. 42, No. 5, February 29, 2024
(1) "Occupational therapy assistant" means a person licensed to assist in the practices of occupational therapy under the supervision of or with the consultation of a licensed occupational therapist whose license is in good standing.
(2) "Supervision" means a collaborative process for the responsible periodic review and inspection of all aspects of occupational therapy services. Responsibility of supervision is shared between the supervising occupational therapist(s) and the occupational therapy assistant(s) and/or all unlicensed personnel involved with the provision of occupational therapy services, including aides and students.
(3) An occupational therapist may assign an increased level of supervision if necessary for the safety of a patient or client. The levels of supervision are:
(a) Direct Supervision: the supervising occupational therapist is in the immediate area of the occupational therapy assistant while performing supportive services.
(b) Close Supervision: the supervising occupational therapist provides initial direction to the occupational therapy assistant and daily contact while on the premises.
(c) General Supervision: the supervising occupational therapist has face-to-face contact with the occupational therapy assistant at least once every 30-calendar days, with the supervising occupational therapist available by telephone, electronic, or written communication.
(4) Supervision Ratios:
(a) An occupational therapist may supervise up to three (3) full-time occupational therapy assistants, but never more than two (2) occupational therapy assistants who require "direct" level of supervision. The total number of supervised occupational therapy assistants, occupational therapy personnel on a limited permit, and non-licensed occupational therapy personnel (including any occupational therapy students, occupational therapy assistant students, licensee applicants required to perform a perceptorship, and/or aides) may not exceed five (5) without prior Board approval. The Board may permit the supervision of a greater number by an occupational therapist if, in the Board's opinion, there would be adequate supervision to protect public health and safety.
(5) Only a licensed occupational therapist shall:
(a) Prepare an initial treatment plan, initiate or reevaluate a client or patient's treatment plan, or authorize in writing a change of a treatment plan;
(b) Delegate duties to a licensed occupational therapy assistant, designate an assistant's duties and assign a level of supervision; and
(c) Authorize a patient discharge
(6) A licensed occupational therapy assistant shall not:
(a) Evaluate or develop a treatment plan independently;
(b) Initiate a treatment plan before a client or patient is evaluated and a treatment plan is prepared by an occupational therapist;
(c) Continue a treatment procedure appearing harmful to a patient or client until the procedure is reevaluated by an occupational therapist; or
(d) Continue or discontinue occupational therapy services unless the treatment plan is approved or re-approved by a supervising occupational therapist.
(7) A supervising occupational therapist shall supervise a licensed occupational therapy assistant as follows:
(a) Supervision should be "Direct" if the occupational therapy assistant has less than 12-months work experience.
(b) Supervision should be "Close" if the occupational therapy assistant has more than 12 months but less than 24 months of experience.
(c) Supervision should be at least "General" if an occupational therapy assistant has more than 24 months of experience.
(d) For occupational therapy assistants employed by state agencies and those employed by public schools and colleges of this state who provide screening and rehabilitation services for the educationally related needs of the student, the "Direct" and "close" supervision mandate based on work experience does not apply. In these instances, supervision should be at least "General".
(e) The following levels of supervision are minimal. An occupational therapist must assign an increased level of supervision if the occupational therapy assistant is new to a practice setting or particular skill. An occupational therapist must assign an increased level of supervision if necessary for the safety of a patient or client.
(8) This rule shall be effective September 1, 2013.
Author: Alabama State Board of Occupational Therapy
Statutory Authority:
Code of Ala. 1975, §§
34-39-3, 34-39-11.
