Florida Administrative Code
64 - DEPARTMENT OF HEALTH
64B11 - Board of Occupational Therapy
Chapter 64B11-4 - OCCUPATIONAL THERAPY BOARD - STANDARDS OF PRACTICE
Section 64B11-4.001 - Use of Prescription Devices
Universal Citation: FL Admin Code R 64B11-4.001
Current through Reg. 50, No. 187; September 24, 2024
(1) Electrical Stimulation Device.
(a) Use of an
electrical stimulation device for which a prescription is required by Federal
law, 21 C.F.R. §801.109, is expressly prohibited by Section
468.203(4),
F.S., except by an occupational therapist or an occupational therapy assistant
who has received training as prescribed in this rule.
(b) For purposes of this rule, an "electrical
stimulation device" is any device for which a prescription is required which
employs transcutaneous electric current (direct, alternating, or pulsatile) for
therapeutic purposes.
(c) The
training required for students, postgraduates, and licensees to qualify for the
use of an electrical stimulation device shall include didactic training of at
least four (4) hours and performance of at least five (5) treatments under
supervision in a clinical setting. The required training may be obtained
through educational programs, workshops, or seminars offered at a college or
university approved for training of occupational therapists by the American
Occupational Therapy Association or of physical therapists by the American
Physical Therapy Association or at clinical facilities affiliated with such
accredited colleges or universities or through educational programs offered by
the American Society of Hand Therapists or Florida Occupational Therapy
Association. Didactic training may be in person or from interactive, real-time
courses. An interactive, real-time course may be a web-based, satellite
transmitted, or video conference, or online instruction program that allows or
requires the licensee to interact in real time, including live chat, with the
instructor during the presentation of the program.
(d) Supervised treatment sessions shall be
conducted under the personal supervision of licensed occupational therapists
and occupational therapy assistants who have completed four hours of coursework
in the use of electrical stimulation devices and five (5) supervised treatments
or licensed physical therapists and physical therapist assistants trained in
the use of electrical stimulation devices. Treatment supervisors must have a
minimum of 24 months prior experience in the use of electrical stimulation
devices. Personal supervision means that the supervisor is in the room with the
trainees and actively provides guidance and supervision of the performance
treatments.
(e) The training
provided which teaches the therapeutic uses of electrical stimulation devices
shall provide for the following minimum competency level:
1. Standards.
a. The expected outcome of treatments with
Therapeutic Electrical Current (hereinafter T.E.C.) must be consistent with the
goals of treatment.
b. Treatment
with T.E.C. must be safe, administered to the correct area, and be of proper
dosage.
c. Treatment with T.E.C.
must be adequately documented.
2. Current Duration and Mode.
a. Ability to determine the duration and mode
of current appropriate to the patient's neurophysiological status while
understanding Ohm's Law of electricity, physical laws related to the passage of
current through various media, as well as impedance.
b. Ability to describe normal
electrophysiology of nerve and muscle; understanding generation of
bioelectrical signals in nerve and muscle; recruitment of motor units in normal
muscle and in response to a variety of external stimuli.
c. Ability to describe normal and abnormal
tissue responses to external electrical stimuli while understanding the
differing responses to varieties of current duration, frequency and intensity
of stimulation.
3.
Selection of Method and Equipment.
a. Ability
to identify equipment with the capability of producing the preselected duration
and mode.
b. Ability to describe
characteristics of electrotherapeutic equipment and understanding the
therapeutic value of different electrotherapeutic equipment.
c. Ability to describe safety regulations
governing the use of electrotherapeutic equipment.
d. Ability to describe principles of
electrical currents.
e. Ability to
describe requirements/idiosyncrasies of body areas and pathological conditions
with respect to electrotherapeutic treatment.
4. Preparation of Treatment.
Ability to prepare the patient for treatment through positioning and adequate instructions.
5. Treatment Administration.
a. Ability to correctly operate equipment and
appropriately adjust the intensity and current while understanding rate of
stimulation, identification of motor points, and physiological effects
desired.
b. Ability to adjust the
intensity and rate to achieve the optimal response, based on the pertinent
evaluative data.
6.
Documentation of Treatments.
Ability to document treatment including immediate and long-term effects of therapeutic electrical current.
(f) Any occupational therapist or
occupational therapy assistant who uses such electrical stimulation device
shall, upon request of the Board, or the Department, present proof that he or
she has obtained the training required by this rule.
(2) Ultrasound Device.
(a) Use of an ultrasound device for which a
prescription is required by Federal law, 21 C.F.R. §801.109, is expressly
prohibited by Section
468.203(4),
F.S., except by an occupational therapist or occupational therapy assistant who
has received training as prescribed in this rule.
(b) For purposes of this rule, an "ultrasound
device" is any device intended to generate and emit ultrasonic radiation for
therapeutic purposes at ultrasonic frequencies above 100 kilohertz
(kHz).
(c) The training required
for students, postgraduates, and licensees to qualify for the use of an
ultrasonic stimulation device shall include didactic training of at least four
(4) hours and performance of at least five (5) treatments under supervision in
a clinical setting. The required training may be obtained through educational
programs, workshops, or seminars offered at a college or university approved
for training of occupational therapists by the American Occupational Therapy
Association or of physical therapists by the American Physical Therapy
Association or at clinical facilities affiliated with such accredited colleges
or universities or educational programs offered through the American Society of
Hand Therapists or Florida Occupational Therapy Association. Didactic training
may be in person or from interactive, real-time courses. An interactive,
real-time course may be a web-based, satellite transmitted, or video
conference, or online instruction program that allows or requires the licensee
to interact in real time, including live chat, with the instructor during the
presentation of the program.
(d)
Supervised treatment sessions shall be conducted under the personal supervision
of licensed occupational therapists and occupational therapy assistants who
have completed four hours of coursework in the use of ultrasound devices and
five (5) supervised treatments or licensed physical therapists and physical
therapist assistants trained in the use of ultrasound devices. Treatment
supervisors must have a minimum of 24 months prior experience in the use of
ultrasound devices. Personal supervision means that the supervisor is in the
room with the trainees and actively provides guidance and supervision of the
performance treatments.
(e) The
training provided which teaches the therapeutic uses of ultrasound devices
shall provide for the following minimum competency level:
1. Standards.
a. The expected outcome of treatment with
ultrasound must be consistent with the goals of treatment.
b. Treatment with ultrasound must be safely
administered to the correct area, and be of proper dosage.
c. Treatment with ultrasound must be
adequately documented.
2.
Instrumentation.
a. Ability to describe the
physiological effects of pulsed versus continuous modes as well as
differentiate tissue responses to the modes of application.
b. Ability to describe ultrasound absorption
characteristics of various body tissues and identify sources and causes of
excessive absorption in normal versus abnormal tissue.
c. Ability to determine the medium to be used
and the temperature of that medium.
d. Ability to select the appropriate sound
head size and contour considering the area and condition being
treated.
e. Ability to describe
equipment characteristics, indications and contraindications for treatment,
including identifying source and mechanisms of generation of ultrasound energy
and its transmission through air and physical matter.
3. Preparation for Treatment. Ability to
prepare the patient for treatment through positioning and adequate
instruction.
4. Determination of
Dosage. Ability to determine dosage through determination of target depth,
chronicity versus acuteness of the condition, and application of power/dosage
calculation rules.
5. Treatment
Administration. Ability to administer treatment through identification of
controls, sequence of operation, correct sound head application techniques and
application of all safety rules and precautions.
6. Documentation of Treatment. Ability to
document treatment, including immediate and long-term effects of clinical
ultrasound.
(f) Any
occupational therapist or occupational therapy assistant who uses such
ultrasound device shall, upon request of the Board, or the Department, present
proof that he or she has obtained the training required by this
rule.
(3) Neurofeedback Device.
(a) Use of a neurofeedback device for
which a prescription is required by Federal law, 21 C.F.R. §801.109, is
expressly prohibited by Section
468.203(4),
F.S., except by an occupational therapist or occupational therapy assistant who
has received training as prescribed in this rule.
(b) For purposes of this rule, a
"neurofeedback device" is any device that provides immediate feedback from a
computer-based program that measures brainwave activity with the use of sound,
visual and/or tactile input to cue the brain to reorganize and retrain
itself.
(c) The training required
for students, postgraduates, and licensees to qualify for the use of a
neurofeedback device shall include didactic training of at least sixteen (16)
hours and performance of at least five (5) treatments under supervision in a
clinical setting. The required training may be obtained through educational
programs, workshops, or seminars offered at a college or university approved
for training of occupational therapists by the American Occupational Therapy
Association or of physical therapists by the American Physical Therapy
Association or at clinical facilities affiliated with such accredited colleges
or universities or educational programs offered through the American Society of
Hand Therapists or Florida Occupational Therapy Association. Didactic training
may be in person or from interactive, real-time courses. An interactive,
real-time course may be a web-based, satellite transmitted, or video
conference, or online instruction program that allows or requires the licensee
to interact in real time, including live chat, with the instructor during the
presentation of the program.
(d)
Supervised treatment sessions shall be conducted under the personal supervision
of licensed occupational therapists and occupational therapy assistants who
have completed sixteen (16) hours of coursework in the use of neurofeedback
devices and five (5) supervised treatments, licensed physical therapists and
physical therapist assistants who have completed sixteen(16) hours of
coursework in the use of neurofeedback devices and five (5) supervised
treatments, medical doctors trained in the use of neurofeedback devices,
psychologists trained in the use of neurofeedback devices, or other licensed
healthcare professionals trained in the use of neurofeedback devices. Treatment
supervisors must have a minimum of 24 months prior experience in the use of
neurofeedback devices. Personal supervision means that the supervisor is in the
room with the trainees and actively provides guidance and supervision of the
performance treatments.
(e) The
training provided which teaches the therapeutic uses of neurofeedback devices
shall provide for the following minimum competency level:
1. Standards.
a. The expected outcome of training with
neurofeedback devices must be consistent with the goals of treatment.
b. Training with neurofeedback devices must
be safely administered to the scalp.
c. Training with neurofeedback devices must
be adequately documented.
2. Instrumentation.
a. Ability to describe core concepts,
methods, and instrumentation of neurofeedback.
b. Ability to interpret the EEG
(electroencephalogram) with respect to signal integrity and the presence of
artifacts.
c. Ability to understand
and describe concepts of frequency and amplitude.
d. Ability to create, adjust and adapt
training protocols based on the EEG, clinical observation, and response to
training.
e. Ability to describe
equipment characteristics, indications and contraindications for
training.
3. Preparation
for Training. Ability to prepare the patient for training through positioning
and adequate instruction.
4.
Determination of training duration and intensity.
a. Ability to discern when a trainee exhibits
limited tolerance for an extended training session.
b. Ability to judge the pacing of training
sessions based on tolerance and response to the training
session.
5. Training
Administration. Ability to administer neurofeedback training through
identification of controls, sequence of operation, and application of all
safety rules and precautions.
6.
Documentation of Neurofeedback Training. Ability to document training,
including immediate and long-term effects of clinical neurofeedback
training.
(f) Any
occupational therapist or occupational therapy assistant who uses such
neurofeedback device shall, upon request of the Board, or the Department,
present proof that he or she has obtained the training required by this
rule.
(g) This rule shall be
reviewed, and if necessary, repealed, modified, or renewed through the
rulemaking process five years from the effective
date.
Rulemaking Authority 468.203(4), 468.204 FS. Law Implemented 468.203(4) FS.
New 1-1-88, Formerly 21M-15.001, 61F6-15.001, Amended 12-4-95, Formerly 59R-63.001, Amended 8-9-99, 7-2-00, 4-1-13, 9-2-20, 1-16-23, 10-1-23.
Disclaimer: These regulations may not be the most recent version. Florida may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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