Current through Register Vol. 50, No. 9, September 20, 2024
A. The rules of this Section, together with
those specified in
§4915 and §4919, govern supervision of
an occupational therapy assistant by a supervising occupational therapist in
any clinical setting.
B. An
occupational therapy assistant may assist in implementation of a client program
plan in consultation with and under the supervision of an occupational
therapist. Such supervision shall not be construed in every case to require the
continuous physical presence of the supervising occupational therapist
provided, however, that the supervising occupational therapist and the
occupational therapy assistant must have the capability to be in contact with
each other by telephone or other telecommunication which allows for
simultaneous interactive discussion between the supervising occupational
therapist and occupational therapy assistant. Supervision shall exist when the
occupational therapist responsible for the client gives informed concurrence of
the actions of the occupational therapy assistant and adheres to all
requirements set forth in this Chapter.
C. Prior to Implementation of Program Plan.
Prior to the administration of occupational therapy by an occupational therapy
assistant, the supervising occupational therapist shall, in accordance with
AOTA standards of practice as may from time to time be amended:
1. perform an evaluation;
2. identify and establish occupational
therapy needs, goals and an individual program plan;
3. ensure that the documents created pursuant
to §4925.
C.1 and
§4925. C.2 are made
part of the client's record and accessible to the occupational therapy
assistant prior to his or her the first treatment session with the client;
and
4. be available for a client
care conference.
D.
Throughout the Duration of Program Plan. Following implementation and
throughout the duration of the program plan:
1. a supervising occupational therapist shall
periodically and systematically re-evaluate the appropriateness of all services
delivered. Such information shall be documented in the client's record, which
shall be made available to the occupational therapy assistant. The supervising
occupational therapist preparing such revisions shall communicate any critical
aspect or significant change in the program plan to the occupational therapy
assistant by means of a client care conference prior to the occupational
therapy assistant's next treatment session with the client;
2. at all times during which an occupational
therapy assistant assists in program plan implementation, the supervising
occupational therapist shall be immediately accessible for a client care
conference; and
3. an occupational
therapy assistant shall not administer occupational therapy to any client whose
physical, cognitive, functional or mental status differs substantially from
that identified by the supervising occupational therapist's individual program
plan in the absence of re-evaluation by, or an immediate prior client care
conference with, the supervising occupational therapist.
E. In addition to the terms and conditions
specified in
§4919 and
§4925 A-D, the following additional
requirements are applicable to an occupational therapy assistant's
administration of occupational therapy under the supervision of an occupational
therapist.
1. In any clinical setting, other
than specified by
§4925. E 3:
a. an occupational therapy assistant with
less than one year of practice experience:
i.
shall receive close client care supervision in each clinical setting for not
less than one of every four, or 25+ percent, of those clients to whom he or she
has administered occupational therapy during an average weekly case
load;
ii. in addition, a client
care conference shall be held with respect to each client to whom the
occupational therapy assistant administers occupational therapy;
b. an occupational therapy
assistant with more than one but less than two years of practice experience:
i. shall receive close client care
supervision in each clinical setting for not less than one of every 10, or 10
percent, of those clients seen during an average weekly case load;
ii. in addition, a client care conference
shall be held with respect to each client to whom the occupational therapy
assistant administers occupational therapy;
c. an occupational therapy assistant with
more than two years of practice experience:
i.
shall receive a client care conference with respect to each client to whom the
occupational therapy assistant administers occupational therapy.
2. School System,
Long-Term Psychiatric and Nursing Home Facility Settings. In addition to the
requirements prescribed in
§4925. E 1, clients in
school system, long-term psychiatric or nursing home facility settings shall be
re-evaluated or treated by the supervising occupational therapist not less
frequently than the earlier of once a month or every sixth treatment session.
3. Home Health Setting. The terms
and conditions prescribed by
§4925. E.1 shall not be
applicable to a home health setting. An occupational therapy assistant may
assist in implementation of a client program plan in a home health setting
under the supervision of an occupational therapist provided all the following
terms, conditions and restrictions of this Chapter, except
§4925. E 1, are
strictly observed:
a. an occupational therapy
assistant shall have had not less than two years practice experience in
providing occupational therapy prior to administering occupational therapy in a
home health environment;
b. each
client in a home health setting to whom an occupational therapy assistant
administers occupational therapy shall be re-evaluated or treated by the
supervising occupational therapist not less frequently than the earlier of once
every two weeks or every sixth treatment session; and
c. a face-to-face client care conference
shall occur not less frequently than once every two weeks to discuss all
clients to whom the occupational therapy assistant has administered
occupational therapy in a home health setting. Such conference shall be
documented by the supervising occupational therapist in a supervisory log and
maintained by or at the home health entity.
4. Early Intervention Setting. The terms and
conditions prescribed by
§4925. E.1 shall not be
applicable to an early intervention setting. An occupational therapy assistant
may assist in implementation of a client program plan in an early intervention
setting under the supervision of an occupational therapist provided all the
following terms, conditions and restrictions of this Chapter, except
§4925. E 1, are
strictly observed:
a. an occupational therapy
assistant shall have had not less than two years practice experience in
providing occupational therapy prior to administering occupational therapy in
an early intervention setting;
b.
each client in an early intervention setting to whom an occupational therapy
assistant administers occupational therapy shall be re-evaluated or treated by
the supervising occupational therapist not less frequently than the earlier of
once a month or every sixth treatment session; and
c. a client care conference shall occur not
less frequently than the earlier of once every month or every sixth treatment
session to discuss all clients to whom the occupational therapy assistant has
administered occupational therapy in an early intervention setting. Such
conference shall be documented and maintained by the supervising occupational
therapist in a supervisory log.
F. Mutual Obligations and Responsibilities. A
supervising occupational therapist and occupational therapy assistant shall
bear equal reciprocal obligations to insure strict compliance with the
obligations, responsibilities and provisions set forth in this
Chapter.
G. The administration of
occupational therapy other than in accordance with the provisions of this
Section and
§4919 shall be deemed a violation of
these rules, subjecting the occupational therapist and/or an occupational
therapy assistant to suspension or revocation of licensure pursuant to
§4921. B 18.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
37:3001-3014 and
37:1270.B.(6).
