Code of Massachusetts Regulations
259 CMR - BOARD OF REGISTRATION OF ALLIED HEALTH PROFESSIONALS
Title 259 CMR 3.00 - Occupational therapists
Section 3.02 - Occupational Therapy Service Delivery Process

Universal Citation: 259 MA Code of Regs 259.3

Current through Register 1531, September 27, 2024

(1) Responsibility of the Occupational Therapist.

(a) Responsible for all aspects of occupational therapy service delivery, including Screening, Evaluation and reevaluation and is accountable for the safety and effectiveness of the Occupational Therapy Service Delivery Process.

(b) Must be directly involved in the delivery of services during the Screening, initial Evaluation, reevaluation, and regularly throughout the course of intervention, including discharge/outcome Evaluation.

(c) Responsible for determining when to delegate to other occupational therapy personnel. When delegating aspects of occupational therapy services, the occupational therapist considers the following factors
1. The complexity of the Client's condition.

2. The knowledge, skill and competence of the occupational therapy practitioner and/or the Occupational Therapy Aide.

3. The nature and complexity of the intervention.

4. The needs and requirements of the practice setting.

(d) Assumes primary responsibility for obtaining informed consent from the Client for occupational therapy services to be provided.

(e) Provides appropriate and required supervision (see 259 CMR 3.05) to other occupational therapy personnel, including occupational therapy assistant, occupational therapy student or occupational therapy assistant student and Occupational Therapy Aide.

(f) Assumes responsibility for communicating results of Evaluation, goals, and Intervention Plan to the Client with recommendations about occupational therapy services to be provided.

(g) Initiates and directs the Screening process, analyzes and interprets the data in accordance with applicable laws, other regulatory requirements and AOTA documents.

(h) Initiates and directs the Evaluation process, analyzes and interprets the data in accordance with applicable laws, other regulatory requirements, and AOTA documents.
1. Uses current Assessments and Assessment procedures and follows defined protocols of standardized Assessments.

2. Uses best evidence to inform intervention.

3. Directs all aspects of the initial contact during the occupational therapy Evaluation, including:
a. Determining the need for service (Screening).

b. Determining the Client's goals and priorities based on collaborative discussion with the Client.

c. Establishing intervention priorities.

d. Determining specific needs for further Assessment.

e. Determining specific Assessment tasks that can be delegated to the occupational therapy assistant.

4. Interpret Evaluation data, including information provided by the occupational therapy assistant, occupational therapy student, or occupational therapy assistant student.

(i) Assumes primary responsibility for the development of the occupational therapy Intervention Plan based on the initial Evaluation, including long and short term goals, expected frequency, and duration.

Identifies and documents precautions, contraindications, anticipated progress, and plans for reevaluation on a regular basis or as required by payors and other regulatory bodies.

(j) Assumes primary responsibility for the intervention process.
1. Assumes responsibility for providing appropriate supervision to the occupational therapy assistant when delegating aspects of the occupational therapy intervention.

2. Determines the need for continuing, modifying or discontinuing occupational therapy services in consultation with the Client.

3. Designates or establishes channels of written and/or oral communication with all other care providers, regarding Client's status.

4. Recommends additional consultations or refers Clients to appropriate resources when the needs of the Client can best be served by the expertise of other professionals or services.

(k) Assumes primary responsibility for selecting, measuring and interpreting discharge data/outcomes.
1. Prepares and implements a transition or discontinuation plan based on the Client's needs, goals, performance, and appropriate follow-up resources.

2. Directs responsibility for the contents of the discharge Evaluation/summary.

3. Makes necessary referrals to other professionals or facilities.

(2) Responsibility of Occupational Therapy Assistants.

(a) Occupational therapy assistants may contribute to the Screening process by collecting data with Service Competency and shall communicate the information gathered to the supervising occupational therapist.

(b) Occupational therapy assistants may contribute to the Evaluation process by collecting data and administering specific Assessments, with Service Competency, and shall communicate the information gathered to the supervising occupational therapist.

(c) Occupational therapy assistants may not interpret data beyond the scope of their occupational therapy assistant education or current Service Competency.

(d) Occupational therapy assistants may not initiate or alter an Intervention Plan without prior Evaluation by and approval of the supervising occupational therapist.

(e) Occupational therapy assistants may, with prior documented approval of the supervising occupational therapist, adjust a specific intervention procedure in accordance with changes in Client status.

(f) Occupational therapy assistants may respond to inquiries regarding Client status to appropriate parties within the protocol established by the supervising occupational therapist.

(g) Occupational therapy assistants shall refer inquiries regarding Client prognosis to a supervising occupational therapist.

(3) Responsibility of Occupational Therapy Aides. Occupational Therapy Aides may not act as the primary service provider. Activities which may be performed under the direct supervision of the occupational therapist or occupational therapy assistant by Occupational Therapy Aides are restricted to the following activities:

(a) Follow-up of routine specific exercises.

(b) Application of superficial heat and cold.

(c) Non-intervention related services, including clerical, maintaining supplies and equipment, transporting Clients, and preparing for interventions.

An occupational therapist or occupational therapist assistant must provide direct supervision to an occupational therapy aide performing activities listed in 259 CMR 3.02(6)(a), (b) and (c).

Disclaimer: These regulations may not be the most recent version. Massachusetts 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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