Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: The amendment removes the requirement that
occupational therapists be licensed for one (1) year prior to providing
supervision. This will allow for more employment opportunities, especially in
rural settings.
(1) An
occupational therapy assistant and/or occupational therapy assistant limited
permit holder shall assist an occupational therapist in the delivery of
occupational therapy services in compliance with all state and federal
statutes, regulations, and rules.
(2) The occupational therapy assistant or
occupational therapy assistant limited permit holder may only perform services
under the direct supervision of an occupational therapist.
(A) The manner of supervision shall depend on
the treatment setting, patient/client caseload, and the competency of the
occupational therapy assistant and/or occupational therapy assistant limited
permit holder as determined by the supervising occupational therapist. At a
minimum, supervision shall include consultation of the occupational therapy
assistant and/or occupational therapy assistant limited permit holder with the
supervising occupational therapist prior to the initiation of any
patient's/client's treatment plan and modification of treatment plan.
(B) More frequent face-to-face supervision
may be necessary as determined by the occupational therapist or occupational
therapy assistant and/or occupational therapy assistant limited permit holder
dependent on the level of expertise displayed by the occupational therapy
assistant and/or occupational therapy assistant limited permit holder, the
practice setting, and/or the complexity of the patient/client
caseload.
(C) Supervision shall be
an interactive process between the occupational therapist and occupational
therapy assistant and/or occupational therapy assistant limited permit holder.
It shall be more than peer review or co-signature. The interactive process
shall include but is not limited to the patient/client assessment,
reassessment, treatment plan, intervention, discontinuation of intervention,
and/or treatment plan.
(D) The
supervising occupational therapist or the supervisor's designee must be
available for immediate consultation with the occupational therapy assistant
and/or occupational therapy assistant limited permit holder. The supervisor
need not be physically present or on the premises at all times.
(3) The supervising occupational
therapist has the overall responsibility for providing the necessary
supervision to protect the health and welfare of the patient/client receiving
treatment from an occupational therapy assistant and/or occupational therapy
assistant limited permit holder. The supervising occupational therapist shall-
(A) Be licensed by the board as an
occupational therapist;
(B) Not be
licensed as a limited permit holder;
(C) Not be under restriction or discipline
from any licensing board or jurisdiction;
(D) Not have more than four (4) full-time
equivalent (FTE) occupational therapy assistants under his/her supervision at
one time;
(E) Be responsible for
all referrals of the patient/client;
(F) Be responsible for completing the
patient's evaluation/assessment. The occupational therapy assistant and/or
occupational therapy assistant limited permit holder may contribute to the
screening and/or evaluation process by gathering data, administering
standardized tests and reporting observations. The occupational therapy
assistant and/or occupational therapy assistant limited permit holder may not
evaluate independently or initiate treatment before the supervising
occupational therapist's evaluation/assessment;
(G) Be responsible for developing and
modifying the patient's treatment plan. The treatment plan must include goals,
interventions, frequency, and duration of treatment. The occupational therapy
assistant and/or occupational therapy assistant limited permit holder may
contribute to the preparation, implementation and documentation of the
treatment plan. The supervising occupational therapist shall be responsible for
the outcome of the treatment plan and assigning of appropriate intervention
plans to the occupational therapy assistant and/or occupational therapy
assistant limited permit holder within the competency level of the occupational
therapy assistant and/or occupational therapy assistant limited permit
holder;
(H) Be responsible for
developing the patient's discharge plan. The occupational therapy assistant
and/or occupational therapy assistant limited permit holder may contribute to
the preparation, implementation and documentation of the discharge plan. The
supervising occupational therapist shall be responsible for the outcome of the
discharge plan and assigning of appropriate tasks to the occupational therapy
assistant and/or occupational therapy assistant limited permit holder within
the competency level of the occupational therapy assistant and/or occupational
therapy assistant limited permit holder; and
(I) Ensure that all patient/client
documentation becomes a part of the permanent record.
(4) The supervising occupational therapist
has the overall responsibility for providing the necessary supervision to
protect the health and welfare of the patient/client receiving treatment from
an occupational therapy assistant and/or occupational therapy assistant limited
permit holder. However, this does not absolve the occupational therapy
assistant and/or occupational therapy assistant limited permit holder from
his/her professional responsibilities. The occupational therapy assistant
and/or occupational therapy assistant limited permit holder shall exercise
sound judgement and provide adequate care in the performance of duties. The
occupational therapy assistant and/or occupational therapy assistant limited
permit holder shall-
(A) Not initiate any
patient/client treatment program or modification of said program until the
supervising occupational therapist has evaluated, established a treatment plan
and consulted with the occupational therapy assistant and/or occupational
therapy assistant limited permit holder;
(B) Not perform an evaluation/assessment, but
may contribute to the screening and/or evaluation process by gathering data,
administering standardized tests and reporting observations;
(C) Not analyze or interpret evaluation
data;
(D) Track the need for
reassessment and report changes in status that might warrant reassessment or
referral;
(E) Immediately suspend
any treatment intervention that appears harmful to the patient/client and
immediately notify the supervising occupational therapist; and
(F) Ensure that all patient/client
documentation prepared by the occupational therapy assistant and/or
occupational therapy assistant limited permit holder becomes a part of the
permanent record.
(5)
The supervisor shall ensure that the occupational therapy assistant and/or
occupational therapy assistant limited permit holder provides occupational
therapy as defined in section
324.050,
RSMo appropriate to and consistent with his/her education, training, and
experience.
*Original authority: 324.050, RSMo 1997, amended 1999;
324.056, RSMo 1997, amended 1999; 324.065, RSMo 1997; and 324.086, RSMo 1997,
amended 1999, 2001.
