News and Announcements for the North Carolina Occupational Therapy Board

November 18, 2024

Executive Order 318/Hurricane Helene

 The Board met November 18, 2024 and agreed it will, on a case-by-case basis, allow OT practitioners in good standing in other states and recently retired OT practitioners to provide OT services in disaster declared counties during the Governor’s state of emergency, provided the OT practitioners contact the Board and request a waiver.

November 15, 2023 - OT Compact

 OT Compact Commission Draft Rules:

 Below is a link to the OT Compact website where the draft rules for public comment are posted.  You can find the language in the blue box along with the two sets of rules.  The comment period is for 30 days from November 8 to December 8, 2023. 

 www.otcompact.org

May 6, 2020 - COVID-19 Notice Regarding Section 3 of Executive Order 130

Following a special Board meeting on April 15, 2020, the Board agreed:

1.       to allow OT practitioners licensed in other states to provide OT services in North Carolina so long as the OT practitioner completes the waiver form provided by the Board and is approved, and

 2.       to allow OT practitioners previously licensed in North Carolina, whose licenses were in    good standing and have been expired for less than four years, to provide OT services in North Carolina so long as the OT practitioner completes the waiver form provided by the Board and is approved.

If you meet either of the circumstances in 1 or 2 above, please contact the Board via email at administrator@ncbot.org and the Board will provide you with the waiver form to reenter the field.

March 19, 2020 - COVID-19 Statement from the Board concerning Board Operations

Like you, the North Carolina Board of Occupational Therapy is monitoring the outbreak of COVID-19 and its impact. The Board is committed to maintaining normal operations, and as of March 17, 2020, the Board is operating on its regular schedule. However, to protect the health of the staff, the office is not open for walk-in service, but is available for mail, email, fax and telephone services. Please monitor the Board’s website for updates on the Board’s operating status.

March 18, 2020 - COVID-19 Statement from the Board

Greetings OT Practitioners,

We hope this email reaches you in good health!

The Board has been closely monitoring the COVID-19 medical situation.  We wanted to be in touch with you about our thoughts and our accommodations to you at this time.  Please remember that our mandate from the State is to protect the public.  The Board is also required to follow its Practice Act and Rules that govern Continuing Competence Activities and renewals unless changes to the Practice Act are made by the Legislature or Rules are approved by the Rules Review Commission.

First, if you have an OT license that expires June 30, 2020, we realize that you might have paid for classes or planned to complete Continuing Competence Activities or planned to attend a conference that has now been cancelled.  Likely, for several months, classes will be cancelled pursuant to the directive of both the CDC and the Governor of NC.  We realize this puts a hardship on your ability to acquire the required classes and CCA to renew your license.  Fortunately, the Board’s Continuing Competence Rules allow for many CCA to be achieved through other means than formal continuing education courses.    

For the renewal period ending in June 30, 2020 ONLY, the Board will be allowing all OT Practitioners to renew based on the CCA you have completed.  You must still renew on time and must still enter all your CCA data into the Board’s web-based site, there is no exception to this.  Any CCA not completed, including ethics, that is necessary for your June 30, 2020 renewal will be required for your June 30, 2021 renewal in addition to your regular required CCA for your 2021 renewal.  We are making this one-time accommodation due to the extremely rare situation the world finds itself in at this time.

Secondly, many of you have written to ask if you should be seeing clients at all during this time.  This is a decision each OT Practitioner, your business or the business where you are employed must make.  We all have access to the same medical information as well as Local, State and National directives.  We will share a few links for your information below but there are many more.

The Board is concerned about COVID-19 and its effect on OT Practitioners and the public.  However, the Board does not have legal authority to tell OT Practitioners they cannot work or to tell employers to close their businesses.  The Board also does not have the legal authority to tell OT Practitioners they do not have to comply with their contracts with employers.

Employers, OT Practitioners, the Board and everyone in NC is aware of the COVID-19 Pandemic.  All should follow the advice and directives of CDC, Federal Government, North Carolina Governor Cooper and use their common sense to do whatever they can to protect themselves and others from COVID-19.  This includes OT Practitioners and their employers.

Each OT Practitioner must make the best decision for themselves and their business, taking into account all the factors mentioned above, especially your duty and the Board’s obligation to protect the public.

Here are some links that might be helpful in making your decisions.

Governor Cooper’s Executive Orders:

https://governor.nc.gov/documents/executive-orders

NCDHHS Public Health Coronavirus Task Force on COVID-19:

https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina

CDC.gov:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Duke Health:

https://www.dukehealth.org

Mayo Clinic:

https://www.mayoclinic.org

The North Carolina Board of Occupational Therapy will continue to monitor this unique situation and send further emails when there are changes that need to be communicated. 

We appreciate your continued excellence in your care of your patients, your co-workers and yourself.

Be well,

Lynn Losada, Chair

North Carolina Board of Occupational Therapy

January 1, 2020

The proposed rule changes approved by the Board at their November 2019 meeting to Rules .0801, .0804, and .0805 were approved by the Rules Review Commission in December 2019 and became effective January 1, 2020.  Please review the final changes to the rules by going to the Practice Act and Rules page on the Board’s website.

August 1, 2018

Title 21 - Occupational Licensing Boards and Commissions

Chapter 38 – BOARD OF Occupational Therapy

Proposed Effective Date:  January 1, 2020

Public Hearing:

Date:  September 16, 2019

Time:  11:00 am

Location:  Wells Fargo Capitol Center, 13th Floor Conference Room, 150 Fayetteville Street, Raleigh, NC 27601

Reason for Proposed Action:  The amendments to Rule .0801, .0804 and .0805 are being submitted to clarify continuing competence activity requirements.

Comments may be submitted to:  Charles P. Wilkins, PO Box 2280, Raleigh, NC 27602; phone (919) 832-1380; email cwilkins@bws-law.com

Comment period ends:  October 14, 2019

Procedure for Subjecting a Proposed Rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Fiscal impact. Does any rule or combination of rules in this notice create an economic impact? Check all that apply.

           State funds affected

           Local funds affected

           Substantial economic impact (>= $1,000,000)

           Approved by OSBM

           No fiscal note required

SECTION .0800 – CONTINUING COMPETENCE ACTIVITY

21 NCAC 38 .0801             CONTINUING COMPETENCE DEFINITIONS

As used in this Section:

(1)           "AOTA Approved Provider Program" refers to a voluntary process of review and approval of continuing education (CE) providers by the American Occupational Therapy Association (AOTA) based on criteria and guidelines that assess a provider's ability to develop and implement CE activities that are relevant to the practice of occupational therapy.

(2)           "Contact Hour" means a unit of measure for a continuing education activity. One contact hour equals 60 minutes in a learning activity, excluding meals and breaks. One contact hour equals one point.

(3)           "Continuing Competence" means a process in which an occupational therapist or an occupational therapy assistant develops and maintains the knowledge, performance skills, interpersonal abilities, critical reasoning skills, and ethical practice reasoning skills necessary to perform his or her occupational therapy professional responsibilities.

(4)           "Continuing Education" means structured educational experiences beyond entry-level academic degree work that are intended to provide advanced or enhanced knowledge in a particular area.

(5)           "Continuing Education Credit" means credit given for a formalized activity in the form of contact hours or continuing education units.

(6)           "Continuing Education Unit (CEU)" means a unit of measure for continuing education. One CEU is defined as 10 contact hours of participation in a learning activity excluding meals and breaks.

(7)           "Peer Reviewed" means any written work that is blind reviewed by more than one person.

(8)           "Points" means an assigned unit of measure for each continuing competence activity as defined in Rule .0805 of this Section.

History Note:        Authority G.S. 90-270.69; 90-270.75(a);

Eff. July 1, 2007;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016;

Amended Eff. January 1, 2020.

21 NCAC 38 .0804             SCOPE OF QUALIFIED ACTIVITIES FOR MAINTAINING CONTINUING COMPETENCE

(a)  To be approved by the Board, activities must be related to the licensee's current or anticipated roles and responsibilities in occupational therapy and must serve to protect the public by enhancing the licensee's continuing competence.

(b)  Subject matter for approved activities include research; theoretical or practical content related to the practice of occupational therapy; or the development, administration, supervision, and teaching of clinical practice or service delivery programs by occupational therapists or occupational therapy assistants.

History Note:        Authority G.S. 90-270.69; 90-270.75(a);

Eff. July 1, 2007;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016;

Amended Eff. January 1, 2020.

21 NCAC 38 .0805             QUALIFIED ACTIVITIES FOR MAINTAINING CONTINUING COMPETENCE

Activities that qualify for maintaining continuing competence are:

(1)           Continuing Education:

(a)           Includes attendance and participation at a live presentation such as a workshop, seminar, conference, or in-service educational program. May also include participation in other continuing education activities that require a formal assessment of learning. Examples include electronic or Web-based courses, AOTA Self-Paced Clinical Courses or other formalized self-study courses, or AOTA Continuing Education Articles;

(b)           A licensee may earn one point for each contact hour or equivalent unit that is awarded by the provider. There are no maximum points in this category; and

(c)           Documentation shall include a certificate of completion or similar documentation including name of course, date, author/instructor, sponsoring organization, location, and number of hours attended.

(2)           Academic Coursework:

(a)           Includes participation in on-site or distance learning academic courses from a university, college, or vocational technical adult education course related to the practice of occupational therapy;

(b)           A licensee may earn one point for each contact hour, up to a maximum of six points;

(c)           A licensee enrolled in a graduate or post-graduate OT curriculum has no maximum points in this category; and

(d)           Documentation shall include an original official transcript indicating successful completion of the course, date, and a description of the course from the school catalogue or course syllabus.

(3)           Small Group Study:

(a)           Includes review and discussion of journal articles, clinical videotapes or audiotapes by at least two licensed practitioners;

(b)           A licensee may earn one point for one hour three contact hours spent in an independent study activity, up to a maximum of three points; and

(c)           Documentation shall include title, author, publisher, time spent, and date of completion. Licensee must complete the Small Group Study Form provided by the NCBOT and include a statement that describes how the activity relates to a licensee's current or anticipated roles and responsibilities.

(4)           Mentorship Agreement:

(a)           Participation as a Mentee;

(i)            Participation in a formalized mentorship agreement with a mentor as defined by a signed contract between the mentor and mentee that outlines specific goals and objectives and designates the plan of activities that are to be met by the mentee. These activities must be related to the development of new occupational therapy skills outside current required job performance;

(ii)           A licensee may earn one point for each four 10 contact hours spent in activities directly related to achievement of goals and objectives up to a maximum of five two points; and

(iii)          Documentation shall include name of mentor and mentee, copy of signed contract, dates, hours spent and focus of mentorship activities, and outcomes of mentorship agreement.

(b)           Participation as Mentor:

(i)            Participation in a formalized mentorship agreement with a an occupational therapy practitioner or post Level II fieldwork student mentee as defined by a signed contract between the mentor and mentee that designates the responsibilities of the mentor and specific goals and objectives that are to be met by the mentee. These activities must be related to the development of new occupational therapy skills for the mentee mentee. The mentorship must not be part of the mentor's that are outside current required job performance; responsibilities;

(ii)           A licensee may earn one point for each four hours spent in mentorship activities as a mentor up to a maximum of five points; and

(iii)          Documentation shall include name of mentor and mentee, copy of signed contract, dates, hours spent and focus of mentorship activities, and outcomes of mentorship agreement.

(5)           Fieldwork Supervision:

(a)           Participation as the primary clinical fieldwork educator for Level I or Level II OT or OTA fieldwork students;

(b)           A licensee may earn one-half point for each 40 20 hours of fieldwork, up to a maximum of six 12 points; points for Level I may not exceed six.

(c)           Documentation shall include verification provided by the school to the fieldwork educator with the name of student, school, and dates of fieldwork or the signature page of the completed student evaluation form. Evaluation scores and comments shall be deleted or blocked out; and

(d)           If fieldwork spans two licensure years, credit shall be given only for the year it is completed.

(6)           Professional Writing:

(a)           Publication of a peer-reviewed book, chapter, article or contracted review of occupational therapy resource material;

(b)           During the year written, edited or reviewed a licensee may earn;

(i)            15 points as author of a book;

(ii)           10 points as author of a chapter;

(iii)          Five points as author of a peer-reviewed article;

(iv)          Five points as a contracted reviewer of a print or multimedia occupational therapy resource; or

(v)           10 points as listed editor of a book.

(c)           Documentation shall consist of full reference for publication including title, author, editor, and date of publication; or copy of acceptance letter, if not yet published; and

(d)           Credit for submitted items shall be given for one licensure period only.

(7)           Presentation and Instruction:

(a)           Presentation of an academic course or peer-reviewed or non peer-reviewed workshop, seminar, in-service, electronic or Web-based course for the first time or for which more than 50% of the material has been revised; revised related to occupational therapy;

(b)           A licensee may earn two points for each one contact hour of credit that is awarded for an activity, up to a maximum of six points; and

(c)           Documentation shall include a copy of official program, schedule, or syllabus including presentation title, date, hours of presentation, and type of audience or verification of such, signed by the sponsor.

(8)           Professional Meetings and Activities:

(a)           Consistent with Rule .0804 of this Section, participation in board or committee work with agencies or organizations to promote and enhance the practice of occupational therapy;

(b)           A licensee may earn one point for five hours or two points for 10 or more hours for participation on committees or boards; and

(c)           Documentation must include name of committee or board, name of agency or organization, purpose of service, and description of licensee's role. Participation and hours must be validated by an officer or representative of the organization or committee.

(9)           Board Certification or Specialty Certification:

(a)           The Board shall recognize completion of activities that result in board certification or specialty certification by AOTA during the current licensure period;

(b)           A licensee may earn 15 points for each board certification or specialty certification credential earned or re-certified during the current licensure period; and

(c)           Documentation shall include certificate of completion or other documentation from the recognized certifying body that identifies satisfactory completion of requirements for obtaining board certification or specialty certification. certification or recertification.

(10)         Research and Grants:

(a)           Development of or participation in a research project or grant proposal; proposal relevant to occupational therapy;

(b)           A licensee may earn one point for each three hours spent working on a research project or grant proposal, up to a maximum of five points; and

(c)           Documentation includes verification from the primary investigator indicating the name of the research project, dates of participation, major hypotheses or objectives of the project, and licensee's role in the project or name of grant proposal, name of grant source, purpose and objectives of the project, and verification from the grant author regarding licensee's role in the development of the grant if not the author.

History Note:        Authority G.S. 90-270.69; 90-270.75(a);

Eff. July 1, 2007;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016;

Amended Eff. January 1, 2020.

October 29, 2018

Febuary 6, 2018

Notice is hereby given in accordance with G.S. 150B-21.2 that the Board of Occupational Therapy intends to amend the rules cited as 21 NCAC 38 .0103, .0803, .0903, and .0905.

TITLE 21 – OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS

CHAPTER 38 – BOARD OF OCCUPATIONAL THERAPY

Link to agency website pursuant to G.S. 150B-19.1(c):  http://www.ncbot.org/OTpages/news_and_announcements.html

Proposed Effective Date:  July 1, 2018

Public Hearing:

Date:  March 19, 2018

Time:  11:00 a.m.

Location:  Wells Fargo Capital Center, 13^th Floor Conference Room, 150 Fayetteville Street, Raleigh, NC 27601

Reason for Proposed Action:   The amendments to Rules .0103, .0903 and .0905 are being submitted to clarify supervision changes.  The amendment to Rule .0803 is being submitted to clarify continuing competence activity pre-approval requirements.

Comments may be submitted to:  Charles P. Wilkins, P.O. Box 2280, Raleigh, NC 27602; phone (919) 832-1380; email cwilkins@bws-law.com

Comment period ends:  April 16, 2018

Procedure for Subjecting a Proposed Rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Fiscal impact (check all that apply).

• State funds affected

•  Environmental permitting of DOT affected

• Analysis submitted to Board of Transportation

• Local funds affected

• Substantial economic impact (≥$1,000,000)

• Approved by OSBM

• No fiscal note required by G.S. 150B-21.4

SECTION .0100 ‑ ORGANIZATION AND GENERAL PROVISIONS

21 NCAC 38 .0103             DEFINITIONS

The definitions in G.S. 90-270.67 apply to this Chapter. The following definitions also apply to the Chapter:

(1)           "Activities of daily living" means self-care activities.

(2)           "Assessment" means the specific tools or instruments that are used during the evaluation process.

(3)           "Client" means a person, group, program, organization, or community for whom the occupational therapy practitioner is providing services.

(4)           "Entry-level" means a person who has no experience in a specific position, such as a new graduate, a person new to the position, or a person in a new setting with no previous experience in that area of practice.

(5)           "Evaluation" means the process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results.

(6)           "Instrumental activities of daily living" means multi-step activities to care for self and others, such as household management, financial management and childcare.

(7)           "Intervention" means treatment.

(8)           "Intervention plan" is the program established by the occupational therapist for the delivery of occupational therapy services. It may also be referred to as treatment plan, individualized education plan (IEP), individualized family service plan (IFSP), plan of care, or other terminology as determined by the occupational therapy service delivery setting.

(9)           "Level I Fieldwork" provides introductory level clinical training opportunities.

(10)         "Level II Fieldwork" provides clinical training in preparation for entry-level practice.

(11)         "Neglect of duty" occurs when a Board member fails to attend a majority of the official meetings of the Board within any 12 month period.

(12)         "Occupational Therapy", as defined in G.S. 90-270.67(4), may include evaluation of activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation.

(13)         "Occupational Therapy evaluation, treatment, and consultation" include the following:

(a)           remediation or restitution of performance abilities that are limited due to impairment in biological, physiological, psychosocial and developmental process;

(b)           adaptation of skills, process or environment, or the teachings of compensatory techniques in order to enhance performance;

(c)           disability prevention methods and techniques which facilitate the development or safe application of performance skills;

(d)           promotion of health and wellness to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction; and

(e)           interpretation of the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

(14)         "Occupational therapy practitioner" means an individual currently licensed by the Board as an occupational therapist or an occupational therapy assistant.

(15)         "Occupational therapy services" include the following:

(a)           Methods or strategies selected to direct the process of interventions such as:

(i)            Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired;

(ii)           Compensation, modification, or adaptation of activity or environment to enhance performance;

(iii)          Maintenance and enhancement of capabilities without which performance in everyday life activities would decline;

(iv)          Health promotion and wellness to enable or enhance performance in everyday life activities; and

(v)           Prevention of barriers to performance, including disability prevention.

(b)           Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:

(i)            Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinary systems);

(ii)           Habits, routines, roles, and behavior patterns;

(iii)          Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance; and

(iv)          Performance skills, including motor, process, and communication/interaction skills.

(c)           Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure and social participation, including:

(i)            Therapeutic use of occupations, exercises, and activities;

(ii)           Training in self-care, self-management, home management, and community/work reintegration;

(iii)          Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills;

(iv)          Therapeutic use of self, including one's personality, insights, perceptions, and judgments, as part of the therapeutic process;

(v)           Education and training of individuals, including family members, caregivers, and others;

(vi)          Care coordination, case management, and transition services;

(vii)         Consultative services to groups, programs, organizations, or communities;

(viii)        Modification of home, work school or community environments and adaptation of processes, including the application of ergonomic principles;

(ix)          Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices;

(x)           Assessment, recommendation, and training in techniques to enhance functional mobility, including wheelchair management;

(xi)          Driver rehabilitation and community mobility;

(xii)         Management of feeding, eating, and swallowing to enable eating and feeding performance; and

(xiii)        Application of physical agent modalities, and use of a range of specific therapeutic procedures to enhance performance skills.

(16)         "Occupational therapy student" means an individual currently enrolled in an occupational therapist or occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).

(17)         "Practice Act" refers to the North Carolina Occupational Therapy Practice Act found in G.S. 90-270.65 et. seq.

(18)         "Screening" means obtaining and reviewing data relevant to a potential client to determine the need for further evaluation and intervention.

(19)         "Service Competency" is the ability to provide occupational therapy services in a safe and effective manner. It implies that two practitioners can perform the same or equivalent procedure and obtain the same result.

(20)         "Skilled occupational" therapy services when rendered by an occupational therapist or occupational therapy assistant means functions that require the exercise of professional occupational therapy judgment, including the interpretation of referrals, screening, assessment, evaluation, development or modification of intervention plans, implementation of intervention, reassessment, or discharge planning.

(21)         "Supervision" is the process by which two or more people participate in joint effort to establish, maintain and elevate a level of performance to ensure the safety and welfare of clients during the provision of occupational therapy. A variety of types and methods of supervision may be used. Methods Supervision may include direct face-to-face contact and indirect contact. Examples of methods or types of supervision that involve face-to-face direct contact include observation, modeling, co-treatment, discussions, teaching, instruction, phone conversations and video teleconferencing. Methods of observation include face-to-face, synchronous or asynchronous videoconferencing. Examples of methods or types of supervision that involve indirect contact include phone conversations, written correspondence, electronic exchanges, and other methods using telecommunication technology. Supervision is structured according to the supervisee's qualifications, position, level of preparation, depth of experience and the environment within which the supervisee functions. A change in practice setting may require a change in level of supervision until service competency has been established. Levels of supervision are:

(a)           "Close supervision" requires daily, direct contact at the service delivery site (where intervention plan is provided). at least weekly:

(i)            observation for a minimum of 60 minutes of occupational therapy services provided by the occupational therapy assistant; and

(ii)           review of the occupational therapy assistant's entire caseload, observations and delegated services through direct or indirect contact.

(b)           "General supervision" requires at least monthly direct contact, with supervision available as needed by other methods. or indirect contact.

(c)           "Direct supervision" of unlicensed personnel and volunteers means the Occupational Therapy supervisor must be within audible and visual range of the client and unlicensed personnel and available for immediate physical intervention. Direct supervision is required for unlicensed personnel. Videoconferencing is not allowed for direct supervision.

(22)         "Unlicensed personnel" means individuals within an occupational therapy setting who provide supportive services to the occupational therapist and the occupational therapy assistant and who function only under the guidance, responsibility, and supervision of the licensed occupational therapist or occupational therapy assistant to provide only specifically selected client-related or non-client related tasks for which the unlicensed personnel has been trained and has demonstrated competence.

History Note:        Authority G.S. 90‑270.67; 90‑270.69(4);

Eff. July 1, 1985;

Amended Eff. July 1, 2018; July 1, 2007; May 1, 1989; May 1, 1987;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016.

SECTION .0800 – CONTINUING COMPETENCE ACTIVITY

21 NCAC 38 .0803             APPROVAL OF ACTIVITIES FOR MAINTAINING CONTINUING COMPETENCE

(a)  Provided that the activities are consistent with the provisions of rules in this Section, the Board shall grant pre-approval to:

(1)           Continuing competence activities sponsored or approved by the North Carolina Occupational Therapy Association,

(2)           Continuing competence activities sponsored or approved by the American Occupational Therapy Association,

(3)           Continuing competence activities sponsored by AOTA approved providers.

(b)  A provider who wishes to obtain Board approval of activities for maintaining continuing competence, consistent with Rule .0804 of this Section, shall submit to the Board, at least 90 days in advance of the program, the following:

(1)           course description;

(2)           learning outcomes;

(3)           target audience;

(4)           content focus;

(5)           agenda for the activity;

(6)           amount of contact hours;

(7)           qualifications for the presenter(s);

(8)           sample documentation for demonstrating satisfactory completion by course participants such as certificate of completion.

(c)  Upon review of the completed application, the Board shall notify the provider as to whether or not the program has been approved.

(d)(b)  A provider of a continuing competence activity shall furnish documentation for demonstrating completion to all participants, specifying the following information:

(1)           name of the participant;

(2)           name of the provider;

(3)           dates of the activity and completion;

(4)           title and location of the activity;

(5)           number of contact hours; and

(6)           signature of the provider or representative.

History Note:        Authority G.S. 90-270.69; 90-270.75(a);

Eff. July 1, 2007;

Amended Eff. July 1, 2018;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016.

SECTION .0900 - SUPERVISION, SUPERVISORY ROLES, AND CLINICAL RESPONSIBILITIES OF OCCUPATIONAL THERAPIST AND OCCUPATIONAL THERAPY ASSISTANTS

21 NCAC 38 .0903             Types of supervision

Occupational therapy assistants at all levels require supervision by an occupational therapist. The specific frequency, methods, and content of supervision may vary by practice setting and are dependent on the complexity of client needs, number and diversity of clients, demonstrated service competency of the occupational therapist and the occupational therapy assistant, type of practice setting, requirements of the practice setting, and other regulatory requirements. Based on this the following apply:

(1)           Occupational therapy assistants with less than one year experience and occupational therapy assistants new to a particular practice setting require close supervision;

(2)           Occupational therapy assistants with more than one year of experience require general supervision; and

(3)           Supervision that is more frequent than the minimum level required by the practice setting or regulatory agencies is necessary when the needs of the client and the occupational therapy process are complex and changing, the practice setting provides occupational therapy services to a large number of clients with diverse needs, or the occupational therapist and occupational therapy assistant determine that additional supervision is necessary to ensure safe and effective delivery of occupational therapy services.

History Note:        Authority G.S. 90-270.69;

Eff. July 1, 2007;

Amended Eff. July 1, 2018;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016.

21 NCAC 38 .0905             DELINEATION OF CLINICAL RESPONSIBILITIES

Regardless of the setting in which occupational therapy services are delivered, the occupational therapist and the occupational therapy assistant have the following responsibilities during evaluation, intervention, and outcomes evaluation:

(1)           Evaluations:

(a)           The occupational therapist shall;

(i)            Direct the evaluation process;

(ii)           Determine the need for services;

(iii)          Define the problems within the domain of occupational therapy that need to be addressed;

(iv)          Determine the client's goals and priorities in collaboration with the occupational therapy assistant and the client or caregiver;

(v)           Interpret the information provided by the occupational therapy assistant and integrate that information into the evaluation decision-making process;

(vi)          Establish intervention priorities;

(vii)         Determine specific future assessment needs;

(viii)        Determine specific assessment tasks that can be delegated to the occupational therapy assistant; and

(ix)          Initiate and complete the evaluation, interpret the data, and develop the intervention plan in collaboration with the occupational therapy assistant.

(b)           The occupational therapy assistant may contribute to the evaluation process by implementing specifically delegated assessments for which service competency has been established.

(2)           Intervention Planning:

(a)           The occupational therapist shall develop the occupational therapy intervention plan. The plan shall be developed collaboratively with the occupational therapy assistant and the client or caregiver; and

(b)           The occupational therapy assistant may provide input into the intervention plan.

(3)           Intervention implementation:

(a)           The occupational therapist:

(i)            Shall implement the occupational therapy intervention;

(ii)           May delegate aspects of the occupational therapy intervention to the occupational therapy assistant depending on the occupational therapy assistant's service competency; and

(iii)          Shall supervise all aspects of intervention delegated to the occupational therapy assistant.

(b)           The occupational therapy assistant shall implement delegated aspects of intervention in which the occupational therapy assistant has established service competency; and

(c)           Occupational therapists or occupational therapy assistants shall not be subject to disciplinary action by the Board for refusing to delegate or refusing to provide the required training for delegation, if the occupational therapist or occupational therapy assistant determines that delegation may compromise client safety.

(4)           Intervention review:

(a)           The occupational therapist shall meet with each client who has been assigned to an occupational therapy assistant to further assess the client, to evaluate intervention, and, if necessary, to modify the individual's intervention plan. The occupational therapy assistant may be present at this meeting;

(b)           The occupational therapist shall determine the need for continuing or discontinuing services; and

(c)           The occupational therapy assistant shall contribute to the process of determining continuing or discontinuing services by providing information about the client's response to intervention to assist with the occupational therapist's decision making.

(5)           Documentation:

(a)           The occupational therapy practitioner shall document each evaluation, intervention and discharge plan recognizing the unique requirements of specific practice settings, payors, and service delivery models. Documentation shall include the following elements:

(i)            Client name or identifiable information;

(ii)           Signature with occupational therapist or occupational therapy assistant designation of the occupational therapy practitioner who performed the service;

(iii)          Date of the evaluation, intervention, or discharge plan;

(iv)          Objective and measurable description of contact or intervention and client response; and

(v)           Length of time of intervention session or evaluation.

(b)           The occupational therapist shall determine the overall completion of the evaluation, intervention, or discharge plan; and

(c)           The occupational therapy assistant shall;

(i)            Document intervention, intervention response and outcome; and

(ii)           Document client's level of function at discharge.

(6)           Discharge:

(a)           The occupational therapist shall determine the client's discharge from occupational therapy services; and

(b)           The occupational therapy assistant shall:

(i)            Report data for discharge summary; and

(ii)           Formulate discharge or follow-up plans under the supervision of the occupational therapist.

(7)           Outcome evaluation:

(a)           The occupational therapist is responsible for the selection, measurement, and interpretation of outcomes that are related to the client's ability to engage in occupations; and

(b)           The occupational therapy assistant must be knowledgeable about the client's targeted occupational therapy outcome and provide information relating to outcome achievement.

(8)           Supervision of occupational therapy students:

(a)           An occupational therapy practitioner shall comply with Accreditation Council for Occupational Therapy Education (ACOTE) requirements for experience when supervising Level II fieldwork occupational therapist and occupational therapy assistant students, which ACOTE requirements, including subsequent amendments and editions, are incorporated by reference. Copies of the incorporated material are available for inspection at the Board office and are available for purchase for five dollars ($5.00);

(b)           The occupational therapist may supervise Level I and Level II fieldwork occupational therapist and occupational therapy assistant students; and

(c)           The occupational therapy assistant may:

(i)            Supervise Level I occupational therapist or occupational therapy assistant students;

(ii)           Supervise Level II occupational therapy assistant students; and

(iii)          Participate in the supervision of Level II occupational therapist students under the direction and guidance of the supervising occupational therapist.

(9)           Supervision of unlicensed personnel and volunteers. Direct supervision is required for unlicensed personnel. Unlicensed personnel or volunteers may be supervised by occupational therapists or occupational therapy assistants.

History Note:        Authority G.S. 90-270.69;

Eff. July 1, 2007;

Amended Eff. July 1, 2018; December 1, 2009;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016.

November 23, 2015

Periodic Review of Rules:

House Bill 74, which was passed in the 2013 Session of the North Carolina Legislature, requires all state agencies, including occupational licensing Boards, to review the North Carolina Administrative Code (NCAC) (aka “rules”) every ten years.  In accordance with the bill, the Board has begun reviewing its rules, NCAC Title 21 – Occupational Licensing Boards and Commissions, Chapter 38 – Occupational Therapy.

The Board’s website, www.ncbot.org, includes a spreadsheet  that lists all the Board’s 52 rules and their corresponding determinations, as well as the full text of the 52 rules.

Click HERE to access the spreadsheet containing the 52 rules and their determinations.

Click HERE to access the full text of the existing rules.

“Public comment” is defined by G.S. 150B-21.3A(a)(5) as a written objection to all or part of a rule. Additionally, pursuant to G.S. 150B-21.3A(c)(2), in order for the Rules Review Commission to determine whether the public comment has merit, the public comment must address the specific substance of the rule and address any of the standards of Commission review, as set forth in G.S. 150B-21.9(a).  Public comments about the rules must be written with objection to a rule in whole or in part from any member of the public, including an association or other organization representing the regulated community or other members of the public. 

Comments may be sent via US Postal Service (USPS) or other delivery service (UPS, FedEx, etc.) and electronic submission including email.  All comments must be USPS postmarked, delivered or emailed as of January 23, 2016, to be accepted.

US Mail

North Carolina Board of Occupational Therapy

PO Box 2280

Raleigh, NC  27602

Delivery Service

North Carolina Board of Occupational Therapy

150 Fayetteville Street, Suite 1900

Raleigh, NC  27601

Email

administrator@ncbot.org, Subject:  Rules Review

If you have any questions regarding this process, please contact Elizabeth J. Kirk, Administrative Director of the Board at (919) 832-1380 ext. 0 or administrator@ncbot.org.

December 16, 2014

ANNOUNCEMENT BY THE NC BOARD OF OCCUPATIONAL THERAPY

PLEASE NOTE:  YOU ARE REQUIRED TO TAKE AT LEAST ONE HOUR OF ETHICS BETWEEN JUNE 1, 2014 AND JUNE 30, 2015 FOR YOUR 2015-2016 RENEWAL AND EACH RENEWAL THEREAFTER.  CONTINUING COMPETENCE ACTIVITIES ARE NOW REQUIRED TO BE TAKEN BETWEEN JULY 1 OF THE PRECEDING YEAR AND JUNE 30 OF THE RENEWAL YEAR.  FOR YOUR 2015-2016 RENEWAL, YOU WILL BE GIVEN A ONE-MONTH EXTENSION ON TAKING YOUR CONTINUING COMPETENCE ACTIVITIES SINCE THE NEW RULE CHANGE IS EFFECTIVE JANUARY 1, 2015.

PLEASE SEE RULE CHANGES, IN BOLD:

21 NCAC 38 .0802             CONTINUING COMPETENCE REQUIREMENTS FOR LICENSURE

(a) Licensed occupational therapists and occupational therapy assistants applying for license renewal shall document having earned a minimum of 15 points for approved continuing competence activities between July 1 of the preceding year and June 30 of the current year.  Documentation of each continuing competence activity shall comply with Rule .0805 of this Chapter.

(b)  For each renewal period, the licensee shall document completion of at least one contact hour of a qualified activity for maintaining continuing competence related to ethics in the practice of occupational therapy that shall be included in the total points for the year.  Continuing competence activities in ethics shall be related to developing the licensee’s ability to reflect on, determine, and act on the moral aspects of practice as required by Rule .0308 of this Chapter.

(c)  Continuing competence contact hours exceeding the total needed for renewal shall not be carried forward to the next renewal period.

(d)  Continuing competence activities shall not include new employee orientation or annual training required by the employer.

(e)  Licensees shall not receive credit for completing the same continuing competence activity more than once during a renewal period.

July 16, 2014

Public hearing to discuss North Carolina Board of Occupational Therapy rule change

The North Carolina Board of Occupational Therapy will be holding a public hearing to discuss one (1) change to the Rules of the Board.  This hearing is mandated by G.S. 150B-21.2(c) and will be held at 11:00am on September 22, 2014 in the large conference room on the 13th floor of the Well Fargo Bank building.  The text of the changes is as follows:

TITLE 21 – OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS

CHAPTER 38 - BOARD OF OCCUPATIONAL THERAPY

Notice is hereby given in accordance with G.S. 150B-21.2 that the NC Board of Occupational Therapy intends to amend the rules cited as 21 NCAC 38 .0802.

Link to agency website pursuant to G.S. 150B-19.1(c):  www.ncbot.org

Proposed Effective Date:  December 1, 2014

Public Hearing:

Date:  September 22, 2014

Time:  11:00 a.m.

Location:  Wells Fargo Capitol Center, 150 Fayetteville Street, 13th Floor Conference Room, Raleigh, NC  27601

Reason for Proposed Action: 

21 NCAC 38 .0802 - These amendments are being submitted to clarify continuing competence activity requirements.

Procedure by which a person can object to the agency on a proposed rule:  Any person may object to either of these proposed rule changes by submitting a written statement to Charles P. Wilkins at P.O. Box 2280, Raleigh, NC 27602, postmarked on or before October 14, 2014.

Comments may be submitted to:  Charles P. Wilkins, P.O. Box 2280, Raleigh, NC 27602; phone (919) 832-1380; fax (919) 833-1059; email cwilkins@bws-law.com

Comment period ends:  October 14, 2014

Procedure for Subjecting a Proposed Rule to Legislative Review:  If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1).  The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule.  The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission.  If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

SECTION .0800 - CONTINUING COMPETENCE ACTIVITY

21 NCAC 38 .0802             CONTINUING COMPETENCE REQUIREMENTS FOR LICENSURE

(a) Licensed occupational therapists and occupational therapy assistants applying for license renewal shall document having earned a minimum of 15 points for approved continuing competence activities between June 1 July 1 of the preceding licensure period and May 31 June 30 of the current licensure period.  Documentation of each continuing competence activity shall comply with Rule .0805.

(b)  For each renewal period, each licensee shall document completion of at least one contact hour of a qualified activity for maintaining continuing competence related to ethics in the practice of occupational therapy, which shall be included in the total points for the year.  Continuing competence activities in ethics shall be related to developing the licensee’s ability to reflect on, determine, and act on the moral aspects of practice as required by Rule .0308 of this Chapter.

(c)  Continuing competence contact hours exceeding the total needed for renewal shall not be carried forward to the next renewal period.

(d)  Continuing competence activities shall not include new employee orientation or annual training required by the employer.

(e)  Licensees shall not receive credit for completing the same continuing competence activity more than once during a renewal period.

Authority G.S. 90-270.69; 90-270.75(a);

July 16, 2014

Telehealth and the North Carolina Board of Occupational Therapy

An occupational therapy practitioner may deliver evaluation, treatment, and consultation through telecommunication and information technologies. N.C.G.S. 90-270.67.4

1. An occupational therapy practitioner is required to be licensed in North Carolina if the practitioner provides occupational therapy services to a client who is in North Carolina.
2. An occupational therapy practitioner who is in North Carolina and does not provide occupational therapy services to clients in North Carolina does not need to be licensed in North Carolina.
3. An occupational therapy practitioner who is in North Carolina but provides occupational therapy services to clients in a state other than North Carolina is required to follow the laws and regulations of the state where the client is receiving the services.
4. An occupational therapy practitioner licensed in North Carolina may provide occupational therapy services to a client in North Carolina even if the occupational therapy practitioner is in another state.

An occupational therapy practitioner may provide supervision requiring direct contact through video teleconferencing. 21. N.C.A.C. 38, Rule .0103(21)

January 21, 2013

ANNOUNCEMENT BY THE NC BOARD OF OCCUPATIONAL THERAPY

PLEASE NOTE:  ONE HOUR OF ETHICS CONTINUING COMPETENCE ACTIVITY IS NOT REQUIRED FOR YOUR 2014-2015 RENEWAL.  HOWEVER, ETHICS WILL BE MANDATORY EACH YEAR BEGINNING WITH YOUR 2015-2016 RENEWAL.  THEREFORE, YOU WILL BE REQUIRED TO TAKE AT LEAST ONE HOUR OF ETHICS BETWEEN JUNE 1, 2014 AND MAY 31, 2015 FOR YOUR 2015-2016 RENEWAL AND EACH RENEWAL THEREAFTER.

PLEASE SEE RULE CHANGES, IN BOLD, WHICH ARE NOT REFLECTED IN THE PRACTICE ACT AND RULES BOOKLET:

21 NCAC 38 .0301             LICENSE NUMBER: DISPLAY OF LICENSE AND iDENTIFICATION BADGE

(a) Each individual who is issued a license shall be issued a license number.  Should that number be retired for any reason (such as death, failure to renew the license, or any other reason) that number shall not be reissued.  The license and current renewal card must be available for inspection at the licensee's principal place of business.

(b) Persons licensed under this Chapter shall be required to comply with the provisions of G.S. 90-640.

(c) A licensed person shall be exempted from the requirement in Paragraph (b) of this Rule if such person notifies the Board in writing, at the address set forth in Rule .0102 of this Chapter, that the person's safety or some therapeutic concern requires that only a first name and level of licensure be displayed.

21 NCAC 38 .0802             CONTINUING COMPETENCE REQUIREMENTS FOR LICENSURE

(a) Licensed occupational therapists and occupational therapy assistants applying for license renewal shall document having earned a minimum of 15 points for approved continuing competence activities between June 1 of the preceding licensure period and May 31 of the current licensure period.  Documentation of each continuing competence activity shall comply with Rule .0805.

(b)  For each renewal period, each licensee shall document completion of at least one contact hour of a qualified activity for maintaining continuing competence related to ethics in the practice of occupational therapy, which shall be included in the total points for the year.  Continuing competence activities in ethics shall be related to developing the licensee’s ability to reflect on, determine, and act on the moral aspects of practice as required by Rule .0308 of this Chapter.

(c)  Continuing competence contact hours exceeding the total needed for renewal shall not be carried forward to the next renewal period.

(d)  Continuing competence activities shall not include new employee orientation or annual training required by the employer.

(e)  Licensees shall not receive credit for completing the same continuing competence activity more than once during a renewal period.

October 21, 2013

The NCBOT presented at the 2013 NCOTA Annual Conference on October 18th-20th in Raleigh, NC.  The NC Board of Occupational Therapy recognized Barbara Williams for her contributions to furthering the profession of occupational therapy through dedicated service as Board Administrator from 2005-2012.

May 23, 2013

NCOTA Seeks Nominees for both OT and School Based Position on Licensure Board (NCBOT)

The North Carolina Occupational Therapy Practice Act obligates the NC Occupational Therapy Association (NCOTA) to seek and nominate candidates to serve on the North Carolina Board of Occupational Therapy (NCBOT, the licensure Board). NCOTA is currently seeking a qualified occupational therapist and a qualified school counselor interested in serving on the NCBOT for four year terms, October 2013 - 2017.

Pursuant to NC General Statute 90-270.68 an applicant for the occupational therapist position must be an occupational therapist, resident of NC, licensed to practice in NC and shall have practiced, taught, or engaged in research in occupational therapy for at least three of the five years immediately preceding appointment to the NCBOT.  The School Based position shall be a counselor, educator, or school-based professional certified or licensed under North Carolina law who is employed in the North Carolina public school system, is not an occupational therapists or occupational therapy assistant, and is nominated by the NCOTA after consultation with the North Carolina School Counselors Association.

All members of the NCBOT are required to file an annual Statement of Economic Interest with the State Board of Ethics.

The NCOTA Executive Board reviews the qualifications of all applicants based on criteria established in the Practice Act, including geographic representation, clinical specialty, and other factors that promote broad representation of occupational therapy on the NCBOT. The NCOTA then submits names and credentials of nominees to the Governor, who makes the final decision on appointment. The occupational therapist seat to be filled is currently held by Christine Gunnigle. Ms. Gunnigle is not seeking re-appointment.  The school counselor position is currently held by Melanie Mills.  Ms. Mills is not eligible for reappointment since she is completing her second four-year term.

If you are an occupational therapist or school counselor interested in serving on the NCBOT and you meet the qualifications, submit your name, a brief history of your experience in OT or public schools (including your current role, location and employer and your curriculum vita) and a brief statement (no more than 250 words) of why you want to serve to: Nominations, PO Box 20432, Raleigh, NC 27619, fax: 919-771-0115. Deadline for receipt of complete nominations is August 1, 2013.

The current composition and representation on the Board is

THERAPIST MEMBERS:

Christine T. Gunnigle, OTR/L, Chair

William W Walsh, OTR/L, Vice Chair

Ron L Taylor, OTA/L

Denise Donica, DHS, OTR/L, BCP

PHYSICIAN MEMBER:

 Stephen Lang M.D., Durham County

PUBLIC MEMBER:

  Russell L. Stephenson, Jr., Secretary/Treasurer

SCHOOL BASED PROFESSIONAL MEMBER:

  Melanee Mills, MS

Febuary 1, 2013

Ethics Required for 2013 Renewals   

This is a reminder that an Ethics course is required as part of your Continuing Competence Activity for 2013 Renewals.

Rule .0802(b) states that every two (2) years all licensees shall document completion of at least one contact hour (one point) of an ethics course related to the practice of occupational therapy. The one point may be included in the total of the required point total for the renewal period.

Whether Ethics activity is required can be determined by the year of the renewal.  Ethics activity  is required for renewals occurring on odd years and not required for renewals occurring on even years.  For example: Ethics a is not required for renewals in 2012 but are be required for renewals in 2013. It will be clearly indicated in the Continuing Competence section of the website if the ethics activity is required for the current renewal period.

The ethics course must meet the requirements for continuing competence activity found in Rules Section .0800 (Rules .0801 - .0808). Additionally, whoever presents the course must meet the requirements of Rule .0803(b). It may not be an in-service offered by a co-employee who attended an ethics course.

Enter your ethics activity in the CCA category Ethics regardless of what category of CCA it belongs. This allows the computer to recognize it as your ethics requirement.

January 29 , 2013

Reminder about Online Access to CCA information and Therapist Profile information

Therapist are now able to update their personal, employment and supervision information online.  For complete instructions on how to update this information, click on the Information Tab under the Main Menu.

Therapist are now able to manage their continuing competence activity (CCA) online.  For complete instructions on how to manage this information, click on the Continuing Competence tab under the Main Menu.

January 29, 2013

Change of Board Meeting Dates