CHAPTER 38 ‑ BOARD OF OCCUPATIONAL THERAPY
SECTION .0100 ‑ ORGANIZATION AND GENERAL PROVISIONS
21 NCAC 38 .0101 PURPOSE
(a) These Rules set out standards and procedures, to
license occupational therapists and occupational therapy assistants and to see
that the qualifications and activities of those engaged in occupational therapy
are in accord with law and to carry out the purpose of the Occupational Therapy
Practice Act.
(b) The Board is not a Board of arbitration and has no
jurisdiction to settle disputes between parties.
History Note: Authority G.S. 90-270.66; 90-270.69;
Eff. July 1, 1985;
Amended Eff. July 1, 2007.
21 NCAC 38 .0102 BOARD OFFICE
The administrative offices of the North Carolina Board of
Occupational Therapy are located at:
Wachovia Capitol Center
150 Fayetteville Street, Suite 1900
P.O. Box 2280
Raleigh, North Carolina 27602
Telephone: (919) 832-1380
Office hours are 9:00 a.m. until 5:00 p.m., Monday through
Friday, except holidays.
History Note: Authority G.S. 90-270.69(5);
Eff. July 1, 1985;
Amended Eff. July 1, 2007; February 1, 1994.
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 may include direct face-to-face contact and
indirect contact. Examples of methods or types of supervision that involve
face-to-face contact include observation, modeling, co-treatment, discussions,
teaching, instruction, and video teleconferencing. 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).
(b) "General supervision" requires at
least monthly direct contact, with supervision available as needed by other
methods.
(c) "Direct supervision" 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.
(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, 2007; May 1, 1989; May 1, 1987;
Amended Eff. July 1, 2007 [Fee in (a)(5) expires October
1, 2007 pursuant to G.S. 90-270.77(5).]
21 NCAC 38 .0104 RULE‑MAKING AND ADMINISTRATIVE
HEARING PROCEDURES
History Note: Authority G.S. 90‑270.69(4);
Eff. July 1, 1985;
Amended Eff. May 1, 1987;
Repealed Eff. May 1, 1989.
SECTION .0200 ‑ APPLICATION FOR LICENSE
21 NCAC 38 .0201 APPLICATION PROCESS
(a) Each applicant, including those trained outside the United States or its territories, for an occupational therapist or occupational therapy
assistant license shall complete an application form provided by the Board.
This form shall be submitted to the Board and shall be accompanied by:
(1) one head and shoulders photograph (passport
type), taken within the past six months, of the applicant of acceptable quality
for identification, two inches by two inches in size;
(2) the proper fees, as required by 21 NCAC 38
.0204;
(3) evidence from the National Board for
Certification of Occupational Therapy (NBCOT) of successful completion of the
certification examination administered by it. Evidence of successful
completion of the NBCOT certification examination shall be accepted as proof of
graduation from an accredited curriculum and successful completion of field
work requirements;
(4) two signed statements on forms provided by
the Board attesting to the applicant's good moral character; and
(5) successful completion of a jurisprudence
exam administered by the Board.
(b) An applicant previously licensed in any state
re-entering the field of occupational therapy after not practicing occupational
therapy for more than 24 months shall complete 90 days of general, supervised,
re-entry fieldwork and shall provide to the Board;
(1) a written plan for 90 days of general,
supervised, re-entry fieldwork within 10 days of securing employment; and
(2) monthly documentation confirming that the
general, supervised, re-entry fieldwork is being provided.
History Note: Authority G.S. 90‑270.69(4); 90‑270.70;
Eff. July 1, 1985;
Amended Eff. July 1, 2007; May 1, 1989; May 1, 1987;
Amended Eff. March 23, 2009.
21 NCAC 38 .0202 EXEMPTIONS
History Note: Authority G.S. 90‑270.70; 90‑270.71;
Eff. July 1, 1985;
Repealed Eff. May 1, 1987.
21 NCAC 38 .0203 INTERVIEWS
Interviews may be required by the Board should it have
questions about the qualifications of an applicant.
History Note: Authority G.S. 90‑270.69(1),(4);
Eff. July 1, 1985;
Amended Eff. May 1, 1989.
21 NCAC 38 .0204 FEES
(a) Fees are as follows:
(1) a request for an initial application for
licensure as an occupational therapist or occupational therapy assistant is ten
dollars ($10.00);
(2) application for issuance of a license or
re-issuance of an expired license is one hundred dollars ($100.00);
(3) annual renewal of a license is fifty
dollars ($50.00);
(4) late renewal of a license is an additional
fifty dollars ($50.00).
(b) Fees shall be non-refundable and shall be paid in cash
or in the form of a cashier's check, certified check or money order made
payable to the North Carolina Board of Occupational Therapy. Personal checks
shall be accepted for payment of renewal fees.
History Note: Authority G.S. 90-270.77;
Eff. July 1, 1985;
Amended Eff. February 1, 1994; May 1, 1989; May 1, 1987;
Amended Eff. October 1, 2007; July 1, 2007.
SECTION .0300 ‑ LICENSING
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.
History Note: Authority G.S. 90-270.69(4); 90-270.73; 90-640;
Eff. July 1, 1985;
Amended Eff. February 1, 2014; July 1, 2007; May 1, 1989.
21 NCAC 38 .0302 LICENSE RENEWAL
(a) Any licensee desiring the renewal of a license shall
apply for renewal and shall submit the renewal application, documentation of
continuing competence activities, and the fee. Occupational therapy assistants
who are employed must also include evidence of required supervision.
(b) Licenses not renewed by June 30 are expired. Persons
whose licenses are expired for 24 months or less and who desire to be licensed
shall apply for and complete the requirements to renew the license. The person
shall also provide proof of 15 points of continuing competence activities for
the last year the license was current and for each full year the person's
license was expired.
(c) Any person whose license is expired and who engages in
any occupational therapy activities governed by the occupational therapy law
shall be subject to the penalties prescribed in G.S. 90-270.76, 90-270.79,
90-270.80 and 90-270.80A.
(d) Licenses expired in excess of 24 months shall not be
renewed. Persons whose licenses are expired in excess of 24 months and who
desire to be licensed shall apply for and complete the requirements for a new
license.
(e) Members of the armed forces whose licenses are in good
standing and to whom G.S. 105-249.2 grants an extension of time to file a tax
return are granted that same extension of time to pay the license renewal fee
and to complete the continuing competence activity requirement prescribed in 21
NCAC 38 .0800. A copy of military orders or the extension approval by the
Internal Revenue Service must be furnished to the Board. If approved,
continuing competence activity points acquired during this extended time period
shall not be utilized for future renewal purposes.
History Note: Authority G.S. 90-270.69(4); 90-270.75; 93B-15(b);
105-249.2;
Eff. July 1, 1985;
Amended Eff. May 1, 2010; July 1, 2007; May 1, 1989.
21 NCAC 38 .0303 LIMITED PERMITS
History Note: Authority G.S. 90-270.69(4); 90-270.74;
Eff. July 1, 1985;
Amended Eff. July 1, 2007; May 1, 1989; May 1, 1987;
Repealed Eff. October 1, 2007.
21 NCAC 38 .0304 GROUNDS FOR LICENSE DENIAL OR
DISCIPLINE
(a) In addition to the conduct set forth in G.S. 90-270.76,
the Board may deny, suspend, or revoke a license, or impose probationary
conditions on a license, upon any of the following grounds:
(1) writing a check given to the Board in
payment of required fees which is returned unpaid;
(2) allowing an unlicensed occupational
therapist or occupational therapy assistant to practice under the licensee's
supervision or control;
(3) making any false statement or giving any
false information in connection with an application for a license or renewal of
a license or any investigation by the Board or the Board's designee;
(4) committing a crime the circumstances of
which relate to the occupational therapy profession;
(5) violating any federal or state statute or
rule which relates to the occupational therapy profession;
(6) practicing occupational therapy while the
licensee's ability to practice was impaired by alcohol or other drugs or a
physical or mental disability or disease;
(7) engaging in sexual misconduct. For the
purposes of this Paragraph, sexual misconduct includes:
(A) Engaging in or soliciting sexual relationships,
whether consensual or non-consensual, while an Occupational Therapist or
Occupational Therapy Assistant/patient relationship exists with that person;
(B) Making sexual advances, requesting sexual favors or
engaging in physical contact of a sexual nature with patients or clients;
(8) obtaining or attempting to obtain payment
by fraud or deceit;
(9) violating any Order of the Board;
(10) failing to properly make the disclosures
required by 21 NCAC 38 .0305;
(11) abandoning or neglecting a patient or client
under and in need of immediate professional care, without making reasonable
arrangements for the continuation of care;
(12) recording or communicating false or
misleading data, measurements or notes regarding a patient;
(13) delegating responsibilities to a person when
the licensee delegating knows or has reason to know that the competency of that
person is impaired by physical or psychological ailments, or by alcohol or
other pharmacological agents, prescribed or not;
(14) practicing or offering to practice beyond
the scope permitted by law;
(15) accepting and performing professional responsibilities
which the licensee knows or has reason to know that he or she is not competent
to perform;
(16) performing, without supervision,
professional services which the licensee is authorized to perform only under
the supervision of a licensed professional;
(17) harassing, abusing, or intimidating a
patient either physically or verbally;
(18) failure to exercise supervision over persons
who are authorized to practice only under the supervision of the licensed
professional;
(19) promoting an unnecessary device, treatment
intervention or service for the financial gain of the practitioner or of a
third party;
(20) delegating professional responsibilities to
a person when the licensee delegating the responsibilities knows or has reason
to know that the person is not qualified by training, by experience, or by
licensure to perform the responsibilities;
(21) billing or charging for services or
treatments not performed; or
(22) making treatment recommendations based on
the extent of third party benefits instead of the patient's condition.
(b) A licensee has been incompetent in practice under G.S.
90-270.76(a)(5) if the licensee has engaged in conduct which evidences a lack
of ability, fitness or knowledge to apply principles or skills of the
profession of occupational therapy.
(c) When a person licensed to practice occupational therapy
is also licensed in another jurisdiction and that other jurisdiction takes
disciplinary action against the licensee, the North Carolina Board of
Occupational Therapy may summarily impose the same or lesser disciplinary
action upon receipt of the other jurisdiction's actions. The licensee may
request a hearing. At the hearing the issues shall be limited to:
(1) whether the person against whom action was
taken by the other jurisdiction and the North Carolina licensee are the same
person;
(2) whether the conduct found by the other
jurisdiction also violates the North Carolina Occupational Therapy Practice
Act; and
(3) whether the sanction imposed by the other
jurisdiction is lawful under North Carolina law.
History Note: Authority G.S. 90-270.69(4); 90-270.76;
Eff. July 1, 1985;
Amended Eff. January 1, 2009; July 1, 2007; May 1, 1989.
21 NCAC 38 .0305 CONTINUING DUTY TO REPORT CERTAIN
CRIMES AND CIVIL SUITS
All occupational therapists and occupational therapy
assistants are under a continuing duty to report to the Board within 30 days
all:
(1) convictions of or pleas of guilty or no contest to
a felony or any crime such as fraud that involves moral turpitude; and
(2) civil lawsuits arising out of or related to a
licensee's practice of occupational therapy.
History Note: Authority G.S. 90-270.69(2),(4); 90-270.74;
Eff. July 1, 1985;
Amended Eff. March 1, 2008; July 1, 2007; May 1, 1989.
21 NCAC 38 .0306 PROFESSIONAL CORPORATION
21 NCAC 38 .0307 RENEWAL OF CERTIFICATE OF
REGISTRATION
History Note: Authority G.S. 55B‑2;
Eff. October 1, 1986;
Amended Eff. May 1, 1989;
Repealed Eff. February 1, 1994.
21 NCAC 38 .0308 Code of Ethics
Pursuant to G.S. 90-270.76(a)(2) the Board adopts by
reference the Occupational Therapy Code of Ethics (2005) of the American
Occupational Therapy Association, including subsequent amendments and
editions. Copies of the American Occupational Therapy Association Code of
Ethics may be obtained online at http://www.aota.org at no cost. To the extent
the Occupational Therapy Code of Ethics might conflict with the North Carolina
Occupational Therapy Practice Act or the Rules of the North Carolina Board of
Occupational Therapy, the North Carolina Occupational Therapy Practice Act or
the Rules of the North Carolina Board of Occupational Therapy shall take
precedent.
History Note: Authority G.S. 90-270.69(4);
Eff. December 1, 2009.
SECTION .0400 ‑ GENERAL
21 NCAC 38 .0401 CHANGE OF ADDRESS OR BUSINESS NAME
All licensees shall notify the Board in writing of each
change of name, residence, trade name, business address, or mailing address,
within ten days of such change.
History Note: Authority G.S. 90-270.69(2),(4);
Eff. July 1, 1985;
Amended Eff. July 1, 2007; May 1, 1989.
21 NCAC 38 .0402 ADVERTISING
In all advertisements relating to occupational therapy, the
occupational therapist's or occupational therapy assistant's name and license
number shall be given. A licensee may not advertise under a name that is
different from the licensee's surname unless written notice has been filed with
the Board. The licensee shall notify the Board of all certificates of assumed
name filed with any county register of deeds in compliance with G.S. 66-68.
History Note: Authority G.S. 90-270.69(4);
Eff. July 1, 1985;
Amended Eff. July 1, 2007; May 1, 1989.
SECTION .0500 ‑ RULES
21 NCAC 38 .0501 PETITIONS FOR ADOPTION, AMENDMENT,
OR REPEAL OF RULES
(a) General. The procedure for petitioning the Board to
adopt, amend, or repeal a rule is governed by G.S. 150B‑16.
(b) Submission. Rule‑making petitions shall be sent
to the Board. No special form is required, but the petitioner shall state his
name and address. There are no minimum mandatory contents of a petition, but
the Board considers the following information to be pertinent:
(1) a draft of any proposed rule or amendment
to a rule;
(2) the reason for the proposal;
(3) the effect of the proposal on existing
rules or decisions;
(4) data supporting the proposed rule change;
(5) practices likely to be affected by the
proposed rule change;
(6) persons likely to be affected by the
proposed rule change.
(c) Disposition. The Board shall review the petition at
its next regular meeting following receipt of the petition, and the Board shall
render its decision to either deny the petition or initiate rule‑making.
The Board shall notify the petitioner of its decision in writing within the 120‑day
period set by G.S. 150B‑16.
History Note: Authority G.S. 90‑270.69(4); 150B‑16;
Eff. May 1, 1989.
21 NCAC 38 .0502 PROCEDURE FOR ADOPTION OF RULES
(a) General. The procedure for the adoption, amendment or
repeal of a rule is governed by G.S. 150B.
(b) Notice of Rule-Making. Any person who wishes to
receive individual notice shall file a written request with the Board and shall
be responsible for the cost of mailing said notice.
(c) Public Hearing. Any public rule-making hearing
required by G.S. 150B shall be conducted by the Chairman of the Board or by any
person he may designate. The presiding officer shall have complete control of
the hearing and shall conduct the hearing so as to provide a reasonable
opportunity for any interested person to present views, data and comments.
Oral presentations shall not exceed 15 minutes. Written presentations shall be
acknowledged by the presiding officer and shall be given the same consideration
as oral presentations.
History Note: Authority G.S. 150B-21.2;
Eff. May 1, 1989;
Amended Eff. July, 1, 2007.
21 NCAC 38 .0503 TEMPORARY RULES
The power of the Board to adopt temporary rules and the
procedure by which such rules are put into effect are governed by G.S. 150B‑13.
History Note: Authority G.S. 150B‑13;
Eff. May 1, 1989.
21 NCAC 38 .0504 DECLARATORY RULINGS
(a) General. The issuance of declaratory rulings by the
Board is governed by G.S. 150B‑17.
(b) Contents of Request. A request for a declaratory
ruling shall be in writing and addressed to the Board. The request shall
contain the following information:
(1) The name and address of the person making
the request;
(2) The statute or rule to which the request
relates;
(3) A concise statement of the manner in which
the person has been aggrieved by the statute or rule; and
(4) A statement as to whether a hearing is
desired, and if desired, the reason therefor.
(c) Refusal to Issue Ruling. The Board shall ordinarily
refuse to issue a declaratory ruling under the following circumstances:
(1) When the Board has already made a
controlling decision on substantially similar facts in a contested case;
(2) When the facts underlying the request for a
ruling on a rule were specifically considered at the time of the adoption of
the rule in question; and
(3) When the subject matter of the request is
involved in pending litigation in North Carolina.
History Note: Authority G.S. 150B‑17;
Eff. May 1, 1989.
SECTION .0600 ‑ ADMINISTRATIVE HEARING PROCEDURES
21 NCAC 38 .0601 APPLICABLE HEARING RULES
When the Board elects to have the Office of Administrative
Hearings hear a contested case, the Board's rules pertaining to contested case
hearings, instead of the rules of the Office of Administrative Hearings, shall
apply.
History Note: Authority G.S. 90‑270.69(4); 150B‑38(h);
Eff. May 1, 1989.
21 NCAC 38 .0602 RIGHT TO HEARING
When the Board acts or proposes to act, other than in rule‑making
or declaratory ruling proceedings, in a manner which will affect the rights,
duties, or privileges of a specific, identifiable person, such person has the right
to an administrative hearing. When the Board proposes to act in such a manner,
it shall give all such affected persons notice of their right to a hearing by
mailing to them, by certified mail, at their last known address a notice of the
proposed action and a notice of a right to a hearing.
History Note: Authority G.S. 150B‑11; 150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0603 REQUEST FOR HEARING
(a) Any time an individual believes that individual's
rights, duties, or privileges have been affected by the Board's administrative
action, but has not received notice of a right to an administrative hearing,
that individual may file a formal request for a hearing.
(b) Before an individual may file a request, that
individual is encouraged to exhaust all reasonable efforts to resolve the issue
informally with the Board.
(c) Subsequent to such informal action, if still
dissatisfied, the individual should submit a request to the Board's office,
with the request bearing the notation: "REQUEST FOR ADMINISTRATIVE
HEARING". The request should contain the following information:
(1) name and address of the petitioner;
(2) a concise statement of the action taken by
the Board which is challenged;
(3) a concise statement of the way in which the
petitioner has been aggrieved; and
(4) clear and specific statement of request for
a hearing.
(d) The request will be acknowledged promptly and, if
deemed appropriate by the Board in accordance with 21 NCAC 38 Rule .0604, a
hearing will be scheduled.
History Note: Authority G.S. 150B‑11; 150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0604 GRANTING OR DENYING HEARING REQUEST
(a) The Board will grant a request for a hearing if it
determines that the party requesting the hearing is a "person
aggrieved" within the meaning of G.S. 150B‑2(6).
(b) The denial of a request for a hearing will be issued
immediately upon decision, and in no case later than 60 days after the
submission of the reasons leading the Board to deny the request.
(c) Approval of a request for a hearing will be signified
by issuing a notice as required by G.S. 150B‑38(b) and explained in Rule
.0605 of this Section.
History Note: Authority G.S. 150B‑11; 150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0605 NOTICE OF HEARING
(a) The Board shall give the party or parties in a
contested case a notice of hearing not less than 15 days before the hearing.
Said notice shall contain the following information, in addition to the items
specified in G.S. 150B‑38(b):
(1) the name, position, address, and telephone
number of a person at the offices of the Board to contact for further
information or discussion;
(2) the date, time and place for a pre‑hearing
conference, if any; and
(3) any other information deemed relevant to
informing the parties as to the procedure of the hearing.
(b) If the Board determines that the public health, safety
or welfare requires such action, it may issue an order summarily suspending a
license. Upon service of the order, the licensee to whom the order is directed
shall immediately cease the practice of occupational therapy in North
Carolina. The Board shall promptly give notice of hearing pursuant to G.S.
150B‑38 following service of the order. The suspension shall remain in
effect pending issuance by the Board of a final agency decision pursuant to
G.S. 150B‑42.
History Note: Authority G.S. 150B‑3; 150B‑11;
150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0606 WHO SHALL HEAR CONTESTED CASES
All administrative hearings will be conducted by the Board,
a panel consisting of a majority of the members of the Board, or an
administrative law judge designated to hear the case pursuant to G.S. 150B‑40(e).
History Note: Authority G.S. 150B‑11; 150B‑38;
150B‑40;
Eff. May 1, 1989.
21 NCAC 38 .0607 INFORMAL PROCEDURES
The Board and the other party or parties may agree in
advance to simplify the hearing by: decreasing the number of issues to be
contested at the hearing; accepting the validity of certain proposed evidence;
accepting the findings in some other case with relevance to the case at hand;
or agreeing to such other matters as may expedite the hearing.
History Note: Authority G.S. 150B‑11; 150B‑41;
Eff. May 1, 1989.
21 NCAC 38 .0608 PETITION FOR INTERVENTION
(a) A person desiring to intervene in a contested case must
file a written petition with the Board's office. The request should bear the
notation: "PETITION TO INTERVENE IN THE CASE OF (name of case)".
(b) The petition must include the following information:
(1) the name and address of petitioner;
(2) the business or occupation of petitioner,
where relevant;
(3) a full identification of the hearing in
which petitioner is seeking to intervene;
(4) the statutory or non‑statutory
grounds for intervention;
(5) any claim or defense in respect of which
intervention is sought; and
(6) a summary of the arguments or evidence
petitioner seeks to present.
(c) If the Board determines to allow intervention, notice
of that decision will be issued promptly to all parties, and to the petitioner.
In cases of discretionary intervention, such notification will include a
statement of any limitations of time, subject matter, evidence or whatever else
is deemed necessary which are imposed on the intervenor.
(d) If the Board's decision is to deny intervention, the
petitioner will be notified promptly. Such notice will be in writing,
identifying the reasons for the denial, and will be issued to the petitioner
and all parties.
History Note: Authority G.S. 150B‑11; 150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0609 TYPES OF INTERVENTION
(a) Intervention of Right. A petition to intervene as of
right, as provided in the North Carolina Rules of Civil Procedure, Rule 24,
will be granted if the petitioner meets the criteria of that rule and the petition
is timely.
(b) Permissive Intervention. A petition to intervene
permissively, as provided in the North Carolina Rules of Civil Procedure, Rule
24, will be granted if the petitioner meets the criteria of that rule and the
Board determines that:
(1) There is sufficient legal or factual
similarity between the petitioner's claimed rights, privileges, or duties and
those of the parties to the hearings; and
(2) Permitting intervention by the petitioner
as a party would aid the purpose of the hearing.
(c) Discretionary Intervention. The Board may allow
discretionary intervention, with whatever limits and restrictions are deemed
appropriate.
History Note: Authority G.S. 150B‑11; 150B‑38;
Eff. May 1, 1989.
21 NCAC 38 .0610 DISQUALIFICATION OF BOARD MEMBERS
(a) Self‑disqualification. If for any reason a Board
member determines that personal bias or other factors render that member unable
to hear a contested case and perform all duties in an impartial manner, that
Board member shall voluntarily decline to participate in the hearing or
decision.
(b) Petition for Disqualification. If for any reason any
party in a contested case believes that a Board member is personally biased or
otherwise unable to hear a contested case and perform all duties in an
impartial manner, the party may file a sworn, notarized affidavit with the
Board. The title of such affidavit should bear the notation: "AFFIDAVIT
OF DISQUALIFICATION OF BOARD MEMBER IN THE CASE OF (name of case)".
(c) Contents of Affidavit. The affidavit must state all
facts the party deems to be relevant to the disqualification of the Board
member.
(d) Timeliness and Effect of Affidavit. An affidavit of
disqualification will be considered timely if filed ten days before
commencement of the hearing. Any other affidavit will be considered timely
provided it is filed at the first opportunity after the party becomes aware of
facts which give rise to a reasonable belief that a Board member may be
disqualified under this Rule.
Where a petition for disqualification is filed less than ten
days before a hearing or during the course of a hearing, the hearing shall
continue with the challenged Board member sitting. Petitioner shall have the
opportunity to present evidence supporting his petition, and the petition and
any evidence relative thereto presented at the hearing shall be made a part of
the record. The Board, before rendering its decision, shall decide whether the
evidence justifies disqualification. In the event of disqualification, the
disqualified member will not participate in further deliberation or decision of
the case.
(e) Procedure for Determining Disqualification:
(1) The Board will appoint a Board member to
investigate the allegations of the affidavit.
(2) The investigator will report to the Board
the findings of the investigation.
(3) The Board shall decide whether to
disqualify the challenged individual.
(4) The person whose disqualification is to be
determined will not participate in the decision but may be called upon to
furnish information to the other members of the Board.
(5) When a Board member is disqualified prior
to the commencement of the hearing or after the hearing has begun, such hearing
will continue with the remaining members sitting provided that the remaining
members still constitute a majority of the Board.
(6) If four or more members of the Board are
disqualified pursuant to this Rule, the Board shall petition the Office of
Administrative Hearings to appoint an administrative law judge to hear the
contested case pursuant to G.S. 150B‑40(e).
History Note: Authority G.S. 150B‑11; 150B‑38;
150B‑40;
Eff. May 1, 1989.
21 NCAC 38 .0611 SUBPOENAS
(a) Requests for subpoenas for the attendance and testimony
of witnesses or for the production of documents, either at a hearing or for the
purposes of discovery, shall be made in writing to the Board, shall identify
any document sought with specificity, and shall include the full name and home
or business address of all persons to be subpoenaed and, if known, the date,
time, and place for responding to the subpoena. The Board shall issue the
requested subpoenas within three days of receipt of the request.
(b) Subpoenas shall contain: the caption of the case; the
name and address of the person subpoenaed; the date, hour and location of the
hearing in which the witness is commanded to appear; a particularized
description of the books, papers, records or objects the witness is directed to
bring with him to the hearing, if any; the identity of the party on whose
application the subpoena was issued; the date of issue; the signature of the
presiding officer or his designee; and a "return of service". The
"return of service" form, as filled out, shows the name and capacity
of the person serving the subpoena, the date on which the subpoena was
delivered to the person directed to make service, the date on which service was
made, the person on whom service was made, the manner in which service was
made, and the signature of the person making service.
(c) Subpoenas shall be served by the sheriff of the county
in which the person subpoenaed resides, when the party requesting such subpoena
prepays the sheriff's service fee. The subpoena shall be issued in duplicate,
with a "return of service" form attached to each copy. A person
serving the subpoena shall fill out the "return of service" form for
each copy and properly return one copy of the subpoena, with the attached
"return of service" form completed, to the Board.
(d) Any person receiving a subpoena from the Board may
object thereto by filing a written objection to the subpoena with the Board's
office. Such objection shall include a concise, but complete, statement of
reasons why the subpoena should be revoked or modified. These reasons may
include lack of relevancy of the evidence sought, or any other reason
sufficient in law for holding the subpoena invalid, such as that the evidence
is privileged, that appearance or production would be so disruptive as to be
unreasonable in light of the significance of the evidence sought, or other
undue hardship.
(e) Any objection to a subpoena must be served on the party
who requested the subpoena simultaneously with the filing of the objection with
the Board.
(f) The party who requested the subpoena, in such time as
may be granted by the Board, may file a written response to the objection. The
written response shall be served by the requesting party on the objecting
witness simultaneously with filing the response with the Board.
(g) After receipt of the objection and response thereto, if
any, the Board shall issue a notice to the party who requested the subpoena and
the party challenging the subpoena, and may notify any other party or parties
of an open hearing, to be scheduled as soon as practicable, at which evidence
and testimony may be presented, limited to the narrow questions raised by the
objection and response.
(h) Promptly after the close of such hearing, the majority
of the Board members hearing the contested case will rule on the challenge and
issue a written decision. A copy of the decision will be issued to all parties
and made a part of the record.
History Note: Authority G.S. 150B‑11; 150B‑39;
150B‑40;
Eff. May 1, 1989.
21 NCAC 38 .0612 WITNESSES
Any party may be a witness and may present witnesses on the
party's behalf at the hearing. All oral testimony at the hearing shall be
under oath or affirmation and shall be recorded. At the request of a party or
upon the Board's own motion, the presiding officer may exclude witnesses from
the hearing room so that they cannot hear the testimony of other witnesses.
History Note: Authority G.S. 150B‑11; 150B‑38;
150B‑40;
Eff. May 1, 1989.
21 NCAC 38 .0613 FINAL DECISION
In all cases heard by the Board, the Board will issue its
decision within 60 days after its next regularly scheduled meeting following
the close of the hearing. The decision will be the prerequisite "final
agency decision" for the right to judicial review. To obtain judicial
review, the person seeking review must file a petition with the court in
accordance with the provisions of G.S. 150B‑45.
History Note: Authority G.S. 150B‑45;
Eff. May 1, 1989;
Amended Eff. February 1, 1994.
21 NCAC 38 .0614 PROPOSALS FOR DECISION
(a) When an administrative law judge conducts a hearing
pursuant to G.S. 150B‑40(e), a "proposal for decision" shall be
rendered within 45 days of the hearing pursuant to the Rules of the Office of
Administrative Hearings, 26 NCAC 3 .0026. The parties may file written
exceptions to this "proposal for decision" and submit their own
proposed findings of fact and conclusions of law. The exceptions and
alternative proposals must be filed within ten days after the party has
received the "proposal for decision" as drafted by the administrative
law judge.
(b) Any exceptions to the procedure during the hearing, the
handling of the hearing by the administrative law judge, rulings on evidence,
or any other matter must be written and refer specifically to pages of the
record or otherwise precisely identify the occurrence to which exception is
taken. The exceptions must be filed with the Board within ten days of the
receipt of the proposal for decision. The written exceptions should bear the
notation: "EXCEPTIONS TO THE PROCEEDINGS IN THE CASE OF (name of
case)".
(c) Any party may present oral argument to the Board upon
request. The request must be included with the written exceptions.
(d) Upon receipt of request for further oral argument,
notice will be issued promptly to all parties designating the time and place
for such oral argument.
(e) Giving due consideration to the proposal for decision
and the exceptions and arguments of the parties, the Board may adopt the proposal
for decision or may modify it as the Board deems necessary. The decision
rendered will be a part of the record and a copy thereof given to all parties.
The decision as adopted or modified becomes the "final agency
decision" for the right to judicial review. Said decision will be
rendered by the Board within 60 days of the next regularly scheduled meeting
following the oral arguments, if any. If there are no oral arguments
presented, the decision will be rendered within 60 days of the next regularly
scheduled Board meeting following receipt of the written exceptions.
History Note: Authority G.S. 150B‑11; 150B‑38;
150B‑40;
Eff. May 1, 1989.
SECTION .0700 ‑ PROFESSIONAL CORPORATIONS
21 NCAC 38 .0701 AUTHORITY AND DEFINITIONS
As used in this Section:
(1) "Administrator" means the administrator
of the North Carolina Board of Occupational Therapy.
(2) "Board" means the North Carolina Board of
Occupational Therapy.
(3) "Legal Counsel" means the legal counsel
to the North Carolina Board of Occupational Therapy.
(4) "Licensee" means any individual who is
duly licensed to practice occupational therapy in North Carolina as an
occupational therapist or occupational therapy assistant.
(5) "Occupational therapy related services"
means those activities through which occupational therapy, as defined in G.S.
90-270.67(4), is practiced.
(6) "Professional Corporation" means
professional corporations organized for the purpose of providing occupational
therapy related services in North Carolina.
History Note: Authority G.S. 55B-2; 55B-12;
90-270.69(4);
Eff. February 1, 1994;
Amended Eff. July 1, 2007.
21 NCAC 38 .0702 PREREQUISITES FOR INCORPORATION
The following requirements must be met in order to
incorporate:
(1) The incorporator, whether one or more, of a
professional corporation shall be licensed to practice occupational therapy in North Carolina as an occupational therapist.
(2) Before the filing of the articles of incorporation
with the Secretary of State, the incorporators shall file with the administrator
of the Board a copy of the original articles of incorporation, together with a registration
fee of fifty dollars ($50.00).
(3) The copy of the articles of incorporation shall be
accompanied by an application to the Board (Corp. Form 01) certified by all
incorporators, setting forth the names, addresses and N.C. license numbers of
each shareholder of the corporation who will be practicing occupational therapy
for the corporation.
(4) Included with the articles of incorporation shall
be a statement that all such persons are licensed to practice occupational
therapy in North Carolina as occupational therapists, and stating that the
corporation will be conducted in compliance with the Professional Corporation
Act and the rules of this Section.
(5) If the articles are changed in any manner before
being filed with the Secretary of State, they shall be resubmitted to the
administrator of the Board and shall not be filed until approved by the
administrator of the Board.
History Note: Authority G.S. 55B-4; 55B-10;
90-270.69(4);
Eff. February 1, 1994;
Amended Eff. July 1, 2007.
21 NCAC 38 .0703 CERTIFICATE OF REGISTRATION
The Certificate of Registration shall be issued as follows:
(1) The legal counsel or administrator shall issue a
Certificate of Registration (Corp. Form 02) for the professional corporation to
become effective only when the professional corporation files the articles of
incorporation with the Secretary of State and if:
(a) the legal counsel or administrator of the
Board finds that no disciplinary action is pending before the Board against any
of the licensed incorporators or persons who will be directors, officers, or
shareholders of such corporation; and
(b) it appears to the legal counsel or administrator
that such corporation will be conducted in compliance with the law and rules.
(2) The proposed original articles of incorporation,
and the Certificate of Registration, shall be returned to the incorporators for
filing with the Secretary of State. The copy of the articles and a copy of the
certification shall be retained in the administrative offices of the Board. If
the required findings cannot be made, the registration fee shall be refunded to
the incorporators.
(3) The initial Certificate of Registration shall
remain in effect until June 30 of the year in which it was issued unless
suspended or terminated as provided by law. The Certificate of Registration
shall be renewed annually thereafter.
(4) Prior to the date of expiration of the certificate,
the corporation shall submit its written application for renewal upon a form as
provided by the Board. The application shall be accompanied by check in the
amount of twenty-five dollars ($25.00) in payment of the renewal fee. The
Board shall renew the certificate provided that the Board finds that the
corporation has followed the law and the rules of the Board.
(5) If the corporation does not apply for renewal of
its Certificate of Registration within 30 days after the date of its
expiration, the Certificate of Registration shall be automatically suspended.
Upon suspension of the Certificate of Registration, the legal counsel or the administrator
of the Board shall notify the Secretary of State in writing.
(6) The Certificate of Registration may be reinstated
within the fiscal year upon payment of the renewal fee plus a late renewal fee
of ten ($10.00), if such corporation is then otherwise qualified and entitled
to a renewal of its Certificate of Registration.
History Note: Authority G.S. 55B-10; 55B-11; 55B-12;
90-270.69(4);
Eff. February 1, 1994;
Amended Eff. July 1, 2007.
21 NCAC 38 .0704 GENERAL AND ADMINISTRATIVE
PROVISIONS
(a) If the legal counsel or administrator shall decline to
issue a Certificate of Registration required by 21 NCAC 38 .0703(1), or decline
to renew the same when requested, or shall refuse to take any other action
required of him/her in writing by a professional corporation, the aggrieved
party may request, in writing, a review of such action by the Board, and the
Board shall provide a formal hearing for such aggrieved party before a majority
of the Board.
(b) All amendments to charters of professional
corporations, all merger and consolidation agreements to which a professional
corporation is a party, and all dissolution proceedings and similar changes in
the corporate structure of a professional corporation shall be filed with the
legal counsel or administrator of the Board for approval before being filed
with the Secretary of State.
(c) The legal counsel or administrator may issue the
certificate (Corp. Form 04) required by G.S. 55B-6 when stock is transferred in
a professional corporation, and such certificate shall be permanently attached
to the stub of the transferee’s certificate in the stock book of the
professional corporation.
History Note: Authority G.S. 55B-6; 90-270.69(4);
Eff. February 1, 1994;
Amended Eff. July 1, 2007.
21 NCAC 38 .0705 FORMS
The following forms may be secured from the office of the
Board regarding professional corporations:
(1) Regulations adopted by the Board relating to
Professional Corporations whose purpose is providing occupational therapy
related services;
(2) Corp. Form 01 ‑ Certificate of
Incorporator(s) and Application for a Certificate of Registration for a
Professional Corporation;
(3) Corp. Form 02 ‑ Certificate of Registration
of a Professional Corporation for the Purpose of Providing Occupational Therapy
Related Services;
(4) Corp. Form 03 ‑ Application for Renewal of
Certificate of Registration; and
(5) Corp. Form 04 ‑ Certificate Authorizing
Transfer of Stock in Professional Corporation Organized to Provide Occupational
Therapy Related Services.
History Note: Authority G.S. 55B‑12; 90‑270.69(4);
Eff. February 1, 1994.
21 NCAC 38 .0706 FEES
(a) Initial issuance of a Certificate of Registration
requires a fee of fifty dollars ($50.00).
(b) Renewal of a Certificate of Registration requires a fee
of twenty‑five dollars ($25.00).
(c) Late renewal of a Certificate of Registration requires
an additional fee of ten dollars ($10.00).
History Note: Authority G.S. 55B‑10; 55B‑11;
55B‑12; 90‑270.69(4);
Eff. February 1, 1994.
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 reasoning skills necessary to
perform his or her 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.
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.
History Note: Authority G.S. 90-270.69; 90-270.75(a);
Eff. July 1, 2007;
Amended Eff. January 1, 2015; February 1, 2014.
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) 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.
21 NCAC 38 .0804 SCOPE OF QUALIFIED ACTIVITIES FOR
MAINTAINING CONTINUING COMPETENCE
(a) To be approved by the Board, activities must be related
to 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.
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
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
hours spent in activities directly related to achievement of goals and
objectives 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.
(b) Participation as Mentor:
(i) Participation in a formalized mentorship
agreement with a 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
that are outside current required job performance;
(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 hours of fieldwork, up to a maximum of six points;
(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;
(b) A licensee may earn two points for each one
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.
(10) Research and Grants:
(a) Development of or participation in a
research project or grant proposal;
(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.
21 NCAC 38 .0806 WAIVER OF REQUIREMENTS
The Board shall waive all or part of the continuing
competence activity requirements of this Section if an occupational therapist
or occupational therapy assistant submits written request for a waiver and
provides evidence to the satisfaction of the Board of an illness, injury,
financial hardship, family hardship, or other similar extenuating circumstance
which precluded the individual's completion of the requirements. The Board
shall add the unfulfilled continuing competence hours to the following year's
requirements.
History Note: Authority G.S. 90-270.69; 90-270.75(a);
Eff. July 1, 2007.
21 NCAC 38 .0807 DOCUMENTATION/REPORTING PROCEDURES
(a) Licensees shall maintain the required proof of
completion for each continuing competence activity as specified in the rules of
this Section. The required documentation shall be retained by the licensee for
two years following the last day of the license renewal period for which the
continuing competence activities were earned.
(b) Licensees shall not send their continuing competence
activity documentation to the Board unless audited or otherwise requested by
the Board.
History Note: Authority G.S. 90-270.69; 90-270.75(a);
Eff. July 1, 2007.
21 NCAC 38 .0808 AUDIT OF CONTINUING COMPETENCE
ACTIVITIES
(a) The Board shall perform a random audit of licensees'
continuing competence activity requirements at least once during each licensing
period.
(b) A licensee who is audited shall provide proof of
completion of the continuing competency activities.
(c) A licensee who fails to comply with the continuing
competence activity requirements of this Section shall be subject to
disciplinary action that may include suspension or revocation of license.
History Note: Authority G.S. 90-270.69; 90-270.75(a);
Eff. July 1, 2007.
Section .0900 - SUPERVISION, SUPERVISORY ROLES, AND CLINICAL
RESPONSIBILITIES OF OCCUPATIONAL THERAPIST AND OCCUPATIONAL THERAPY ASSISTANTS
21 NCAC 38 .0901 NOTIFICATION OF SUPERVISION CHANGE
Occupational therapy assistants and supervising occupational
therapists must notify the Board office in writing of any change in ceasing or
assuming supervision. The occupational therapist is responsible for
supervision of the occupational therapy assistant until official notice that
supervision has ceased is received at the Board office. Failure to notify the
Board may subject both the occupational therapist and occupational therapy
assistant to disciplinary action. Notices must be signed. Telephone or email
notices shall not be accepted.
History Note: Authority G.S. 90-270.69;
Eff. July 1, 2007.
21 NCAC 38 .0902 Supervision is an interactive
process.
The occupational therapist and the occupational therapy
assistant are each responsible for supervision to ensure safe and effective
service delivery of occupational therapy services and to foster professional
competence and development. The supervising occupational therapist shall
provide supervision. The occupational therapy assistant shall obtain
supervision. Evidence of supervision must be recorded on a supervisory log or
in the documentation.
History Note: Authority G.S. 90-270.69;
Eff. July 1, 2007.
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.
21 NCAC 38 .0904 DOCUMENTATION OF SUPERVISION
(a) Documentation of supervision is the responsibility of
both the occupational therapist and occupational therapy assistant.
Documentation must include the frequency of supervisory contact, method(s) or type(s)
of supervision, content areas addressed, and names and credentials of the
persons participating in the supervisory process.
(b) Supervision must reflect a review of all aspects of the
occupational therapy assistant's practice. In any situation, the occupational
therapist is ultimately responsible for all delegated services. Co-signature
on occupational therapy service documentation, even if mandated by statute or
rule, does not accurately satisfy supervision requirements.
(c) Effectiveness of the supervision shall be regularly
evaluated by both the occupational therapist and the occupational therapy
assistant.
History Note: Authority G.S. 90-270.69;
Eff. July 1, 2007.
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. 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. December 1, 2009.
SECTION .1000 – SUPERVISION OF LIMITED PERMITTEES
21 NCAC 38 .1001 Limited Permit
21 NCAC 38 .1002 SUPERVISION OF LIMITED PERMITTEE
21 NCAC 38 .1003 SERVICE COMPETENCY OF limited
permittee
21 NCAC 38 .1004 SIGNATURE OF limited permittee
21 NCAC 38 .1005 BOARD NOTIFICATION
History Note: Authority G.S. 90-270-69; 90-270.74;
Eff. July 1, 2007;
Repealed Eff. November 1, 2007.
section .1100 – supervision of unlicensed personnel
21 NCAC 38 .1101 RESPONSIBILITY OF THE OCCUPATIONAL
THERAPY PRACTITIONER
(a) The occupational therapy practitioner is responsible
for the quality of all occupational therapy services provided to the client by
persons under the practitioner's supervision. It is the occupational therapy
practitioner who provides skilled occupational therapy services through the
exercise of professional judgment.
(b) The occupational therapy practitioner shall provide and
review these Rules with each unlicensed person under the practitioner's
supervision.
History Note: Authority G.S. 90-270-69;
Eff. July 1, 2007.
21 NCAC 38 .1102 DELEGATION OF DUTIES TO UNLICENSED
PERSONNEL
(a) Unlicensed personnel do not provide skilled
occupational therapy services. Unlicensed Personnel are trained by an
occupational therapist or occupational therapy assistant to perform specifically
delegated tasks. The occupational therapist is responsible for the overall use
and actions of the unlicensed personnel. Unlicensed personnel first must
demonstrate competency to be able to perform the assigned, delegated client and
non-client related tasks.
(b) The occupational therapist must oversee the
development, documentation, and implementation of a plan to supervise and
routinely assess the ability of the unlicensed personnel to carry out client
and non-client related tasks. The occupational therapy assistant may
contribute to the development and documentation of this plan.
(c) The occupational therapy assistant may supervise
unlicensed personnel.
(d) Non-client related tasks include clerical and
maintenance activities and preparation of the work area or equipment.
(e) Client-related tasks are routine tasks during which the
unlicensed personnel may interact with the client but does not provide skilled
occupational therapy services. The following factors must be present when an
occupational therapist or occupational therapy assistant delegates a selected
client-related task to the unlicensed personnel;
(1) The outcome anticipated for the delegated
task is predictable;
(2) The situation of the client and environment
is stable and will not require the judgment interpretation, or adaptations be
made by the unlicensed personnel;
(3) The client has demonstrated some previous
performance ability in executing the task; and
(4) The task routine and process have been
established.
(f) When performing delegated client-related tasks the
supervisor must ensure that the unlicensed personnel;
(1) is trained and able to demonstrate
competency in carrying out the selected task and using equipment, if
appropriate;
(2) has been instructed on how to specifically
carry out the delegated task with the specific client, and
(3) knows the precautions, signs and symptoms
for the particular client that would indicated the need to seek assistance for
the occupational therapist or occupational therapy assistant.
(g) The supervision of the unlicensed personnel must be
documented and include;
(1) information about frequency and methods of
supervision used;
(2) the content of supervision; and
(3) the names and credentials of all persons
participating in the supervisory process.
(h) Occupational therapy practitioners shall not allow
employer or work place pressures to result in the prohibited use of unlicensed
personnel.
(i) Services provided by unlicensed personnel may not be
billed, charged, or identified as "occupational therapy."
History Note: Authority G.S. 90-270-69;
Eff. July 1, 2007.
