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BOARD OF OCCUPATIONAL THERAPY2005 Evergreen Street, Suite 2050, Sacramento, CA 95815T: (916) 263-2294 F: (916) 263-2701E-mail: [email protected] Web: www.bot.ca.gov
STATE OF CAL.IFORNIA
ocaBOARD MEETING NOTICE AND AGENDA
November 4, 2010
University of St. Augustine700 Windy Point Drive, Bldg. A
San Marcos, CA 92069
(760) 591·3012 Directions only
9:00 a.m. Board meeting
The public may provide comment on any issue before the board at the time the matter is discussed.
1. Call to order, roll call, establishment of a quorum.
2. President's remarks. (M. Evert)
3. Board member updates/activities.
4. Approval of the July 28-29, 2010, Board meeting minutes. (M. Evert)
5. Director's Report - Representative from Department of Consumer AffairsA. Enforcement Reform: Consumer Protection Enforcement Initiative
(CPEI)B. SB 1441 - Uniform Standards (SB 1441) Regarding Substance Abusing
Healing Arts licenseesC. Federal Healthcare ReformD. Other Items of Interest
6. Practice Committee Report. (L. Florey)A. Practice Committee's Roles and Responsibilities and recommended
changes to the Board.B. Board-approved legislative proposal to amend definition of Occupational
Therapy, Business and Professions Code Section 2570.2(k), andrecommendation to the Board.
C. Discussion of specialized occupational therapy skills acquired post entry-level recognition of various certification organizations, andrecommendation to the Board.
D. Discussion and consideration of amending Title 16, Division 39, Section4161, Continuing Competency, and recommendation to the Board.
E. Selection of 2011 Practice Committee meeting dates.
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Board Meeting Notice and AgendaNovember 4,2010Page 2
7. American Occupational Therapy Association's request that Board reconsiderregulatory language to amend Title 16, Division 39, California Code ofRegulations (CCR) Section 4123, Limited Permit, and add section 4125,Representation, adopted at July zs" Board meeting. (H. Martin)
8. Discussion and consideration of adding Title 16, Division 39, CCR Section 4171,Notification to Consumers. (H. Martin)
9. Regulations Update. (H. Martin)
10.Legislation Update. (H. Martin)A. Consideration of adding new Business and Professions Code Section
requiring registration of occupational therapy aides.B. Any other bills of interest to the Board.
11.Executive Officer's report. (H. Martin)A. Revenue and expenditure information.B. Personnel updates.C. Other informational items.
12.Enforcement data and reports. (H. Martin)
13.Public comment session for items not on the agenda.
14.Discussion and consideration of future agenda items at March 3, 2011, meeting.
15.The Board will convene in CLOSED SESSION pursuant to Government CodeSection 11126(a)(1) for the Evaluation of the Executive Officer.
16.The Board will convene in CLOSED SESSION pursuant to Government CodeSection 11126(c)(3) to deliberate on Disciplinary Decisions.
Return to Open Session.
Adjournment.
UNIVERSITY OF ST. AUGUSTINEFOR HEALTH SCIENCES
700 Windy Point Drive, Bldg. ASan Marcos, CA 92069
(760) 591·3012
Directions:- From 1-78, go north on Twin Oaks Valley Road- Left on Borden- Right on Windy Point Drive- Left into Campus, (Bldg. A)
IUniversity of 4 III..·.·.·.....•.•.•..·.·...•St. Augustine II
Windy Point Drive
Borden
Twin OaksValley Road
1-781-5 1-15
AGENDA ITEM 4
ApPROVAL OF JULY 28-29, 2010, BOARD MEETING MINUTES.
The draft minutes are attached for review.
Board Meeting November 4,2010 San Marcos, CA
ITEMTOBE
PROVIDED
AGENDA ITEM 6
PRACTICE COMMITTEE REpORT.
The following were included in the Practice Committee meeting materials:
A. Practice Committee's Roles and Responsibilities.B. Legislative proposal to amend BPC 2570.2(k) approved at July Board
meeting, letter from AOTA re: proposed amendment to Definition ofOccupational Therapy Practice for the AOT A Model Practice Act and theproposal, and AOTA's document entitled Occupational Therapy ResearchAgenda.
C. No attachment.D. Proposed amendment to CCR 4161.E. No attachment.
Board Meeting November 4,2010 San Marcos, CA
California Board of Occupational TherapyPRACTICE COMMITTEE
Roles & Responsibilities
1. Review and provide recommendations to Board staff on Applicationsfor Advanced Practice Post-Professional Education received fromcourse providers;
2. Review and provide recommendations to Board staff on initialapplications for licenses/certificates received from individuals whohave not been engaged in the practice occupational therapy for fiveyears;
3. Review and provide recommended responses to the Board onvarious practice issues/questions submitted by licensees andconsumers;
4. Provide guidance on continuing competency audits, includingreviewing and providing recommendations on audit responses, ifnecessary;
5. Review and provide recommendations to Board staff on applicants forthe Expert Reviewer Program;
6. Review and provide recommendations to Board staff on revisions tovarious applications and forms used by the Board;
7. Review and provide recommendations to the Board on practicerelated proposed regulatory amendments.
8. Establish resource pool of Expert Reviewers to review and providerecommendations to Board staff on Applications for AdvancedPractice Approval in hand therapy, physical agent modalities, andswallowing assessment, evaluation, or intervention.
Revised August 2006
Amend Business & Professions Code Section 2570.2(k)
(k)WPFaetieeef eOccupational therapy" means the therapeutic use of purposeful andmeaningful goal-dlrected activities (occupations) which engage the individual's body and mindin meaningful, organized, and self-directed actions that maximize independence. prevent orminimize disability. and promote or maintain health. well being. and qualilY of life.Occupational therapy services encompass research. education of students. occupationaltherapy assessment. treatment. education of, and consultation with, ineMsYals ",~e l:lwJe ~eenF8feFRM;jfor eS6YJ9atieRsltl:leFaI=lYservises sYbseqyent to ElisgneBis ef eisssse eFelBeNer (erwl:le aFa reeeMRg essYJ9atienal tl:leFaI=lYserviees as JJartef an InEiMElYalii!9E1iElyeatlen Plan(liP) pYFSyant to tl:le feEleFallneMeYalB witl:l Disabilities iElYeatien Aet (IDEA}). individuals.groups. programs, organizations. or communities.illOccupational therapy assessment identifieS performance abilities and limitations that arenecessary for self-maintenance. learning, work, and other similar meaningfUl activities.Occupational therapy treatment is focused on developing. improving. or restoring functionaldaily living skills. compensating for and preventing dysfunction. or minimizing disability.Occupational therapy techniques that are used for treatment Involve teaching activities of dailyliVing (excluding speech-language skills); designing or fabricating selective temporary orthoticdevices, and applying or training in the use of assistive technology or orthotic and prostheticdevices excluding galt training). Occupational therapy consultation provides expert advice toenhance function and quality of life. Consultation or treatment may involve modification oftasks or environments to allow an Individual to achieve maximum independence. Services areprovided individually, Q[ in groups~, eFtf:lFaYgf:l6esial gFOYpS.(2) The licensed occupational therapist or occupational therapy assistant maY assume avarietY of roles in their profession. including but not limited to. clinician. suoervlsor ofoccuPational theraDV students and volunteers. researcher. scholar. consultant. administrator.faculty. clinical instructor. continuing education instructor and educator of consumers/clients.The term "client" is used to name the entity that receives occupational theraDV services.Clients may be categorized as: .a) Individuals. including individuals who may be involved in supporting or caring for the client(I.e. caregiver. teacher. parent. employer. spouse);b) IndMduals within the context of a group (e.g .. a family. a class); orc) individuals within the context of a population (e.g .. an organization. a community).(I) wHand therapy" is the art and science of rehabilitation of the hand. wrist. and forearmrequiring comprehensive knowledge of the upper extremity and specialized skills inassessment and treatment to prevent dysfunction. restore function, or reverse theadvancement of pathology. This definition is not Intended to prevent an occupational therapistpracticing hand therapy from providing other occupational therapy services authorized underthis act in conjunction with hand therapy.(m) wPhysical agent modalities" means techniques that produce a response in soft tissuethrough the use of light, water, temperature, sound, or electricity. These techniques are usedas adjunctive methods in conjunction with. or in immediate preparation for, occupationaltherapy services.
An~A The American,I" Ocaipa~onal Therapy_ _ • _ Association, Inc.
MEMORANDUM
TO: AOT A Board of DirectorsRepresentative AssemblyAffiliated State Association PresidentsCommission on PracticeCommission on Continuing Competence and Professional DevelopmentSpecial Interest Section Steering CommitteeAccreditation Council for Occupational Therapy EducationAssociation of Student Delegates Steering CommitteeCommission on EducationEthics CommissionEducation Program DirectorsState Legislative ChairpersonsState Occupational Therapy Regulatory BoardsPaul Grace, President and CEO, NBCOTAOTA Staff
FROM: Chuck WillmarthDirector, State Affairs and Reimbursement & Regulatory Policy
Marcy Buckner, JDState Policy Analyst
DATE: September 23,2010
SUBJECT: Feedback regarding the revised Definition of Occupational Therapy Practice forthe AOTA Model Practice Act
AOTA has worked with state occupational therapy associations to enact state licensure laws formore than 30 years. Part of that support has included the development of reference documentssuch as the AOTA Model Practice Act, which includes a definition of occupational therapypractice.
The Definition of Occupational Therapy Practice for the AOTA Model Practice Act reflects thecurrent scope of practice of occupational therapy and consistency with other AOTA documents.It is intended for use by state associations and state regulatory boards in updating state practiceacts to reflect current practice and terminology. Once enacted into law, the definition legallydefines the occupational therapy scope of practice in state statutes.
Revisions to the definition were last adopted by the RA in 2004. In June 2010, AOTA's StateAffairs Group sought input from the Association's leadership, external stakeholders, and themembership in order to facilitate revisions to the definition. The input that was submitted wasreviewed by AOT A staff, and has been compiled in to a revised version of the definition. We arenow seeking comments on the revised version of the definition through this Zoomerang Survey:http://www.zoomerang.com/SurveyIWEB22B6PWLFCCA.
Memorandum regarding the revised Definition of Occupational Therapy PracticeSeptember 23, 2010Page 2
The survey breaks the existing definition paired with the revised definition into six sections toprovide feedback and then asks three general questions about the document. In the revised text,words with a strikethrough have been deleted and words with an underline have been added.
You may also submit proposed edits to the document using the "track changes" feature inWORD to [email protected]. You may access the revised definition in WORD here:http://www .aota.orglDocumentVaultlSurveyslModel- Def Revision.aspx
Please complete the survey and/or submit feedback by October 29,2010. Your input in thisprocess will help define the occupational therapy scope of practice as the profession works torealize the Centennial Vision.
-
Draft Revisions to the Model Definition of Occupational Therapy Practice based on StakeholderInput September 2010Please submit comments to [email protected] by October 29,2010.
Note: Text with a strikethrough has been deleted and text with an underline has beenadded. Sections A and B in the current version were switched in the revised version, so A isnow Band B is now A.
Defmition of Occupational Therapy Practice for the AOT A Model Practice Act
The practice of occupational therapy means the therapeutic use of everyday life acti •. occupations) withindividuals 6f groups, or populations for the fJlil'pose of to address participation e: in roles and situations inhome, school, workplace, community, and other settings. Occupational thera . es are provided fer the fJlU'J'oseofpromo~ag for habilitation. rehabilitation, and promoting health and we ose who have or are at riskfor developing an illness, injury, disease, disorder, condition, impairmen limitation, orparticipation restriction. Occupational therapy addresses the physica , sensory, and otheraspects of performance in a variety of contexts to support engag that affect physicaland mental health, well-being, and quality oflife.
A.
1.
The practice of occupational therapy includes:
2.3. contexts and activity demands that
4.
B. ocess of interventions such as:ration of a skill or ability that has not yet developed
C.e8tires to promote or enhance safety and performance in activities of daily living(ADL), instrume , .'1lctivities of daily living (IADL), education, work, play, rest and sleep. leisure, andsocial participation, including:
1. Therapeutic use of occupations, exercises, and activities.2. Training in self-care, self-management, health management and maintenance. home management,
and community/work reintegration.3. Development, remediation, or compensation of physical, mental. cognitive, neuromuscular,
sensory functions and behavioral skills.4. Therapeutic use of self, including one's personal ity, insights, perceptions, and judgments, as part
of the therapeutic process.5. Education and training of individuals, including family members, caregivers, groups. and others.6. Care coordination, case management, and transition services.7. Consultative services to groups, programs, organizations, or communities.
-
8. Modification of environments (home, work, school, or community) and adaptation of processes,including the application of ergonomic principles.
9. Assessment, design, fabrication, application, fitting, and training in seating and positioning.assistive technology, adaptive devices, and orthotic devices, and training in the use of prostheticdevices.
10. Assessment, recommendation, and training in techniques to enhance functional mobility, includingwheeleheir management of wheelchairs and other mobility devices.
l.L Low vision rehabilitation.H . .lb...Driver rehabilitation and community mobility.H. .ll.-Management of feeding, eating, and swallowing to enable eating and feeding performance.H. 14. Application of physical agent modalities, and use of a range of specific therapeutic procedures(such as wound care management; techniques to enhance sensory, percep cognitive processing;manual therapy techniques) to enhance performance skills.
Adopted by the Representative Assembly 5/21/04 (Agenda All, Char
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CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
PROPOSED AMENDED REGULATORY LANGUAGETitle 16, Division 39, California Code of Regulations
Proposed amendments are shown by strikeout for deleted text and underlined for new text.
Article 7. Continuing Competency Requirements
§4161. Continuing Competency.
(a) Effective January 1,2006, each occupational therapy practitioner renewing a license orcertificate under Section 2570.10 of the Code shall submit evidence of meeting continuingcompetency requirements by having completed twenty-four (24) professional developmentunits (PDUs) during the preceding renewal period, twelve (12) PDUs for eash twelve monthperiod, acquired through participation in professional development activities.
(1) One (1) hour of participation in a professional development activity qualifies for onePDU;(2) One (1) academic credit equals 10 PDUs;(3) One (1) Continuing Education Unit (CEU) equals 10 PDUs.
(b) Topics and subject matter shall be pertinent to the practice of OT. Course material musthave a relevance or direct application to a consumer of occupational therapy services. Exceptas provided in subdivision (c), pProfessional development activities acceptable to the boardinclude but are not limited to, programs or activities sponsored by the American OccupationalTherapy Association (AOTA) or the Occupational Therapy Association of California; post-professional coursework completed through any approved or accredited educational institution,that is not part of a sourse of study leading to an asademis degree; or otherwise meets all ofthe following criteria:
(1) The program or activity contributes directly to professional knowledge, skill, and ability;(2) The program or astivity relates directly to the practise of ossupational therapy; and(-6j @The program or activity must be objectively measurable in terms of the hoursinvolved.
(c) PDUs may also be obtained through any or a combination of the following:(1) Involvement in structured special interest or study groups with a minimum of three (3)participants. Three (3) hours of participation equals one (1) PDU, with a maximum of six (6)PDUs credited per renewal period.(2) Structured mentoring with an individual skilled in a particular area. For each 20 hours ofbeing mentored, the practitioner will receive three (3) PDUs, with a maximum of six (6)PDUs credited per renewal period.(3) Structured mentoring of a colleague to improve his/her skills. Twenty (20) hours ofmentoring equals three (3) PDUs, with a maximum of six (6) PDUs credited per renewalperiod.(4) Supervising the fieldwork of Level II occupational therapist and occupational therapyassistant students. For each 60 hours of supervision, the practitioner will receive .5 PDU~with a maximum of twelve (12) PDUs credited per renewal period.
(5) Publication of an article in a non-peer reviewed publication. Each article equals five (5)PDUs, with a maximum of ten (10) PDUs credited per renewal period.(6) Publication of an article in a peer-reviewed professional publication. Each articleequals10 PDUs, with a maximum often (10) PDUs credited per renewal period.(7) Publication of chapter(s) in occupational therapy or related professional textbook. Eachchapter equals 10 PDUs, with a maximum often (10) PDUs credited per renewal period.(8) Making professional presentations at workshops, seminars and conferences. For eachhour presenting, the practitioner will receive two (2) PDUs, with a maximum of six (6) PDUscredited per renewal period.(9) Attending a meeting of the California Board of Occupational Therapy. Each meetingattended equals two (2) PDUs, with a maximum of six (6) PDUs earned credited perrenewal period.(10) Attending board outreach activities. Each presentation attended equals two (2) PDUs,with a maximum of four (4) PDUs earned credited per renewal period.
(d) Partial credit will not be given for the professional development activities listed insubsection (c) and a maximum of twelve (12) PDUs may be credited for the activities listed insubsection (c).(e) This section shall not apply to the first license or certificate renewal following issuance ofthe initial license or certificate.(f) Of the total number of PDUs required for each renewal period, a minimum of one half of theunits must be directly related to the delivery of occupational therapy services, which(1) The delivery of occupational therapy services may include: models, theories or frameworksthat relate to client/patient care in preventing or minimizing impairment, enabling functionwithin the person/environment or community context. Other activities may include, but are notlimited to, occupation based theory assessment/interview techniques, intervention strategies,and community/environment as related to one's practice.(g) Applicants who have not been actively engaged in the practice of occupational therapywithin the past five years completing continuing competency pursuant to section 2570.14(a) ofthe Code to qualify for licensure/certification shall submit evidence of meeting the continuingcompetency requirements by having completed, during the two year period immediatelypreceding the date the application was received, forty (40) PDUs that meet the requirements ofsubsection (b). The forty PDUs shall include:
(1) Thirty-seven (37) PDUs directly related to the delivery of occupational therapy services,which may include the scope of practice for occupational therapy practitioners or theoccupational therapy practice framework;(2) One (1) PDU related to occupational therapy scope of practice;(3) One (1) PDU related to occupational therapy framm' ••ork;~ !.2} One (1) Three (3) PDU§ related to ethical standards of practice for an occupationaltherapist in occupational therapy.
Note: Authority cited: Sections 2570.10 and 2570.20, Business and Professions Code.Reference: Section 2570.10, Business and Professions Code.
AGENDA ITEM 7
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION'S REQUESTTHAT THE BOARD RECONSIDER REGULATORY LANGUAGE.
The following are attached for review:
• Letter from AOT A regarding regulatory proposal to amend Section4123, Limited Permit, and add section 4125, Representation
• Proposed text to amend Section 4123, Limited Permit, and add section4125, Representation, adopted by Board at July meeting.
Board Meeting November 4,2010 San Marcos, CA
An~A The American,I" Occu~at~onalTherapy_ _ _ _ Association, Inc.
Occupational Therapy:Living Life To Its Fullest
October 25,2010
VIA EMAIL [email protected] Board of Occupational Therapy2005 Evergreen Street, Suite 2050Sacramento, California 95815
RE: Proposed Regulatory Language Add CCR Section 4125
Dear Board Members:
On behalf of the American Occupational Therapy Association, Inc. (AOTA), and its 3,200members in California, I am requesting that the Board revisit the proposed regulatory languagethat would add Section 4125 to the California Code of Regulations. These comments are beingsent as a follow up to AOTA's previous letters dated June 7, 2010 and January 28,2010. Whilewe understand that the Board approved the regulatory text at its last meeting held July 28-29,2010, we request that Board clarify the intent of the regulation through an amendment to theregulatory text and through written communication to the licensees. The suggested changes areincluded below.
If the board wishes to proceed with the addition of Section 4125, we suggest the followingamendments to the proposed regulatory text. We believe that the phrase "and currentlyregistered with the National Board for Certification in Occupational Therapy (NBCOT)" willcreate confusion and may go beyond the underlying statute (2570.18). Therefore we request thatthe phrase be deleted. Instead we suggest the addition of language within the regulation to statethat: (1) "0.T.R." and "Occupational Therapist Registered" are privately held trademarks; and(2) "COTA" and "Certified Occupational Therapy Assistant" are privately held trademarks.
In section 4125(c), we suggest that "by" be changed to "as" to further clarify the language and tobe consistent with section 2570.18(d) of the statute.
Proposed Amendments· Section 4125 (As passed by CBOT July 28·29,2010)
Stril(ethrough Text Suggested Text to be DeletedUnderlined Text = Suggested Text to be added
§ 4125. Representation
(a)(1) Unless licensed as an occupational therapist by the Board, a person may not use theprofessional abbreviations "OT" or "O.T.lL.," or refer to themselves as an "OccupationalTherapist" or use any other words, letters, symbols, manner, or means with the intent torepresent that the person practices or is authorized to practice occupational therapy in California.
The AmericanOccupational TherapyAssociation, Inc.
4720 Montgomery LaneBethesda, MO 20814-3425
301-652-2682301-652-7711 Fax
800-377-8555 TOOwww.aota.org
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AOTALetterOctober 25, 2010Page 2
(2) Unless licensed as an occupational therapist by the Board, aREt6YrreRtly registereEt 'Niththe NatieRal 8earEt fer CertifisatieR iR OssYl3atieRal Theral3Y (N8COT) , a person may notuse the professional abbreviations "OTR.," or "O.T.R.lL.," or refer to themselves as"Occupational Therapist, Registered," or "Registered Occupational Therapist" or use any otherwords, letters, symbols, manner, or means, with the intent to represent that the person practicesor is authorized to practice occupational therapy in California. "O.T.R." and "OccupationalTherapist Registered" are privately held trademarks.
(b)( 1) Unless licensed as an occupational therapy assistant, a person may not use theprofessional abbreviations "O.T.A." or "O.T.A.lL," or refer to themselves as an "OccupationalTherapy Assistant," or use any other words, letters, symbols, manner, or means with the intent torepresent that the person practices or is authorized to practice occupational therapy in California.
(2) Unless licensed as an occupational therapy assistant aREt6YrreRtly registereEt ••·.·ith NBCOT,a person may not use the professional abbreviations "C.O.TA" or "C.O.T.A.lL.," or refer tothemselves as "Certified Occupational Therapy Assistant," or use any other words, letters,symbols, manner, or means, with the intent to represent that the person practices or is authorizedto practice occupational therapy in California. "C.O.T.A." and "Certified Occupational TherapyAssistant" are privately held trademarks.
(c) Pursuant to section 2570.18, the unauthorized representation n byan occupational therapistor an occupational therapy assistant constitutes an unfair business practice under Section 17200,false and misleading advertising under Section 17500, and a violation of the Ethical Standards ofPractice
AOTA continues to believe that the new section goes beyond the intent of the existing law andwould inappropriately empower the California Board of Occupational Therapy to enforce theprivate trademarks held by a private credentialing organization. Our view is that the underlyingstatute (2570.18) does not support the addition of this provision and that private trademarksshould not be protected by the Board through state regulation. We do not believe that theCalifornia Board of Occupational Therapy should use its limited financial resources to enforcethe private trademarks held by a private credentialing organization.
Weare concerned that licensees could be required by the Board to provide proof of currentregistration with the National Board for Certification in Occupational Therapy (NBCOT) as acondition for licensure renewal or for other reasons at any time. It is our understanding that theBoard is not seeking authority to enforce NBCOT requirements by adding Section 4125. It isalso our understanding that the intent of this language is to prevent someone that is not licensedfrom using the titles and professional abbreviations as allowed by statute. If this is the case,then we believe that: (1) the regulation should be clarified; and (2) the Board must communicatethe intent of the regulation to licensees.
We understand the concern about the professional abbreviations. We believe that the Boarddoes have authority to take action against unlicensed individuals that use professionalabbreviations with the intent to represent that they practice or are authorized to practiceoccupational therapy and we do not believe that the Board should enforce a private trademark.
AOTALetterOctober 25,2010Page 3
As suggested above, we believe that the Board should clarify the intent of the regulation tolicensees. The Board's website includes General Frequently Asked Questions online at:http://www.bot.ca.gov/fonns pubs/gen fags.shtml. We believe that the addition of new as wellas revised frequently asked questions, in addition to amending the regulatory language, could beused to communicate the intent of the regulation. We suggest the following questions andanswers be changed or added:
General Frequently Asked Questionshttp://www.bot.ca.gov/forms pubs/gen fags.shtml
Underlined Text = Suggested Text
Proposed Revisions to Existing FAQs on CBOT's website
g. Do I need to continue to be certified by NBCOT in order to renew our license?A. No. NBCOT owns the trademarks "OCCUPATIONAL THERAPIST REGISTERED OTR" and"CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA." If you wish to use thetrademarks. contact NBCOT.
g. Now that I'm licensed. what letters do I put after my signature?A. OTPA section 2570.18 lists all the abbreviations you may use once you are licensed. NBCOTowns the trademarks "OCCUPATIONAL THERAPIST REGISTERED OTR" and "CERTIFIEDOCCUPATIONAL THERAPY ASSISTANT COTA." If you wish to use the trademarks, contactNBCOT.
Proposed FAQs
g. If I choose to use OTR or COTA after my signature. will CBOT reguire me to submitproof of current certification with NBCOT.A. No. Section 4125 of Title 16. California Code of Regulations (CCR) requires that occupationaltherapists that wish to use OTR and occupational therapy assistants who wish to use COTA mustbe licensed.
g. I am not licensed but I am currently certified with NBCOT. May I use OTR or COTA aftermy signature?A. No. Section 4125 of Title 16, California Code of Regulations (CCR) provides that onlylicensed occupational therapists may use OTR and only licensed occupational therapy assistantsmay use COTA.
Thank you for the opportunity to share our request with the Board regarding the proposedregulatory language to add Section 4125 to the California Code of Regulations. We would behappy to discuss our request further with the Board. If that would be helpful, please contactAOTA's Director of State Affairs Chuck Willmarth at 301/652-6611 ext 2019 or via email [email protected].
AOTALetterOctober 25,2010Page 4
Sincerely,
Christina A. MetzlerChief Public Affairs OfficerAmerican Occupational Therapy Association
cc: Shawn Phipps, MS, OTR/L, President, Occupational Therapy Association of California
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
PROPOSED AMENDED REGULATORY LANGUAGETitle 16, Division 39, California Code of Regulations
Proposed amendments are shown by strikeout for deleted text and underline for newtext. Proposed amendments for modified text are shown by double strikeout fordeleted text and double underline for new text.
Article 3. License, Certificate, Limited Permit, Inactive Status, and Representation
§ 4123. Limited Permit
(a) To qualify for a limited permit, a person must have applied to the National Boardfor Certification in Occupational Therapy (NBCOT) to take the licensing examinationwithin four (4) months of completing the education and fieldwork requirements forlicensure or certification and request NBCOT provide their examination score reportbe forwarded to the Board.
(1) Upon receipt from NBCOT, the applicant must forward to the Board a copy of theAuthorization to Test (ATT) letter.
2 The a Iicant must rovide documentation or other evidence to the Board torove that the a Iicant re uested their examination score be sent from NBCOT to
the Board, before a limited permit may be issued.(21Q} A limited permit shall only be valid for three (3) months from the date ofissuance by the Board, upon receipt of a failing result, or two (2) weeks followinq theexpiration of the applicants' eligibility to test period, whichever occurs first.f31!1} The limited permit holder must immediately notify the Board of the results ofthe examination.
f41@ The limited permit holder must provide the Board the name, address andtelephone number of their employer and identify the name and license number oftheir supervising occupational therapist (OT). Any change to employer orsupervising OT must be provided to the Board, in writing, within 10 days of thechange.
(b) The limited permit will be cancelled, and the fee forfeited, upon notification to theBoard or the limited permit holder by the test administrator that the holder failed topass the first examination.
Note: Authority cited: Section 2570.20, Business and Professions Code.Reference: Sections 2570.5,2570.6,2570.7,2570.9,2570.16, and 2570.26,Business and Professions Code, and Sections 4100,4102,4110,4111,4112,4114,4120, and 4130, California Code of Regulations.
§ 4125. Representation
a 1 Unless licensed as an occu ational thera ist hBoard. a person may not use the professional abbreviations "O.T." or "O.T.lL.," orrefer to themselves as an "Occupational Therapist" or use any other words. letters,symbols. manner. or means with the intent to represent that the person practices oris authorized to oractice occuoational therapy in California.(2) Unless Rsl€ii;S EIlicensed is BFElsti€lSas an occupational therapist by the Board~and currently iR esse stElF!€iiRE!registered with the National Board for Certification inOccupational Therapy (NBCDT) . a person may not use the professionalabbreviations "D.T.R.," or "D.T.R.lL.." or refer to themselves as "OccupationalTherapist. Registered," or "Registered Occupational Therapist" or use any otherwords, letters, symbols. manner, or means. with the intent to represent that theperson practices or is authorized to practice occupational therapy in California=aM€llslFFSRtl'(FseistsFs8 wit'"' ~JQGOT.(b)(1) Unless Rsl€iiF!€1Ellicensed \s BFEl8ti8Sas an occupational therapy assistant. aperson may not use the professional abbreviations "D.T.A." or "D.T.A.lL." or refer tothemselves as an "Occupational Therapy Assistant." or use any other words, letters,symbols, manner, or means with the intent to represent that the person practices oris authorized to practice occupational therapy in California.(2) Unless ,",slsiR€IEIlicensed \8 BFEls\issas an occupational therapy assistant andcurrently iF!esse! stElF!e!iF!eregistered with NBCDT, a person may not use theprofessional abbreviations "C.D.T.A." or "C.O.T.A.lL.," or refer to themselves as"Certified Dccupational Therapy Assistant." or use any other words, letters, symbols.manner. or means, with the intent to represent that the person practices or isauthorized to practice occupational therapy in California ElRSSlslFFSR\lyFS€listsFsswit'"' MiGOT.(c) Pursuant to section 2570.18, the unauthorized representation by an occupationaltherapist or an occupational therapy assistant constitutes an unfair business practiceunder Section 17200. false and misleading advertising under Section 17500, and aviolation of the Ethical Standards of Practice.
Note: Authority cited: Section 2570.20. Business and Professions Code.Reference: Sections 2570.3,2570.18,17200, and 17500, Business andProfessions Code.
2
AGENDA ITEM 8
DISCUSSION AND CONSIDERATION OF ADDING TITLE 16,DIVISION 39, CCR SECTION 4171, NOTICE CONSUMERS.
The following are attached for review:
• Proposed regulatory language to add section CCR 4141, Notice toConsumers.
• Assembly Bill 583.
Board Meeting November 4,2010 San Marcos, CA
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
PROPOSED AMENDED REGULATORY LANGUAGETitle 16, Division 39, California Code of Regulations
Proposed amendments are shown by strikeout for deleted text and underline for newtext.
Add section 4171 to Article 8 of Division 39 of Title 16 of the California Code ofRegulations to read as follows:
§ 4171. Notice to Consumers.(a) An occupational therapy practitioner shall provide notice to each patient or client ofhis or her name, license type, and that his or her license is issued and regulated by theboard.(b) A licensee may disclose his or her name and license type by wearing a name tag inat least 18-point type, or by prominently posting a copy of his or her license in thepractice area or office where he or she works.(c) A licensee may disclose that his or her license is issued and regulated by the boardby any of the following methods:(1) Including on a name tag, "CA Board of Occupational Therapy."(2) Verbally at the time that services are requested, and each time services arerendered.(3) On a business card identifying the person as a licensee of the California Board ofOccupational Therapy that is provided to the patient or client at the time of initialevaluation.(4) Written notice in a statement that includes the following information, either given to apatient or client in connection with services provided, or posted in an area visible topatients or clients on the premises where the licensee provides occupational therapyservices:
NOTICE TO CONSUMERS
Occupational therapists and occupational therapy assistantsare licensed and regulated by the
California Board of Occupational Therapy(916) 263-2294www.bot.ca.gov
(A) If given to a patient or client. the notice shall be in at least 14-point type in Arial font.provided at the time of evaluation.(B) If posted where services are provided, the notice shall be in at least 48-point type inArial font.
Authority cited: Section 2570.20, Business and Professions Code; Reference: Sections138 and 680, Business and Professions Code.
BUSINESS AND PROFESSIONS CODE
138. Every board in the department, as defined in Section 22, shall initiate the process ofadopting regulations on or before June 30, 1999, to require its licentiates, as defined inSection 23.8, to provide notice to their clients or customers that the practitioner is licensedby this state. A board shall be exempt from the requirement to adopt regulations pursuantto this section if the board has in place, in statute or regulation, a requirement that providesforconsumer notice of a practitioner's status as a licensee of this state.
680. (a) Except as otherwise provided in this section, a health care practitioner shalldisclose, while working, his or her name and practitioner's license status, as granted bythis state, on a name tag in at least 18-point type. A health care practitioner in a practice oran office, whose license is prominently displayed, may opt to not wear a name tag. If ahealth care practitioner or a licensed clinical social worker is working in a psychiatricsetting or in a setting that is not licensed by the state, the employing entity or agency shallhave the discretion to make an exception from the name tag requirement for individualsafety or therapeutic concerns. In the interest of public safety and consumer awareness, itshall be unlawful for any person to use the title "nurse" in reference to himself or herselfand in any capacity, except for an individual who is a registered nurse or a licensedvocational nurse, or as otherwise provided in Section 2800. Nothing in this section shallprohibit a certified nurse assistant from using his or hertitle.
(b) Facilities licensed by the State Department of Social Services, the State Departmentof Mental Health, or the State Department of Health Services shall develop and implementpolicies to ensure that health care practitioners providing care in those facilities are incompliance with subdivision (a). The State Department of Social Services, the StateDepartment of Mental Health, and the State Department of Health Services shall verifythrough periodic inspections that the policies required pursuant to subdivision (a) havebeen developed and implemented by the respective licensed facilities.
(c) For purposes of this article, "health care practitioner" means any person whoengages in acts that are the subject of licensure or regulation under this division or underany initiative act referred to in this division.
Assembly Bill No. 583
CHAPTER 436
An act to add Section 680.5 to the Business and Professions Code, relatingto health care practitioners.
[Approved by Governor September 29, 2010. Filed withSecretary of State September 29,2010.]
LEGISLATIVE COUNSEL'S DIGEST
AB 583, Hayashi. Health care practitioners: disclosure of education.Existing law requires a health care practitioner to disclose, while working,
his or her name and practitioner's license status on a name tag in at least18-point type or to prominently display his or her license in his or her office,except as specified.
This bill would require each of those health care practitioners to disclosethe type of license and, except as specified, the highest level of academicdegree he or she holds either in a prominent display in his or her office orin writing, in a specified format given to a patient on his or her initial officevisit. The bill would require a physician and surgeon, and an osteopathicphysician and surgeon, who is certified in a medical specialty, as specified,to also disclose, in either of those manners the name of the certifying boardor association. The bill would exempt specified health care practitioners,including, without limitation, persons working in certain licensed laboratoriesand health care facilities, as specified, from these requirements.
The people of the State of California do enact as follows:
SECTION 1. Section 680.5 is added to the Business and ProfessionsCode, to read:
680.5. (a) (1) A health care practitioner licensed under Division 2(commencing with Section 500) shall communicate to a patient his or hername, state-granted practitioner license type, and highest level of academicdegree, by one or both of the following methods:
(A) In writing at the patient's initial office visit.(B) In a prominent display in an area visible to patients in his or her
office.(2) An individual licensed under Chapter 6 (commencing with Section
2700) or Chapter 9 (commencing with Section 4000) is not required todisclose the highest level of academic degree he or she holds.
(b) A person licensed under Chapter 5 (commencing with Section 2000)or under the Osteopathic Act, who is certified by (1) an American Board ofMedical Specialties member board, (2) a board or association with
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requirements equivalent to a board described in paragraph (1) approved bythat person's medical licensing authority, or (3) a board or association withan Accreditation Council for Graduate Medical Education approvedpostgraduate training program that provides complete training in the person'sspecialty or subspecialty, shall disclose the name of the board or associationby either method described in subdivision (a).
(c) A health care practitioner who chooses to disclose the informationrequired by subdivisions (a) and (b) pursuant to subparagraph (A) ofparagraph (1) of subdivision (a) shall present that information in at least24-point type in the following format:
HEALTH CARE PRACTITIONER INFORMATION1. Name and license .2. Highest level of academic degree .. .3. Board certification (ABMSIMBC) .
(d) This section shall not apply to the following health care practitioners:(1) A person who provides professional medical services to enrollees of
a health care service plan that exclusively contracts with a single medicalgroup in a specific geographic area to provide or arrange for professionalmedical services for the enrollees of the plan.
(2) A person who works in a facility licensed under Section 1250 of theHealth and Safety Code or in a clinical laboratory licensed under Section1265.
(3) A person licensed under Chapter 3 (commencing with Section 1200),Chapter 7.5 (commencing with Section 3300), Chapter 8.3 (commencingwith Section 3700), Chapter 11 (commencing with Section 4800), Chapter13 (commencing with Section 4980), or Chapter 14 (commencing withSection 4990.1).
(e) A health care practitioner, who provides information regarding healthcare services on an Internet Web site that is directly controlled oradministered by that health care practitioner or his or her office personnel,shall prominently display on that Internet Web site the information requiredby this section.
o
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AGENDA ITEM 9
REGULATIONS UPDATE.
The Regulations Update Report is attached for review.
Board Meeting November 4, 2010 San Marcos, CA
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LEGISLATION UPDATE.
Board Meeting
AGENDA ITEM 10
November 4,2010 San Marcos, CA
Assembly Bill No. 2385
CHAPTER 679
An act to add and repeal Article 3.7 (commencing with Section 78265)of Chapter 2 of Part 48 of Division 7 of Title 3 of the Education Code,relating to public postsecondary education.
[Approved by Governor September 30, 2010. Filed withSecretary of State September 30, 2010.]
LEGISLATIVE COUNSEL'S DIGEST
AB 2385, John A. Perez. Pilot Program for Innovative Nursing and AlliedHealth Care Profession Education at the California Community Colleges.
Existing law establishes the California Community Colleges, under theadministration of the Board of Governors of the California CommunityColleges, as one of the segments of public postsecondary education in thisstate. Existing law establishes community college districts, each of whichis administered by a governing board, throughout the state, and authorizesthese districts to provide instruction to students at the community collegecampuses maintained by the districts.
The bill would establish the Pilot Program for Innovative Nursing andAllied Health Care Profession Education at the California CommunityColleges under the administration of the Office of the Chancellor of theCalifornia Community Colleges to facilitate the graduation of communitycollege nursing and allied health students by piloting innovative models toexpand the state's capacity to prepare a qualified health care workforce.The bill would require the chancellor's office to establish the pilot programat up to 5 campuses throughout the state according to specified requirements.
The bill would express legislative intent that the pilot program be fundedwith a combination of state apportionment funding, federal grants,employer-based partnerships, and private philanthropic resources.
The bill would require the chancellor's office to collect appropriate datafor the purpose of evaluating the effectiveness of the pilot program. Thebill would require the chancellor's office to analyze this data, and contractwith an external evaluator to conduct an independent evaluation, withfindings and recommendations with respect to the pilot program to bereported to the Legislature on or before January 1,2017.
The bill would provide that its provisions would be implemented in anyfiscal year only to the extent that the chancellor's office determines thatsufficient moneys are available to administer the program.
The bill would provide that the pilot program would become inoperativeon July 1,2017, and as ofJanuary 1,2018, would be repealed.
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The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) Allied health care occupations are expected to grow dramatically in
the next decade, and California labor market data show that, by 2017, alliedhealth care occupations are projected to account for more than 1,100,000jobs around the state, an increase of close to 130,000 jobs, or 13 percent,from 2007.
(b) Health care industry experts project a growing demand for care dueto burgeoning population growth and an aging population. Retirements byhealth care employees will place additional strain on a system struggling totrain the number of qualified individuals necessary to meet the demands ofthe health care industry.
(c) Although one of the most publicized shortage areas has been registerednurses, a wide variety of allied health care occupations also face workershortages.
(d) The California Community Colleges system currently trainsapproximately 70 percent of registered nurses statewide, offering educationalprograms in a variety of allied health care professions.
(e) Allied health care profession education programs are among the mostcostly education programs offered by community colleges and colleges havebeen forced by fiscal constraints to limit their enrollment capacity.
(f) Currently, most associate degree nursing and allied health careprofession courses are offered over four semesters or two school years, andrequire the completion of 70 units in program courses, assuming that thestudent has met all ofthe prerequisite requirements and is ready to start theprogram immediately.
(g) The goal of this bill is to pilot innovative program delivery andcurriculum models to enable more students to earn their degrees and expandthe state's capacity to train a qualified health care workforce withoutcompromising the integrity of program and licensure requirements.
(h) Successful program models would be a center of innovation and afoundation for the newest educational technology and curricular ideas.
(i) The enactment of the federal American Recovery and ReinvestmentAct of 2009 (Public Law 111-5) and the federal Patient Protection andAffordable Care Act (Public Law 111-148) provided opportunities forCalifornia to address critical health care workforce shortages.
SEC. 2. Article 3.7 (commencing with Section 78265) is added toChapter 2 of Part 48 of Division 7 of Title 3 of the Education Code, to read:
Article 3.7. Pilot Program for Innovative Nursing and Allied Health CareProfession Education at the California Community Colleges
78265. (a) The Pilot Program for Innovative Nursing and Allied HealthCare Profession Education at the California Community Colleges is herebyestablished under the administration of the Office of the Chancellor of the
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-3- Ch.679
California Community Colleges. The goal of the pilot program shall be tofacilitate the graduation of community college nursing and allied healthstudents by piloting innovative models to expand the state's capacity toprepare a qualified health care workforce.
(b) The chancellor's office shall establish the pilot program at up to fivecampuses throughout the state.
(c) The pilot programs shall test innovative program delivery models toexpand the capacity of community colleges to offer health care training tostudents in occupations for which there is a substantial labor market demand.Pilot programs shall test health care education models that use tools suchas technology and flexible scheduling, and shall coordinate student servicesand financial assistance to the maximum extent possible in order to facilitatea student's successful program completion.
(d) The chancellor's office shall pursue a variety of funding sources tohelp support the development and delivery of the pilot programs and createhigh-quality curriculum delivery models to be used in health care certificateand degree programs. These funding sources shall include, but not be limitedto, federal grants, philanthropic funds, employer monetary and in-kindcontributions, and state and federal workforce funds.
(e) The chancellor's office, contingent upon obtaining resources to supportthe development and delivery of the pilot programs, shall develop a requestfor application for community colleges to participate in the pilot programcommencing on or after the 2011-12 academic year. The chancellor's officeshall develop the request for application in collaboration with representativesfrom education, labor, health care employers, licensing and credentialingentities, regional occupational centers and programs, hospitals and nursingorganizations, and other appropriate entities. The chancellor's office shallspecify the amount of baseline funding provided for each pilot programbased upon funding sources developed pursuant to subdivision (d). Pilotprograms shall be in high-demand allied health care or nursing programs.
(f) The chancellor's office shall select pilot programs that do all of thefollowing:
(1) Provide students with an industry-recognized certificate or degree inhealth care fields for which there is a demonstrated shortage of workers inthe labor market and documented support from employers.
(2) Demonstrate a capacity to train specified health care workers, or theability to sustain or expand current innovative health care education andtraining programs, or both. Limited capacity may be demonstrated by waitinglists to enter existing community college allied health care or nursingprograms.
(3) Provide evidence of sufficient clinical sites for offering the pilotprogram.
(4) Include high-quality curriculum delivery models as part of the pilotprogram. All courses shall meet the curriculum standards approved by theappropriate state licensing entities that oversee each health occupation, andshall not in any way shorten the clinical units or hours as determined by theappropriate state licensing entities that oversee each health occupation.
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Ch.679 -4-
Curriculum already approved by the appropriate state licensing entities thatoversee each health occupation shall be deemed to satisfy the requirementsof this paragraph.
(5) Provide flexibility in the delivery of coursework, including, but notlimited to, intensive weekend, evening, and summer courses to enablestudents to efficiently complete program requirements.
(6) Offer coordinated supportive services to students, including, but notlimited to, tutoring and financial advising.
(7) Demonstrate clear, nonduplicative, and articulated education pathwayswith local secondary and postsecondary education entities.
(8) Identify resources to support the pilot program, including, but notlimited to, funding provided by the chancellor's office obtained from outsidesources for the support of the pilot program, local workforce investmentfunding, and locally provided employer or philanthropic resources.
(g) The chancellor's office shall select, to the extent possible, pilotprograms that are geographically distributed throughout the state.
(h) In selecting the pilot programs, the chancellor's office may giveconsideration to existing innovative programs currently underway withinthe community college system that require additional resources to move toscale.
78265.1. As used in this article the following definitions apply:(a) "Chancellor's office" means the Office of the Chancellor of the
California Community Colleges.(b) "Pilot program" means the Pilot Program for Innovative Nursing and
Allied Health Care Profession Education at the California CommunityColleges established by Section 78265.
78265.2. (a) It is the intent of the Legislature that the pilot programattract and admit a diverse and talented pool of students likely to succeedin an innovative program model setting.
(b) To effectuate the legislative intent expressed in subdivision (a), bothof the following shall occur:
(1) In selecting students for admission to the pilot program, participatingcampuses may use a diagnostic assessment tool identified by the chancellor'soffice pursuant to Section 78261. The use of a diagnostic assessment toolby a participating campus shall be part of a comprehensive program-basedsupport system for students who need skills enhancement prior to enteringthe program. When the number of applicants for the pilot program exceedsthe capacity to admit students, a participating campus may do either of thefollowing when that process is deemed feasible:
(A) Administer the multicriteria screening process established underSection 78261.5.
(B) Give preference to students who have participated ina health sciencepathway program, including, but not limited to, a California PartnershipHealth Science and Medical Technology Academy, or a Career AdvancementAcademy.
(2) Participating campuses shall provide support services to help studentscomplete the pilot program. These support services shall include, but not
92
-5- Ch.679
necessarily be limited to, the presence of student success advisers, tutors,mentors, appropriate financial assistance, and aid in placing students whocomplete the program in appropriate internships.
78265.3. It is the intent of the Legislature that the pilot program befunded with a combination of state apportionment funding, employer-basedpartnerships, federal grants, and private philanthropic resources.
78265.4. The chancellor's office shall collect appropriate data for thepurpose of evaluating the effectiveness of the pilot program. The chancellor'soffice shall analyze this data, and contract with an external evaluator toconduct an independent evaluation, with findings and recommendationswith respect to the pilot program to be reported to the Legislature on orbefore January 1,2017.
78265.5. This article shall be implemented in any fiscal year only to theextent that the chancellor's office determines that sufficient moneys areavailable to administer the program.
78265.6. This article shall become inoperative on July 1,2017, and, asof January 1,2018, is repealed, unless a later enacted statute, that becomesoperative on or before January 1,2018, deletes or extends the dates on whichit becomes inoperative and is repealed.
o
92
AGENDA ITEM 11
EXECUTIVE OFFICER'S REpORT.
The following are attached for review:
A. Revenue and Expenditure InformationB. No attachment.C. Other informational items:
• Memo from DCA Legal Office re: Board Meeting Protocols• AOTA's State Issue Update (August 6,2010, September 13,2010, and
October 26, 2010) .
Board Meeting November 4, 2010 San Marcos, CA
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DEPARTMENT OF CONSUMER AFFAIRS
DIVISION OF LEGAL AFFAIRS1625 N. Market Blvd., Suite S 309, Sacramento, CA 95834P (916) 574-8220 F (916) 574-86231
STATE C F CALIFCRNIA STATE 'AND CONSUMER SERVICES AGSNCY • ARhlOLD SCHWAAZENEGGER. GOVERNOR
MEMORANDUM
DATE: October 7,2010
TO: Executive OfficersBoard Presidents/Chairs
FROM:CD~~d~
DOREATHEA JOI-jNSONDeputy DirectorLegal Affairs
SUBJECT: Board Meeting Protocols
Three Duties for Board Meetings
1. Give adequate notice of meetings that will be held and agenda items. "
! '2. Conduct' meetings in open session.
3. Provide the public an opportunity to comment.
First DutyAdequate Notice of Meetings and Agenda Items
1. Timely Law requires 10 days notice to those on a mailing list and postingnotice and agenda on your website.
2. Specific Notice Detailed, itemized agenda, identifying all items ,of businessto be conducted at the meeting.
Items not on agenda cannot be discussed nor can they be acted on.
Can't discuss items under the heading of "New or Old Business" unlessthey are specifically identified.
Test for Specific Notice --Is an item specific enough for a member of thepublic to reasonably ascertain the nature of the business to occur at themeeting?
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Second DutyConduct Meetings
Open Session)
General rule: Meetings must be conducted inOpen Session and all discussionand actions must take place in the public, unless specifically authorized by law to.go into closed session, with regard to that item of business.
Vote in public.- Votes must be publically taken. Secret votes or votes by proxy
are not permitted.
Closed Session
Business statutorily authorized to be conducted in closed session:
Disciplinary matters;
Preparing, approving or grading examinations;
Pending litigation;
_ Matters affecting personal privacy;
_ Executive officer appointment, employment or dismissal.
Once in closed session, you can only discuss those matters that were identifiedas closed session on your aqenda.
Third DutyPublic Comment At The Meeting
General Rule
Must allow public comment on each open session agenda item.
Suggested script to be read at the beginning of the meeting:
The Board Chair will allow public comment on agenda items, as those items aretaken up by the Board, during the meeting. Under the Open Meetings Act, theBoard may not take any action on items raised by public comment that are not onthe Agenda, other than to decide whether to schedule that item for a future
meeting.
If any person desires to address the Board, it will be appreciated if he or she willstand or come forward and give his or her name, and if he or she represents anorganization, the name of such organization, so that we will have a record of allthose who appear. Please note that a person wishing to provide comment is not
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required to identify him or herself when making public comment, but it isappreciated.
In order to allow the Board sufficient time to conduct its scheduled business,public comment will be limited to _ minutes. Please make your commentsfocused and relevant to the duties of the Board. It is not necessary to repeatstatements or views of a previous speaker, it is sufficient to state that you agree.Wrmen statements should be summarized and submitted to the Board. Theyshould not be read.
If as chairperson/president, I forget to ask for public comment on an agenda item,it is not because I intend to limit comment but just because I forgot. So in thatsituation, please raise your hand and I will recognize you.
Suggested script to be used for each item on the agenda:1. Call the Agenda Item .2. Committee Presents the agenda item3. Ask for a motion4. Ask for a second, unless the motion is made by the committee (second
is not needed)5. Ask for board discussion. .6. Ask ifthere is public comment. [You may reverse the order of these 2.)7. Ask if there is further board discussion8. Repeat the Motion9. Take the vote
Suggested script for public comment on items not on the agenda:
The board values input from the public as part of its consumer protectionmission. It invites and welcomes public comment during this section of theagenda. However, board members cannot engage in dialogue with those whotestify during this section of the agenda due to constraints imposed on the boardand its members by law. The law prohibits the board from substantivelydiscussing or voting on any matter brought up during public comment. Amember of the public who would like the board to discuss a general topic notrelated to a specific case involving one of its licensees can ask the board toconsider placing the issue on the board's agenda for a future meeting.
If you have an application or disciplinary charges pending before the board, weask that you not discuss the details of your case or pending complaint since the.board members will be the "judges" and by law are not permitted to receiveevidence or information that is not part of the administrative record in the case.
Disruptive persons:
The public has the right to express its disapproval, and may sometimes makeemotional presentations. It is the board's duty and obligation to allow that publiccomment. Since the purpose of the meeting is for the agency to conduct itsbusiness, commenters shouldn't be permitted to thwart that purpose and may be
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removed from the meeting if disruptive behavior continues after a request that it
stop.
Suggested script to use when there is a disruptive person:
Under the Open Meetings Act (Govemment Code Section 11126.5), if youcontinue in this manner, I will ask you to leave the meeting and if you do notleave the meeting, you will be removed. Accordingly, I am asking you todiscontinue your disruptive conduct so that all participants can be heard in an
orderly fashion.
Miscellaneous
Wording of Motions
Motions must be clearly worded.
The test: Could a reasonable person reading the motion understand what theboard meant to accomplish? .
Chair should restate the motion before the discussion and just before the vote
is taken
Improper Disclosure of Information
Improperfor information received during closed session to be publicly'disclosed without authorization of the body as a whole.
Role of the Attorney
The attorney's role during board meetings is to advise the agency of itsobligations and authority under the law when it appears that the agency may bedeviating from it, e.g. Open Meetings Act, quorum requirements, practice acts,regulations. In some cases, it may be necessary for the attorney to assist theagency in identifying an issue, framing a motion that accurately reflects theagency's deliberations and intent or seeking clarification from a speaker or board
member.
When a problem is identified, the attorney is expected to assist the board indeveloping a lawful alternative method of accomplishing the board's goal.
ltis not the attorney's responsibility or role to chair the meetings or direct thediscussion. And the attorney should refrain from doing so even if requested to
take on that role.
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AOTA State Issue UpdateAugust 16, 2010
This update summarizes the state legislative and regulatory activity from July 30August 15 that could impact the profession. Additional information about theseproposals is available upon request. This report is distributed to state presidents and stateOT association legislative/government affairs chairs.
Legislation:
California: CA AB 1647 would make it unlawful for any person to hold themselves outas a certified athletic trainer unless they have met specified educational requirements andhave been certified by a specified entity and has either graduated from a college oruniversity, after completing an accredited athletic training education program orcompleted requirements for certification by that specified entity. In June, AOTA andOTAC worked closely together to send a letter to the sponsor, AssemblymemberHayashi, regarding previously introduced language that allowed physicians and surgeonsto develop "protocols" that define "athletic training activities" without any parameters instatute. AOTA and OTAC suggested alternative language. Subsequently the bill wasamended to exclude the language at issue. The bill passed the Senate on August 12 andnow the Assembly must vote to concur with the Senate'samendments.http://www.leginfo.ca. gov/pub/09-l O/billlasm/ab 1601-l650/ab 1647 bill 20100628 amended sen v92.html
llIinois: IL EO 32 was issued by Governor Pat Quinn on July 30. The executive ordercreates the Health Reform Implementation Council. The purpose of the council is tomake recommendations to the governor regarding the implementation of health carereform. The council will make recommendations on opportunities in the Affordable CareAct (ACA) for states to establish a health insurance exchange; to reform Medicaidservice structures; to develop an adequate health care workforce; to incentivize deliverysystems to assure high quality health care; to identify federal grants, pilot programs, andother non-state funding sources to assist with implementation of the ACA; and to fosterwidespread adoption of electronic medical records and participation in the Illinois HealthInformation Exchange.http://www.illinois.gov/publicincludes/statehome/gov/documents/EO%20l0-l2.pdf
Massachusetts: MA HB 4935 was signed in to law by Governor Deval Patrick onAugust 3. The bill requires coverage of medically necessary autism treatments andtherapeutic care, including occupational therapy. The bill is unique in that it does notestablish age registrations nor does it establish a monetary cap on benefits.Massachusetts is the 23rd state to enact autism insurance reform legislation.http://www.mass.gov/legis/bills/house/186/ht04pdf/ht04935.pdf
New Mexico: Governor Bill Richardson issued an executive order, NM EO 32, onAugust 11 establishing the State Office of Health Care Reform which expands the healthcare reform leadership team to facilitate implementation of Federal Health Care Reform.
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The office will assist the leadership team in providing advice, guidance, and specificrecommendations to the Governor with respect to implementation of state healthinitiatives and federal health care reform.http://www.governor.state.nm.us/ordersI201OIEO 2010 032.pdf
New York: In special session "w" for the State Budget, New York introduced NY AB2w and its companion bill NY SB 1w on July 30. The legislation establishes the FederalMedicaid Assistance Percentages (FMAP) contingency fund to be distributed if federalMedicaid percentages are not extended by January 1, 2011. This legislation seeks toprovide funding for Medicaid services if federal funds which currently provide monetaryassistance for these services are not available in the future. The Assembly version wassent to the Committee on Ways and Means, and the Senate version was sent to the SenateCommittee on Rules before being transferred to the Committee on Finance in August.http://assembly.state.ny.usllegl?default tld=&bn=A41 002%09%09&Summary= Y&Acti0ns=Y&Text=Y#jump to Text
In related legislation, President Obama signed H.R. 1586 to provide states with $16billion in increased FMAP payments to struggling state Medicaid coffers through June2011.http://vocusgr.vocus.com/GRSPACE2JWebPublish/Controller.aspx?SiteName=AOTA&Definition= ViewIssue&IssueID=67 59
Regulations:
Kentucky: A series of proposed rules (902 KAR 30:001, 902 KAR 30: 110, 302 KAR30:120,902 KAR 30:130, 902 KAR 30:150,902 KAR 30:160, 902 KAR 30:180, KAR90230:200) were published on August 1 that regulate First Steps, Kentucky's earlyintervention program. These proposed rules define terms; set forth the point of entry andservice coordination provisions; establish the evaluation, eligibility and redeterminationof eligibility requirements; amend rules to establish the provisions of assessment and theindividualized family service plans; set forth provisions for provider qualifications,including OTs; amend rules to set forth the provisions of covered services, including OT;set rates to be paid to providers for the provision of approved services, including OT; andamend rules to set forth the procedures for procedural standards for facilities participatingin the First Steps program.
Kentucky: 781 KAR 1:040, published on August 1, prescribes the requirements for theprovision of rehabilitation technology services in order to distribute funds more equitablyover the entire population of otherwise eligible individuals. The proposed rule defines"rehabilitation technology specialist" as an individual who analyzes the needs ofindividuals with disabilities, assists in the selection of the appropriate assistivetechnology, and trains the eligible individual on how to properly use the specificequipment. The focus of the proposed rule is on driver rehabilitation, and it defines"driver rehabilitation specialist" as an individual who plans, develops, coordinates, and
implements driver rehabilitation services for individuals with disabilities. "Driverevaluation" in this case is a clinical and behind-the-wheel evaluation by a certified driverrehabilitation specialist to identify an eligible individual's driver rehabilitation needs toallow that person to drive independently.
Missouri: Proposed and adopted on June 24, but not published until August 2, Missouri12 CSR 10-24.485 establishes the criteria for placement of a permanent disabilityindicator on a driver or nondriver license. To obtain a permanent disability indicator on adriver or nondriver license, an applicant must present a medical statement completed andcertified by a healthcare practitioner that states that the applicant is "permanentlydisabled". Occupational therapists are included in the list of healthcare practitioners thatmay provide a medical statement verifying that an applicant is "permanently disabled".
New Hampshire: Proposed rule Ath 102 was published on August 13, and clarifies whatit means for an athletic trainer to practice under direct supervision of a physician. Thefull text of this regulation is not yet available; clarification of the supervision requirementwill be provided when more than the summary of the regulation is available.
New York: Title 8 NYCRR Section 100.2, proposed on August 4, allows a schooldistrict to provide a Response to Intervention (RTI) program in lieu of providingAcademic Intervention Services (AIS) if: (i) the RTI program is provided in a mannerconsistent with the RTI guidelines (Education Law subdivision (ii) of section 100.2); (ii)the RTI program is made available at the grade levels and subject areas (reading/math)for which students are identified as eligible for AIS; (iii) all students who are otherwiseeligible for AIS shall be provided such AIS services if they are not enrolled in the RTIprogram; and (iv) for the 2010-2011 school year, the school district shall submit to theDepartment, no later than December 15,2010, a signed statement of assurance that theservices provided in the RTI program meet the requirements listed above; and for eachschool year thereafter, the school district shall submit to the Department no later thanSeptember 1st of such school year, a signed.statement of assurance that the servicesprovided under the district's RTI program meet the requirements listed above.
Texas: 40 TAC 12.369.369.3 will go in to effect on August 19 and clarifies the use oftitles and professional degrees when signing documents. A licensed occupationaltherapist shall use the title occupational therapist or the initials OT. OTR is an alternateterm for OT if an individual who is licensed by the TX board takes the responsibility forensuring that he or she is qualified to use it. A licensed occupational therapy assistantshall use the title occupational therapy assistant or the initials OTA. COTA is an alternateterm for OTA if an individual who is licensed by the TX board takes the responsibilityfor ensuring that he or she is qualified to use it. When practicing occupational therapy,any letters designating other titles, academic degrees, or certifications must follow theinitials OT or OTA (example John Doe, OT, CRT or Jane Doe, OTR, PhD).
Texas: 40 TAC 12.373.373.2 clarifies that on-site supervision by a regularly licensedoccupational therapist is required for a temporary licensee practicing occupationaltherapy. This regulation will go in to effect August 19.
Texas: 40 TAC 12.374.374.1 goes in to effect August 19, and clarifies that a licensee orapplicant convicted of a felony must report to the conviction to the board within 60 days.
Texas: 40 TAC 12.374.374.2 adds "failing to give sufficient prior written notice ofresignation of employment (or termination of contract) resulting in loss or delay ofpatient treatment for those patients under your care" as an additional category ofdetrimental practice. This will go in to effect on August 19.
Vermont: Proposed regulation 10P032, proposed on August 5, amends rules toimplement State Fiscal Year 2011 coverage changes by limiting the number of coveredvisits for physical therapy, occupational therapy and speech therapy to 30 visits per yearfor adults and Vermont Health Access Program (VHAP) beneficiaries. VHAP is anaffordable health care program, provided by the Vermont Campaign for Health CareSecurity Education Fund, that provides health care to state residents 18 years of age orolder who are uninsured and meet income eligibility requirements. The proposed rulealso stipulates that the Department of Vermont Health Access (DVHA) shall allowadditional visits through prior authorization for individuals with spinal cord and traumaticbrain injuries, stroke, amputation or severe bum.
AOTA Contact for State Legislative and Regulatory Issues:Marcy BucknerState Policy [email protected] ext 2016
AOTA State Issue UpdateSeptember 13, 2010
This update summarizes the state legislative and regulatory activity from August 30-September 13 that could impact the profession. Additional information about theseproposals is available upon request. This report is distributed to state occupationaltherapy association presidents and state OT association legislative/government affairschairs.
Health Reform:
The Patient Protection and Affordable Care Act (PPACA) charged the US Department ofHealth and Human Services to coordinate efforts with the National Association ofInsurance Commissioners (NAIC) to provide guidance for the implementation of healthcare reform.
AOTA has hired an outside consultant from Stateside Associates to monitor the work ofNAIC and its subcommittees that have been created to develop resources for future stateand federal regulations. Stateside provides AOTA with weekly reports detailing theprogress of NAIC.
Of interest to occupational therapy practitioners, NAIC developed and recently revisedthe definition of rehabilitation and habilitation.
AOTA's consultant worked to keep AOTA informed of the discussions, and AOTA ispleased that OT is included in these definitions which are expected be used as a resourcefor future regulations. AOTA will continue to monitor the progress of NAIC. To viewStateside Associates' weekly NAIC reports, click here:
o August 20, 2010 pdf, 389 kbo August 27, 2010 pdf, 341 kbo September 3, 2010 pdf, 1.5 mbo September 10, 2010 pdf, 2.3 mb
Legislation:
California: Existing law requires a health care practitioner to disclose, while working,his or her name and practitioner's license status on a name tag in at least 18-point type orprominently display his or her license in his or her office. CA AB 583 would haverequired health care practitioners to display the type of license and highest degree held onthe practitioner's nametag in 18 point font. The Occupational Therapy Association ofCalifornia contacted the sponsor, Assemblymember Hyashi, concerning the burden thiswould place on practitioners. The bill, which was sent to Governor Schwarzeneggar for
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his signature on September 3, was amended to now require health care practitioners todisplay the type of license and, except as specified, the highest level of academic degreehe or she holds either prominently displayed in his or her office, or in writing given to apatient on his or her initial office visit instead of having this displayed on thepractitioner's nametag ..http://www.1eginfo.ca. gov/pub/09-1 O/bil1/asm/ab 0551-0600/ab 583 bill 20100831 enrolled.html
California: CA AB 2042, which was also sent to Governor Schwarzeneggar onSeptember 3, prohibits a health care service plan or health insurer from altering the ratesthat apply to individual plan contracts or policies, or altering any benefits included inindividual contracts or policies, more than once each calendar year. There is anexception for policies issued through a publicly funded state health care coverageprogram.http://www.1eginfo.ca.gov/pub/09-1O/bill/asm/ab 2001-2050/ab 2042 bill 20100831 enrolled.html
Minnesota: MN Executive Order 24, issued on August 31, directs all executive branchdepartments and agencies that no application shall be submitted to the federalgovernment in connection with requests for grant funding for programs anddemonstration projects deriving from the Patient Protection and Affordable Care Actunless otherwise required by law, or approved by the office of the Governor. GovernorPawlenty is being criticized by political experts who view the issuance of the executiveorder as a means for Pawlenty to gain exposure for his presidential ambitions. Gov.Pawlenty told reporters in Minnesota that he would do all in his power to limit the reachof the new health care law during his remaining four months in office. "Anything that Ican do to slow down, limit or negate Obamacare, I'm going to try to do it within reason,"he said. For a copy of EO 24, click on this link:http://www.governor.state.mn.us/priori ties/governorsorders/executi veorders/PRODO 10117.html
Regulations:
Alabama: 700-X-3-.05, proposed on September 2, provides that licensed physicaltherapists and physical therapy assistants, as well as nonlicensed physical therapy supportpersonnel must provide identification of their credentials to individuals who come in tocontact with them during to provision of physical therapy services. Appropriateidentification includes embroidery, clip-ons, paper nametags, name badges, or otherappropriate means.
Arizona: R9-28-206, published and adopted on August 27, amends rules concerningcovered services provided for an Arizona Long Term Care Services member regardingoccupational and physical therapies, speech and audiology services, and respiratorytherapy. The amendment provides that the Arizona Health Care Cost Containment
System Administration will not cover more than 15 outpatient physical therapy visits forthe contract year with the exception of the required Medicare coinsurance and deductiblepayment under 9 AAC. 29, Article 3. The amendment does not place a limit onoccupational therapy.
Kentucky: 201 KAR 22:045, 201 KAR 22: 135, 201 KAR 22:020, 201 KAR 22:053, and201 KAR 22:070 were adopted on September 1 and amend the physical therapy rulesregarding continued competency requirements and procedures; fees required to apply fora credential by application, reinstatement, or renewal; the criteria for eligibility for acredential in physical therapy; the code of ethical standards and disciplinary actions; andprovisions for the evaluation of foreign-educated physical therapists applicant'seducational credentials.
Maine: 10-144-101, Ch. II, Section 68, adopted on September 1, providesrules regarding the number of goals to facilitate the delivery of occupational therapyservices in school settings; allows services to be ordered by a practitioner of the healingarts; removes the maximum limit of two visits per year for sensory integration formembers under age 21; and establishes schools as an eligible provider. 10-14-101, Ch. II,Section 85 does the same for physical therapy, and 10-144-101, Ch. II, Section 109 doesthe same for speech and hearing services in schools.
Missouri: 20 CSR 2205-5.010, published on September 1, clarifies the continuingcompetency requirements for occupational therapist and occupational therapy assistants.The requirements have not changed and are still 24 CCCs per biennial review, and 50%of the credits must be directly related to the delivery of occupational therapy services andthe remaining CCCs must be related to one's practice area or setting. The proposedregulation provides further clarification of acceptable CCCs.
Oklahoma: OAC 317:50-1-1 to -16 was published in the Oklahoma Register onSeptember 1, but became effective via an emergency adoption on August 1. Thisemergency rule revises rules to implement a new Home and Community Based WaiverProgram (HCBW) to accommodate the "medically fragile" population with medicalconditions requiring services in excess of those offered by current HCBW programs.This Program will finance non-institutional long-term care services for individualsrequiring skilled nursing or hospital level of care. Individuals must be at least 19 years ofage, have a chronic medical condition which results in prolonged dependency on medicalcare for which daily skilled intervention is necessary and is characterized by one or moreof the following: (1) a life threatening condition characterized by reasonably frequentperiods of acute exacerbation which requires frequent medical supervision and/orphysician consultation and which, in the absence of such supervision or consultation,would require hospitalization; (2) the individual requires frequent time consumingadministration of specialized treatments which are medically necessary; (3) the individualis dependent on medical technology such that without the technology, a reasonable levelof health could not be maintained. Occupational therapy is included as a covered servicein the Medically Fragile Program.
Oregon: OAR 335-060-0010, -095-0030, -0040, -0055 was published in the OregonBulletin on September 1, but became effective via temporary rule adoption on August 11.This rule clarifies and reinforces the requirements that speech language pathologists(SLPs) in Oregon must be licensed by the Board of Examiners for Speech-LanguagePathology and Audiology or be exempt from Board licensure under an exception in theOregon rules in order to supervise speech-language pathology assistants (SLPAs). Theexemption from Board licensure does not limit the duties that can be performed by anSLP appropriately licensed by the teacher Standards and Practices Commission (TSPC).However, the Board has statutory authority to determine criteria under which thissupervision takes place.
Wisconsin: Ins 3.36, adopted on September 2, provides rules relating to theimplementation of mandated insurance coverage for the treatment of autism spectrumdisorders. This rule defines and differentiates between intensive-level evidence-basedbehavioral therapy and nonintensive-level evidence-based therapy; includes provisions topermit individuals who are currently providing services through the department's waiverprogram to be deemed qualified for up to two years for continuity of care; and permitsinsurers and self-funded plans to contract with these individuals who are experienced butmay not meet the qualifications for providing intensive or nonintensive services. Acurrent, valid state-issued license or certificate is necessary in order for a psychiatrist,psychologist, behavior analyst, social worker certified or licensed to practicepsychotherapy, speech pathologist, or occupational therapist to be qualified to providenonintensive-level services or to implement an intensive-level treatment plan. For aperson who is a qualified professional working under the supervision of an outpatientmental health clinic, the clinic shall be certified in order for the professional to providenonintensive-level services or to implement an intensive-level treatment plan developedby a qualified intensive-level provider. The rule also addresses further administrativeconcerns. Occupational therapists are included as "qualified therapists" who may provideevidenced-based therapy.
According to the rule, "qualified intensive-level provider" means an individual actingwithin the scope of a currently valid state-issued license for psychiatry, psychology orbehavior analyst, or a social worker acting within the scope of a currently valid state-issued certificate or license to practice psychotherapy, who provides evidence-basedbehavioral therapy and who has completed at least 2080 hours of training, education andexperience which includes all of the following: 1. Fifteen hundred hours supervisedtraining involving direct one-on-one work with individuals with autism spectrumdisorders using evidence-based, efficacious therapy models. 2. Supervised experiencewith all of the following: a. working with families as the primary provider and ensuringtreatment compliance; b. treating individuals with autism spectrum disorders whofunction at a variety of cognitive levels and exhibit a variety of skill deficits andstrengths; c. treating individuals with autism spectrum disorders with a variety ofbehavioral challenges; d. treating individuals with autism spectrum disorders who haveshown improvement to the average range in cognitive functioning, language ability,adaptive and social interaction skills; and e. designing and implementing progressivetreatment programs for individuals with autism spectrum disorders. 3. Academic
coursework from a regionally-accredited higher education institution with demonstratedcoursework in the application of evidence-based therapy models consistent with bestpractice and research on effectiveness for individuals with autism spectrum disorders.
Wyoming: Chapter 6, adopted and effective on August 31, provides rules for continuingeducation for physical therapists. Twenty hours of continuing education are required foreach biennium, beginning October 2009.
AOTA Contact for State Legislative and Regulatory Issues:Marcy BucknerState Policy [email protected] ext 2016
AOTA State Issue UpdateOctober 26,2010
This update summarizes the state legislative and regulatory activity from September 27October 26 that could impact the profession. Additional information about theseproposals is available upon request. This report is distributed to state occupationaltherapy association presidents and state OT association legislative/government affairschairs.
Health Reform:
AOTA has hired an outside consultant from Stateside Associates to monitor the work ofNAIC and its subcommittees that have been created to develop resources for future stateand federal regulations. Stateside provides AOTA with weekly reports detailing theprogress of NAIC.
Of interest to occupational therapy practitioners, NAIC developed and recently revisedthe definition of rehabilitation and habilitation that will be used in information to explainhealth insurance to consumers. AOTA will be advocating for language to specificallymention occupational therapy in the definition of habilitation just as it is included in thedefinition of rehabilitation.
Here is the latest information from the workgroup that is developing the definitions (as ofOctober 26,2010):
Rehabilitation:Current Definition: Health care services that help a person keep, get back orimprove skills and functioning for daily living that have been lost or impairedbecause a person was sick, hurt or disabled. These services may include physicaland occupational therapy, speech-language pathology and psychiatricrehabilitation services in a variety of inpatient and/or outpatient settings.
Recommendation: Keep it as is. There was some comment about the word"keep" being in there but the working group has discussed this before andalthough maintenance therapy to help someone keep a skill long-term is notcovered, there is an element of rehab aimed at preventing further deterioration,which is captured by "keep." The group was OK with that before so let's leave itas is.
HabilitationSuggest making the definition more parallel to rehab, especially since consumertesting on the summary of benefits indicated that people don't naturally knowwhat habilitation is. Other comments had to do with adding the concept ofhabilitation being only for a medical condition but since the regulations have notcome out yet for essential benefits, it seems best to not try to predict what will bethere. It is also implied that these services would be ordered or recommended by a
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physician for insurance to pay so there is an expectation of medical necessity. So,here is the recommended definition:
Recommendation: Health care services that help a person keep, learn, orimprove skills and functioning for daily living. Examples include therapy for achild who is not walking or talking at the expected age. These services mayinclude physical and occupational therapy, speech-language pathology, andpsychiatric rehabilitation services in a variety of inpatient and/or outpatientsettings.
Source document: NAIC Consumer Information (B) Subgroup StandardDefinitions Glossary Assignments for Second Round Revisions (as of 10126/10)
To view Stateside Associates' most recent weekly NAIC report, click here:• October 1, 2010• October 8, 2010• October 15, 2010• October 22, 2010
Legislation:
California: Existing law requires a health care practitioner to disclose, while working,his or her name and practitioner's license status on a name tag in at least l8-point type orprominently display his or her license in his or her office. CA AB 583 would haverequired health care practitioners to display the type of license and highest degree held onthe practitioner's nametag in 18 point font. The Occupational Therapy Association ofCalifornia contacted the sponsor, Assemblymember Hyashi, concerning the burden thiswould place on practitioners. The bill was amended to require health care practitioners todisplay the type of license and, except as specified, the highest level of academic degreehe or she holds either prominently displayed in his or her office, or in writing given to apatient on his or her initial office visit instead of having this displayed on thepractitioner's nametag. Governor Schwarzeneggar signed the bill on September 29.http://www.leginfo.ca.gov/pub/09-l0lbilllasmlab 0551-0600/ab 583 bill 20100831 enrolled.html
New Jersey: NY AB 3334, introduced on October 7, expands the scope of claims subjectto the "Health Claims Authorization, Processing and Payment Act" toinclude prompt authorization for claims involving benefits provided by.occupationaltherapists, physical therapists, and speech-language pathologists.http://www.njleg.state.nj.usI2010IBills/A3500/3334Il.HTM
New York: Governor David Paterson vetoed NY AB 10372A and its companion bill NYSB 7000B on October 20. The bill would have required health plans to cover evidence-based, medically necessary autism treatments and contained no age or dollar caps. Thelegislation required the creation of regulations to identify treatment and therapy options
for which coverage would have been required for the screening, diagnosis, and treatmentof autism spectrum disorders. Occupational therapy was expected to be covered as a typeof autism treatment.http://assembly.state.ny.usllegl?default fld=&bn=A1 0372%09%09&Summary=Y &Actions=Y&Text=Y
Regulations:
Connecticut: In an uncodified proposed rule published on September 30, the Departmentof Social Services seeks to revise the rates setting methodology for Medicaid SchoolBased Child Health (SBCH) services effective October 1, 2010. The proposed rulemodifies the Medicaid SBCH reimbursement from state aggregate cost-based rates forevaluation and monthly services to a local agency (LEA) service-specific ratemethodology. Occupational therapy is included as a type of service provided throughSBCH.
Georgia: GAC 53-02-.03, .06; -03-.01, -.02; -4-.02, proposed on October 12, clarifies thedefinition of athletic trainer to exclude persons providing services as a first responder,and further defines types of injuries for which they may provide care. The proposed ruleseeks to define an athletic injury as any injury sustained by a person as a result of suchperson's participation in exercise, sports, games, recreation, or other activities whichrequire physical strength, agility, flexibility, range of motion, speed, or stamina and anyinjury, without respect to where or how the injury occurs, which prevents such personfrom participating in the previously listed activities.
Idaho: IDAPA 24.06.01, proposed August 18 but not published until October 6, clarifiesdirect, close, and routine supervision requirements; provides qualification requirementsfor OTs and OTAs utilizing techniques involving deep thermal, electrotherapeuticmodalities, or wound care management; and clarifies the inactive license status and therequirements to reinstate a license.
Kentucky: 201 KAR 28:010, published on October 1, sets forth the definitions of termsand phrases which will be used by the board in enforcing and interpreting the provisionsregulation occupational therapists and occupational therapy assistants.
Kentucky: 201 KAR 28:130, published on October 1, amends rules concerning therequirements of supervision for occupational therapy assistants, aides, students, andtemporary permit holders; and amends rules concerning the documentation required insupervision, and the process for reviewing the supervision process. The amendmentsprovide that the supervising OTIL and the individuals under supervision will both keeplogs documenting whether the supervision was face-to-face, the dates of the supervision,and the hours worked by the OTIL. Review of the supervision process will occur byrandom audit.
Maine: 02-041-10, proposed on September 29, increases the license fees for nineprofessional and occupational licensing programs administered by the Office ofLicensing and Registration. The proposed increase affects occupational therapypractitioners as follows:• OT license fees increase from $80 to $120 for a 2 year license.• OTA license fees increase from $70 to $110 for a 2 year license.• Temporary 6 month OT license fees increase from $25 to $60.• Temporary 6 month OTA license fees increase from $20 to $60.The same regulation provides for a $10 decrease in license fees for an annual physicaltherapy or physical therapy assistant license.
Maine: 10-144-101, Ch III, Section 68, proposed on July 7 and adopted on October 7,specifies a reduction in rates of 10% for all occupational therapy services covered byMaineCare. The regulation is the result of the enactment of ME LD 1671, thesupplemental appropriations bill, which ordered MaineCare Services to reduce the OTrate by 10%.
Nebraska: Title 471 NAC Chapter 018, proposed on October 1, amends rules concerningMedicaid and pediatric feeding disorder clinics and provides for comprehensiveinterdisciplinary treatment for a severe feeding disorder. Comprehensiveinterdisciplinary treatment means the collaboration of medicine, psychology, nutritionscience, speech therapy, occupational therapy, social work, and other appropriate medicaland behavioral disciplines in an integrated program. Nebraska Medicaid may covercomprehensive interdisciplinary treatment for an infant or child with a severe feedingdisorder that impacts the infant's or child's ability to consume sufficient nutrition orally tomaintain adequate growth or weight. Prior authorization is required of all services beforethe services are provided.
Nevada: NAC 641.001, .017, .020, .025, .028, .050, .061, .112, .120, .132, .133, .135,.136, .140, .150-.245 (non seq), proposed on December 30 and adopted on October 16,establishes licensure provisions for behavior analysts and autism behaviorinterventionists.
Ohio: OAC 4753-3-07, -11, -5-01, adopted on September 29, amends rules specifyingrequirements for onsite supervision occurring via telepractice applications during thesupervised professional experience year for speech language pathologists andaudiologists. The rule now provides that when onsite supervision occurs via telepracticeapplications, supervision shall occur using real time, synchronous, encryptedvideoconferencing. Asynchronous, recorded therapy sessions submitted for later reviewshall not meet the requirements for onsite supervision.
Oklahoma: OAC 340:100-18-1 was proposed and adopted on August 13, but was notpublished until October 1. This regulation establishes rules to provide for licensing andcertification of behavior analysts in an effort to bring more practitioners to the state."Applied behavior analysis" is defined as the design, implementation, and evaluation ofinstructional and environmental modifications to produce socially significant
improvements in human behavior through skill acquisition and the reduction ofproblematic behavior. This regulation does not restrict the practice of applied behavioranalysis by human services professionals, including occupational therapists, providedsuch individuals are working within the scope of their professions and the practice ofapplied behavior analysis is commensurate with their level of training and experience.
Texas: A series of regulations relating to speech pathology and audiology were proposedon September 17: 22 TAC 32.741.A.741.1; 22 TAC 32.741.B.741.11 -.15; 22 TAC32.741.C.741.31 -.33; 22 TAC 32.741.C.741.31 -.33; 22 TAC 32.741.D.741.41 -.45; 22TAC 32.741.E.741.61 -.65; 22 TAC 32.741.F.741.81 -.85; 22 TAC 32.741.G.741.91; 22TAC 32.741.1.741.111; .112; 22 TAC 32.741.J.741.121 .122; 22 TAC 32.741.K.741.141;22 TAC 32.741.L.741.161, .162, .164, .165; 32 TAC 32.741.741.163; 22 TAC32.741.M.741.181, .182; 22 TAC 32.741.N.741.191 -.202. These proposed rules clarifydefinitions, including telehealth; communication and hearing screening procedures; thecode of ethics; application, examination, fees, licensure, and continuing educationrequirements.
Texas: 22 TAC 32.741.0.741.211 -.215, proposed on September 17, creates new rulesconcerning telehealth provided by audiologists. Telehealth is defined as the use oftelecommunications and information technologies for the exchange of information fromone site to another for the provision of speech-language pathology or audiology services
Washington: On October 6, the Department of Social and Health ServiceslMedicaidPurchasing Administration issued a proposal statement of inquiry, WAC 388-438, 388-517-0500,388-531-1300,388-535,388-537,388-544, 388-545, 388-547, 388-551,stating that upon order of the governor, the Medicaid Purchasing Administration (MPA)must reduce its budget expenditures for the current fiscal year ending June 30, 2011, by6.3%. To achieve this budget reduction, MPA anticipates making cuts to the followingadult medical services effective January 1, 2011: dental, hospice, vision, podiatry, andhearing aids. Additional cuts will include school-based medical services, state-only alienemergency medical, interpreter services, Medicare Part D copayments, and physical,occupational, and speech therapies. A letter from the Department of Social and HealthServiceslMedicaid Purchasing Administration to stakeholders concerning the 6.3%Medicaid cuts is available here: http://www.doh.wa.gov/sboh/Meetings/2010/10-13/docsfTab03h-HCAMPARed.pdf
Wisconsin: On October 15, the Department of Regulation and Licensing issued astatement of scope of a proposed rule which will create the initial administrative rules ofthe Department of Regulation and Licensing for Behavior Analysts.
AOTA Contact for State Legislative and Regulatory Issues:Marcy BucknerState Policy [email protected] ext 2016
DEPARTMENT OF CONSUMER AFFAIRS
DIVISION OF LEGAL AFFAIRS1625 N. Market Blvd., Suite S 309, Sacramento, CA 95834P (916) 574-8220 F (916) 574-86231
IiJTAT& C F: CAl..lflDRNJA STATE ·AND CONSUMER SERVices AGeNCY • ARNOLD SCHWARZEiNEGGeA, GOVERNOR
oeaMEMORANDUMDATE: October 7, 2010
TO: Executive OfficersBoard Presidents/Chairs
FROM:CD~d~
DOREATHEA JOtjNSONDeputy DirectorLegal Affairs
SUBJECT: Board Meeting Protocols
Three Duties for Board Meetings
1. Give adequate notice of meetings that will be held and agenda items. ..
. 2. Conduct' meetings in open session.
3. Provide the public an opportunity to comment.
First DutyAdequate Notice of Meetings and Agenda Items
1. Timely Law requires 10 days notice to those on a mailing list and postingnotice and agenda on your website.
2. Specific Notice Detailed, itemized agenda, identifying all items of businessto be conducted at the meeting.
Items not on agenda cannot be discussed nor can they be acted on.
Can't discuss items under the heading of "New or Old Business" unlessthey are specifically identified.
Test for Specific Notice --Is an item specific enough for a member of thepublic to reasonably ascertain the nature of the business to occur at themeeting?
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Second DutvConduct Meetings
Open Session')
General rule: Meetings must be conducted inOpen Session and all discussionand actions must take place in'the public, unless specifically authorized by law to,go into closed session, with regard to that item of business.
Vote in public» Votes 'must be publically taken. Secret votes or votes by proxyare not permitted.
Closed Session
Business statutorily authorized to be conducted in closed session:
Disciplinary matters;
Preparing, approving or grading examinations;
Pending litigation;
Matters affecting personal privacy;
_ Executive officer appointment, employment or dismissal.
Once in closed session, you can only discuss those matters that were identifiedas closed session on your agenda.
Third DutyPublic Comment At The Meeting
General Rule
Must allow public comment on each open session agenda item.
Suggested script to be read at the beginning of the meeting:
The Board Chair will allow public comment on agenda items, as those items aretaken up by the Board, during the meeting. Under the Open Meetings Act, theBoard may not take any action on items raised by public comment that are not onthe Agenda, other than to decide whether to schedule that item for a futuremeeting.
If any person desires to address the Board, it will be appreciated if he or she willstand or come forward and give his or her name, and if he or she represents anorganization, the name of such organization, so that we will have a record of allthose who appear. Please note that a person wishing to provide comment is not
2 10/2010
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required to identify him or herself when making public comment, but it isappreciated.
In order to allow the Board sufficient time to conduct its scheduled business,public comment will be limited to _ minutes. Please make your commentsfocused and relevant to the duties of the Board. It is not necessary to repeatstatements or views of a previous speaker, it is sufficient to state that you agree.Written statements should be summarized and submitted to the Board. Theyshould not be read.
If as chairperson/president, I forget to ask for public comment on an agenda item,it is not because I intend to limit comment but just because I forgot. So in thatsituation, please raise your hand and I will recognize you.
Suggested script to be used for each item on the agenda:1. Call the Agenda Item .2. Committee Presents the agenda item3. Ask for a motion4. Ask for a second, unless the motion is made by the committee (second
is not needed)6. Ask for board discussion. .6. Ask if there is public comment. [You may reverse the order of these 2.]7. Ask if there is further board discussion8. Repeat the Motion9. Take the vote
Suggested script for public comment on items not on the agenda:
The board values input from the public as part of its consumer protectionmission. It invites and welcomes public comment during this section of theagenda. However, board members cannot engage in dialogue with those whotestify during this section of the agenda due to constraints imposed on the boardand its members by law. The law prohibits the board from substantivelydiscussing or voting on any matter brought up during public comment. Amember of the public who would like the board to discuss a general topic notrelated to a specific case involving one of its licensees can ask the board toconsider placing the issue on the board's agenda for a future meeting.
Disruptive persons:
If you have an application or disciplinary charges pending before the board, weask that you not discuss the details of your case or pending complaint since theboard members will be the "judges" and by law are not permitted to receive
.evidence or information that is not part of the administrative record in the case.
The public has the right to express its disapproval, and may sometimes makeemotional presentations. It is the board's duty and obligation to allow that publiccomment. Since the purpose of the meeting is for the agency to conduct itsbusiness, commenters shouldn't be permitted to thwart that purpose and may be
3 . 10/2010
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removed from the meeting if disruptive behavior continues after a request that itstop.
Suggested script to use when there is a disruptive person:
Under the Open Meetings Act (Government Code Section 11126.5), if youcontinue in this manner, I will ask you to leave the meeting and if you do notleave the meeting, you will be removed. Accordingly, I am asking you todiscontinue your disruptive conduct so that all participants can be heard in anorderly fashion.
Miscellaneous
Wording of Motions
Motions must be clearly worded.
_ The test: Could a reasonable person reading the motion understand what theboard meant to accomplish? .
Chair should restate the motion before the discussion and just before the voteis taken
Improper Disclosure of Information
Improper for information received during closed session to be publicly'disclosed without authorization of the body as a whole.
Role of the Attorney
The attorney's role during board meetings is to advise the agency of itsobligations and authority under the law when it appears that the agency may bedeviating from it. e.g. Open Meetings Act, quorum requirements, practice acts,regulations. In some cases, it may be necessary for the attorney to assist theagency in identifying an issue, framing a motion that accurately reflects theagency's deliberations and intent or seeking clarification from a speaker or board.member.
4 10/2010
When a problem is identified, the attorney is expected to assist the board indeveloping a lawful alternative method of accomplishing the board's goal.
Iris not the attorney's responsibility or role to chair the meetings or direct thediscussion. And the attorney should refrain from doing so even if requested totake on that role.
AGENDA ITEM 12
ENFORCEMENT DATA ANDREpORTS.
The following are attached for review:
• Enforcement Statistical Report• Probationer Roster• Citation Statistics
Board Meeting November 4, 2010 San Marcos, CA
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