Topics to Cover
Update from the Ohio Occupational Therapy Board
Role of the Board Recent Rules Changes Strategic Plan Enforcement Overview Supervision and Collaboration
Ohio Occupational Therapy Association State Conference
Dialogue with ODE Commonly Asked Questions
October 10, 2008
Q&A Ohio OTPTAT Board
October 10, 2008
OT Section Vision Statement
Board Operations
The OT Section is committed to proactively: Provide education to the consumers of OT services; Enforce practice standards for the protection of the consumers of OT services; Regulate the profession of OT in an everchanging environment; Regulate ethical & multicultural competency in the practice of OT; Regulate the practice of OT in all current & emerging areas of service delivery Ohio OTPTAT Board
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The staff implements those policies Staff cannot make any final decisions on discipline, waiver requests, licensing, etc., unless Board delegates action to staff Ohio OTPTAT Board
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Board Composition – OT Section
Ohio Boards are self-funded All operations funded by licensee fees No General Revenue Funds (tax $$) Fees are established to ensure sufficient
funding for at least five year period Goal is to have 150% reserves to cover emergency situations Goal to limit fee increases while maintaining reasonable fees
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20 Board members (appointed by Gov) 9 full-time employees (Exec Director hired by Board)
The Board sets policy
Board Funding
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Term Expires
Term
Miamisburg
2009
1st
Mary Stover
Columbus
2009
1st
Becky Finni
Amelia
2010
1st
Rebecca LeBron
Olmstead Falls
2008
2nd
Kim Lawler
Frazeysburg
2010
1st
Member
City
Nan Shoemaker
All terms expire on Aug. 27 of designated year. Pursuant to ORC 4755.01, members shall not serve for more than 3 consecutive terms.
Benchmark vs. other boards Ohio OTPTAT Board
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Board Composition
How Rules are Changed
The Board also has a public member who
Rule review is a public process
represents the interests of consumers
Board seeks input on initial draft before rule language is filed Information on proposed changes sent to listserv and posted on Board’s website Once filed, full text of the rules available at http://www.registerofohio.state.oh.us Public hearing on proposed changes required
Genevieve Dennison – New Richmond. 1st term expires in 2011
To seek an appointment to the Board, you
need to contact the Governor’s Office and download the application http://governor.ohio.gov
May 1 effective date is goal October 10, 2008
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Recent Rules Changes
Ohio OTPTAT Board
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Proposed Rules Changes To ensure competence, implement additional restoration requirements if license was in escrow for more than 5 years. Similar to endorsement and reinstatement requirements for individuals out of practice for more than 5 years. 4755-7-08 – Code of ethics
Add additional provision related to sexual boundary violations Ohio OTPTAT Board
4755-3-06 – adds provisions for a
summary suspension if the licensee poses an immediate threat to the public 4755-9-01 – clarified that if a license was valid for 12 months or less, the licensee only needs to complete 10 hours of CE (including at least 1 hour of ethics)
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4755-7-10 – Documentation New rule specifying how licensees, limited permit holders, and students should sign name in documentation. OT/L or OTR/L (depends on NBCOT cert.) OTA/L or COTA/L (depends on NBCOT cert.) LP/OT and LP/OTA for limited permit holders Student OT or S/OT for student occupational therapists Student OTA or S/OTA for student occupational therapy assistants
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Proposed Rules Changes
4755-3-05 – Escrow of license; restoration
Ohio OTPTAT Board
Recent Rules Changes
17 changes effective 5/1/08 4755-1-03 – clarify that board investigators may subpoena both patient records and personnel files of licensees 4755-3-01 – adds requirements for applicants not engaged in active practice of OT for more than 5 years
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Criminal Records Checks
New Renewal Cycle
HB 104 requires the Board to receive results
Board adopted new renewal cycle rules in fall
of FBI & BCI criminal records check before issuing license Law went into effect on 3/24/08. Only applies to initial license applications.
2007. Renew by profession, not last name OTs renew on June 30 of odd years OTAs renew on June 30 of even years
No fingerprints needed for renewal, reinstatement, or restoration
Ohio OTPTAT Board
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Listserv
October 2006 Follow up retreat held in June 2008
Rules changes New information posted to website
Identified and prioritized regulatory areas of
focus and established a vision statement
To join, send an email to:
[email protected] State which listserv you’d like to join
October 10, 2008
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Enforcement Activities
Use of Aides as Service Extenders How to Provide Consumer Education
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Disciplinary Process
Law limits the violations for which the board
Licensees are guaranteed due process
can take disciplinary action (ORC 4755.11) Law limits the types of disciplinary action the board may take
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OT Section held strategic planning retreat in
Important news announced on listserv
Ohio OTPTAT Board
Strategic Planning
Each Section has its own listserv
October 10, 2008
rights All actions must follow ORC Chapter 119 Board receives & investigates complaint Board member, enforcement staff, AAG review investigation findings Issue Notice of Opportunity for Hearing if
Ex: The Board had no authority to levy fines prior to enactment of HB 403 in April 2007
violation occurred
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Disciplinary Process
OT Cases Investigated Per Year
Administrative hearing conducted by Hearing 45
Examiner (the judge) Full Board reviews Hearing Examiner findings (the
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jury) Board issues Adjudication Order
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Specifies the violation and disciplinary action taken
Licensee may appeal order to common pleas
25 Cases
20 15
court
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Most investigations settled via consent agreement
in lieu of formal hearing
5 0 2000 2001 2002 2003 2004 2005 2006 2007
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Types of Cases Investigated – 2004 to 2007 EXP Pprior Aiding ULP Mis/Neg. CEU Scope Billing
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OT Section & OOTA received comments from
license (EXP) accounts for the largest % of cases
school-based licensees for at least 3 years
It is one violation that is easiest to prevent & most expensive for employers
Aiding/Abetting unlicensed
ODE Operating Standards often in conflict
with OT Practice Act Licensee caught in Catch-22
practice (ULP)
Ohio OTPTAT Board
Board Dialogue with ODE
Practice on an expired
October 10, 2008
Usually directly tied to supervising practitioner working on expired license
Fraudulent billing cases are
Follow the operating standards or follow my licensing law?
on the increase
Other
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Board Dialogue with ODE
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Board Dialogue with ODE
OT Section and OOTA worked with ODE
Old 3301-51-09 (G)(4)(c):
about areas of conflict OT Section invited to serve on ODE’s Ohio Caseload Steering Committee Steering Committee will study potential changes (both law and rule) to caseload ratios in current operating standards
An OT shall provide services to no more than 50 school-age children w/disabilities or no more than 40 preschool children w/disabilities. New 3301-51-09 (I)(3)(c) (effective 7/1/08): An OT shall provide services to no more than 50 school-age children w/disabilities or no more than 40 preschool children w/disabilities. An OTA who provides OT techniques must do so under the general supervision of an OT as required by rules 4755-7-01 & 4755-7-03.
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Supervision versus Collaboration
Supervision versus Collaboration What is supervision?
Supervision does NOT always indicate
collaboration BUT…
Collaboration does indicate supervision
“Continue with established OT treatment plan, per collaboration & discussion with OT/L”
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Supervision versus Collaboration
Ohio OTPTAT Board
Who is responsible? ALL OT practitioners
How often?
Supervisor & limited permit holder (OT/OTA) must meet in person 1x/week OTA’s in first year of practice – minimum of 1x/week OTA’s beyond first year of practice – minimum of 1x/month
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Commonly Asked Questions - #2
How should the supervising OT co-sign the supervisee’s documentation? Answer If client documentation includes any type of treatment grid, a single co-signature and date of review on the form is sufficient. For any hand-written documentation, each entry must be co-signed with name, credential, and date. Ohio OTPTAT Board
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Collaboration
Commonly Asked Questions - #1
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Ohio OTPTAT Board
Supervision versus Collaboration
Interactive process must include, but is not limited to, review of the following Client assessment Reassessment Treatment plan Intervention Discontinuation of the intervention and/or treatment plan
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Co-signature not enough Must provide evidence
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Collaboration:
Supervision ensures consumer protection
Proof of supervision?
Is there more to collaboration than…
OAC Rule 4755-7-01
Why supervision?
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What about electronic signatures? Answer Electronic signatures are acceptable if security and integrity are maintained. A copy of the individual’s name, handwritten signature, and electronic signature must be on file where the electronic signature is used. The supervising OT must co-sign and reference the dates of the entries into the client record.
If needed, the OT may make a separate entry referencing the date(s) of the note(s) being reviewed.
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Commonly Asked Questions - #3
Commonly Asked Questions - #4
What are the continuing education requirements? Answer All licensees must complete 20 contact hours of continuing education in the appropriate categories during each 2 year renewal period. At least one contact hour of ethics is required for each renewal. If a license is valid for less than 12 months, 10 contact hours are required, including at least 1 contact hour of ethics.
Can an OTA perform a screen? Answer Screens, or identification of candidates for therapy, may be performed by an OTA since a screen is only data gathering and nonevaluative in nature. All screens must be co-signed by the OT with collaboration documented.
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Commonly Asked Questions - #5
Ohio OTPTAT Board
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Commonly Asked Questions - #6 Can an OTA perform a discharge summary? Answer An OTA may gather and summarize objective information; however, they may not interpret this data. It is the OT’s responsibility to interpret the data gathered by the OTA and make the recommendations for discharge plan development. The collaboration between OT & OTA must be reflected in patient documentation.
Can OTAs complete home assessments? Answer OTAs can gather objective information and report observations, with or without the patient and/or OT present. It is the responsibility of the OT to interpret the data and make recommendations.
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Commonly Asked Questions - #7
Commonly Asked Questions - #8
I got a new job at a different facility. Does this mean that I’m abandoning my current clients? Answer Abandonment is the inappropriate termination of the therapist/client relationship by the OT. Abandonment is generally alleged when the relationship is severed w/o reasonable notice at a time when treatments are still needed. A facility that refuses to fill a vacant OT position does not constitute abandonment on part of the OT (provided that the OT gave reasonable notice).
How can I care for my clients when I’m on vacation? Answer If the evaluating OT will no longer be available to provide and supervise OT care, the patient must be transferred to another OT. Termination of care does not include an OT going on vacation or taking regularly scheduled days off. In those situations, another OT would be providing coverage.
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Commonly Asked Questions - #9
Commonly Asked Questions - #10
What is the caseload ratio for school based therapists? Answer The OT Practice Act does not regulate caseload levels. OH Dept of Education establishes the # of students that an OT may serve. No more than 50 school age children w/disabilities or no more than 40 preschool children w/disabilities. OTA who provides OT techniques must do so under general supervision of OT as required in OT rules.
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What about supervisory ratios for OTAs in school based therapy? Answer A full-time OT may supervise no more than 4 full-time OTAs and/or LP holders. If OT only provides client evals & supervision w/o separate caseload, the OT may supervise 6. This ratio may not be acceptable in school setting. OT is ultimately responsible for all clients/students served by the OTA. OTA does not maintain separate caseload. OT must provide appropriate supervision and assure that treatments are rendered according to safe & ethical standards. October 10, 2008
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Contacting the Board Email:
[email protected] Internet: http://otptat.ohio.gov Phone: 614-466-3774 Fax: 614-995-0816 Mail:
Ohio OTPTAT Board 77 S. High Street, 16th Floor Columbus, OH 43215-6108 October 10, 2008
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