Supervision of Occupational Therapy Aides

PURPOSE: This rule establishes the requirements for the supervision of aides within the practice of occupational therapy. (1) An occupational therapist or occupational therapy assistant must provide direct supervision of an occupational therapy aide at all times. (2) When an occupational therapist or occupational therapy assistant delegates to an occupational therapy aide maintenance or restorative services to patients/clients, the occupational therapist or occupational therapy assistant must be in the immediate area and within audible and visual range of the patient/client and the occupational therapy aide. (3) An occupational therapist or occupational therapy assistant may delegate to an occupational therapy aide only specific tasks which are neither evaluative, assessive, task selective nor recommending in nature, and only after ensuring that the aide has been appropriately trained for the performance of the task. (4) Occupational therapists and occupational therapy assistants must exercise their professional judgement when determining the number of occupational therapy aides they can safely and effectively supervise to ensure that quality care is provided at all times. (5) Any duties assigned to an occupational therapy aide must be determined and appropriately supervised by an occupational therapist or occupational therapy assistant and must not exceed the level of training, knowledge, skill, and competence of the individual being supervised. The licensed occupational therapist or occupational therapy assistant is responsible for the acts or actions performed by any occupational therapy aide functioning in the occupational therapy setting. (6) An occupational therapist or occupational therapy assistant may delegate to an occupational therapy aide duties or functions other than maintenance or restorative services to patients or clients, including but not limited to subsections (6)(A) through (6)(D). When an occupational therapist or occupational therapy assistant delegates to an occupational therapy aide, duties or functions other than maintenance or restorative services to patients or clients, the occupational therapist or occupational therapy assistant must provide direct supervision, however, the occupational therapist or occupational therapy assistant is not required to remain within audible and visual range of the patient/client— (A) Transportation of patients/clients; (B) Preparation or setting up of treatment equipment and work area; (C) Attending to patient’s/client’s personal needs during treatment; and (D) Clerical/secretarial or administrative duties. (7) Duties or functions that an occupational therapist or occupational therapy assistant may not delegate to an occupational therapy aide include, but are not limited to: (A) Interpretation of referrals or prescriptions for occupational therapy services; (B) Evaluative procedures; (C) Development, planning, adjusting or modification of treatment procedures; (D) Acting on behalf of the occupational therapist in any matter related to direct patient care which requires judgement or decision making; and (E) Any act performed independently or without supervision of an occupational therapist. AUTHORITY: sections 324.050, 324.056, 324.065, 324.083 and 324.086, RSMo Supp. 1999.* This rule originally filed as 4 CSR 205-4.030. Original rule filed Aug. 4, 1998, effective Dec. 30, 1998. Amended: Filed Aug. 31, 2000, effective Feb. 28, 2001. Moved to 20 CSR 2205-4.030, effective Aug. 28, 2006. *Original authority: 324.050, RSMo 1997, amended 1999; 324.056, RSMo 1997, amended 1999; 324.065, RSMo 1997; 324.083, RSMo 1997; 324.086, RSMo 1997, amended 1999.