Supervision or Consultation:

Supervision or Consultation: Supervision is defined as aid, direction, and instruction provided by an occupational therapist to adequately ensure the safety, welfare, and best treatment practices of clients during the course of occupational therapy treatment. 1. An occupational therapy assistant issued a limited permit (see Rule 8.4.5). 2. An occupational therapy assistant issued a regular license. To maintain compliance with supervision regulations, the occupational therapist will select from any of the two tiers of guidelines based on need of the patient/client and skill level of occupational therapy assistant. i. Direct Supervision: Supervision I which the occupational therapist, the occupational therapy assistant, and patient/client are present face-to-face for immediate availability within the treatment area to give aid direction, and instruction when occupational therapy procedures or activities are performed. The occupational therapist must provide written documentation of the supervisory visit at least once every seven (7) therapy visits or twenty- one (21) calendar days whichever comes first. ii. Indirect Supervision: The supervising occupational therapist has faced-to-face contact with the patient/client once every seven (7) therapy visits or twenty-one (21) calendar days whichever comes first and communicates with the occupational therapy assistant by verbal communication as well as documented evidence of the communication. b. Supervision or consultation which means face-to-face meetings of supervisor and supervisee (OT and OTA) to review and evaluate treatment and progress at the work site, and regular interim communication between the supervisor and supervisee. A face-to-face meeting is held at least once every seventh treatment day or 21 calendar days, whichever comes first. c. The supervising occupational therapist must be accessible by telecommunications to the occupational therapy assistant on a daily basis while the occupational therapy assistant is treating patients. d. Regardless of the practice setting, the following requirements must be observed when the occupational therapist is supervising or consulting with the occupational therapy assistant: i. The initial visit for evaluation of the patient and establishment of a plan of care must be made by the supervising or consulting occupational therapist. ii. A joint supervisory visit must be made by the supervising occupational therapist and the occupational therapy assistant with the patient present at the patient's residence or treatment setting once every 7 treatment days or every 21 days, whichever comes first. iii. A supervisory visit should include: 1. A review of activities with appropriate revision or termination of the plan of care; 2. An assessment of utilization of outside resources (whenever applicable); 3. Documentary evidence of such visit; 4. Discharge planning as indicated. iv. An occupational therapist may not supervise/consult with more than two (2) occupational therapy assistants except in school settings, or settings where maintenance or tertiary type services are provided, such as the regional treatment centers under the direction of the Department of Mental Health. 3. Occupational therapy aides: a. An occupational therapy aide is an unlicensed person who assists an occupational therapist or occupational therapy assistant as defined in Rule 8.1.3 of these regulations. An occupational therapy aide is a worker who is trained on the job. b. Duties assigned to an occupational therapy aide must be determined and directly supervised by a licensed occupational therapist or occupational therapy assistant and must not exceed the level of specific training, knowledge, skill and competence of the individual being supervised. c. The supervising occupational therapist or occupational therapy assistant is professionally responsible for the acts or actions performed by any occupational therapy aide supervised by the licensee in the occupational therapy setting. d. Documentation of all training specific to the aide's duties must be in the aide's file. e. Duties or functions which occupational therapy aides shall not perform include the following: i. Interpreting referrals or prescriptions for occupational therapy services; ii. Performing evaluative procedures; iii. Developing, planning, adjusting, or modifying treatment procedures; iv. Preparing written documentation of patient treatment or progress; and v. Act independently without the direct supervision of a licensed occupational therapist or occupational therapy assistant during patient therapy sessions. 4. The supervising occupational therapist must be accessible by telecommunications to the occupational therapy assistant daily while treating patients. 5. Regardless of the practice setting, the following requirements must be observed when the occupational therapist is supervising or consulting with the occupational therapy assistant: a. The initial visit for evaluation of the patient and establishment of a plan of care must be made by the supervising or consulting occupational therapist. b. A supervisory visit should include: i. A review of activities with appropriate revision or termination of the plan of care; ii. An assessment of utilization of outside resources (whenever applicable); iii. Documentary evidence of such visit which includes the date, time, and the names of individuals involved; iv. Discharge planning as indicated. c. An occupational therapist may not supervise/consult with more than two (2) occupational therapy assistants except I school settings, or settings where maintenance or tertiary type services are provided, such as the regional treatment centers