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California Occupational Therapy Assistants

Definition of an OTA

“Occupational therapy assistant” means an individual who is licensed pursuant to the provisions of this chapter, who is in good standing as determined by the board, and based thereon, who is qualified to assist in the practice of occupational therapy and who works under the appropriate supervision of a licensed occupational therapist.

What are OTAs allowed to do?

The occupational therapy assistant may contribute to the evaluation process by gathering data, administering standardized tests and reporting observations.

The occupational therapy assistant may contribute to the preparation, implementation and documentation of the treatment and discharge summary.

What activities are expressly prohibited?

The occupational therapy assistant may not evaluate independently or initiate treatment before the supervising occupational therapist performs an assessment/evaluation.

What are the responsibilities of the OT when delegating to a OTA?

The supervising occupational therapist shall determine the occupational therapy treatments the occupational therapy assistant may perform. In making this determination, the supervising occupational therapist shall consider the following:

  • The clinical complexity of the patient/client;
  • Skill level of the occupational therapy assistant in the treatment technique; and
  • Whether continual reassessment of the patient/client status is needed during treatment. This rule shall not preclude the occupational therapy assistant from responding to acute changes in the client's condition that warrant immediate action. The occupational therapy assistant shall inform the supervising occupational therapist immediately of the acute changes in the patient's/client's condition and the action taken.

What type of therapist supervision is required?

“Supervision of an occupational therapy assistant” means that the responsible occupational therapist shall at all times be responsible for all occupational therapy services provided to the client.

The supervising occupational therapist has the continuing responsibility to follow the progress of each patient, provide direct care to the patient, and to assure that the occupational therapy assistant does not function autonomously.

Appropriate supervision of an occupational therapy assistant includes, at a minimum:

  • The weekly review of the occupational therapy plan and implementation and periodic onsite review by the supervising occupational therapist. The weekly review shall encompass all aspects of occupational therapy services and be completed by telecommunication or onsite.
  • Documentation of the supervision, which shall include either documentation of direct client care by the supervising occupational therapist, documentation of review of the client's medical and/or treatment record and the occupational therapy services provided by the occupational therapy assistant, or co-signature of the occupational therapy assistant's documentation.
  • The supervising occupational therapist shall be readily available in person or by telecommunication to the occupational therapy assistant at all times while the occupational therapy assistant is providing occupational therapy services.
  • The supervising occupational therapist shall provide periodic on-site supervision and observation of client care rendered by the occupational therapy assistant.

What is the ratio between supervising OTs and OTAs?

An occupational therapist shall not supervise more occupational therapy assistants, at any one time, than can be appropriately supervised in the opinion of the board. Two occupational therapy assistants shall be the maximum number of occupational therapy assistants supervised by an occupational therapist at any one time, but the board may permit the supervision of a greater number by an occupational therapist if, in the opinion of the board, there would be adequate supervision and the public’s health and safety would be served. In no case shall the total number of occupational therapy assistants exceed twice the number of occupational therapists regularly employed by a facility at any one time.

What the supervising OT document?

The occupational therapist who is responsible for appropriate supervision shall formulate and document in each client’s record, with his or her signature, the goals and plan for that client, and shall make sure that the occupational therapy assistant assigned to that client functions under appropriate supervision. As part of the responsible occupational therapist’s appropriate supervision, he or she shall conduct at least weekly review and inspection of all aspects of occupational therapy services by the occupational therapy assistant.

OTA Supervision and Delegation

Occupational therapy assistants may supervise:

  • Level I occupational therapy students;
  • Level I and Level II occupational therapy assistant students; and
  • Aides providing non-client related tasks.

Citations

Cal. Bus. & Prof. Code § 2570.2

Cal. Bus. & Prof. Code § 2570.3

Cal. Code Regs. tit. 16 § 4181

Cal. Code Regs. tit. 16 § 4182

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