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New Jersey Occupational Therapy Use of Modalities

A licensed occupational therapist may use physical agent modalities as set forth in this section for the purpose of enhancing the functional performance of a client. For purposes of this section, "physical agent modalities" shall mean those modalities that produce a biophysical response through the use of light, water, temperature, sound, electricity or mechanical devices.

A licensed occupational therapist may use superficial thermal agents, such as hydrotherapy/whirlpool, cryotherapy (cold packs, ice), fluidotherapy, hot packs, paraffin, water, infrared light and other commercially available heating and cooling technologies and mechanical devices, such as vaso-pneumatic and continuous passive motion devices.

A licensed occupational therapist shall demonstrate competency, prior to using any of the following advanced physical agent modalities: diathermy; high-voltage galvanic stimulation; micro current stimulation; transcutaneous electrical nerve stimulation; neuromuscular electrical stimulation; iontophoresis; therapeutic ultrasound; phonophoresis; and cold lasers.

Training Requirements

A licensed occupational therapist may use advanced physical agent modalities if he or she has completed a Council-approved training course, which meets the following requirements:

The training course shall include at least thirty (30) hours of didactic instruction. For purposes of this subsection, "didactic instruction" means live, in-person instruction and may include interactive telephonic or electronic instruction but shall not include videotaped or audiotaped instruction. The training course shall include:

    • Four (4) hours of training in the use of heat wave physical agent modalities;
    • Sixteen (16) hours of training in the use of electric wave physical agent modalities;
    • Six (6) hours of training in the use of sound wave physical agent modalities; and
    • Four (4) hours of training in the use of light wave physical agent modalities;

The training course shall include instruction in the following:

    • Principles of physics related to specific properties of light, water, temperature, sound or electricity, as indicated by each modality;
    • Physiological, neurophysiological and electrophysiological changes, as indicated, which occur as a result of the application of each modality;
    • The response of normal and abnormal tissue to the application of each modality;
    • Indications or contraindications related to the selection and application of each modality;
    • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including risks and benefits;
    • Safety rules and precautions related to each modality;
    • Methods of documenting the effectiveness of the immediate and long-term effects of treatment;
    • Characteristics of the equipment, including safe operation, adjustment and care of the equipment; and
    • Hands-on application of each modality by each course participant. Such instruction shall be provided in-person. Interactive telephonic or electronic instruction in the application of modalities shall not be permitted.

The primary instructor of the course shall be a licensed occupational therapist, a licensed physical therapist, a licensed physical therapist assistant or a licensed physician.

A licensed occupational therapist may use advanced physical agent modalities if he or she holds a current certification from the Hand Therapy Certification Commission or any other national organization that utilizes substantially similar certification standards.

Documentation

A licensed occupational therapist shall retain documentation relating to his or her training in the use of advanced physical agent modalities and shall make such documentation available to the Council upon request. The documentation shall include, if applicable:

    • The name and address of the person or organization presenting the program, workshop or seminar;
    • The name and address of the facility where the program, workshop or seminar was presented;
    • A copy of the program, workshop or seminar syllabus, which includes a detailed description of the learning objectives and teaching methods employed in the course and the qualifications of the instructor(s); and
    • A certificate of completion from the program, workshop or seminar sponsor.

A licensed occupational therapist who uses the advanced physical agent shall submit documentation verifying that he or she has obtained training in the use of advance physical agent modalities that is substantially similar to the requirements on or before May 4, 2010. After May 4, 2010, a licensed occupational therapist shall meet the requirements above in order to use advanced physical agent modalities.

Delegation

A licensed occupational therapist may delegate the application of the superficial thermal agent and mechanical device modalities to a licensed occupational therapy assistant consistent with the delegation requirements. Delegation of the application of such modalities to anyone other than a licensed occupational therapy assistant shall be deemed professional misconduct and may subject a licensee to the penalties.

A licensed occupational therapist may delegate the application of the advanced physical agent modalities to a licensed occupational therapy assistant consistent with the delegation requirements. Delegation of advanced physical agent modalities to anyone other than a licensed occupational therapy assistant who has satisfied the delegation requirements shall be deemed professional misconduct and may subject a licensee to the penalties.

Misconduct

A licensed occupational therapist who uses the advanced physical agent modalities without having satisfied the requirements shall be deemed to have engaged in professional misconduct and may be subject to the penalties.

Notwithstanding the fact that a licensed occupational therapist is permitted to use advanced physical agent modalities because he or she has satisfied the training requirements of this section, a licensed occupational therapist shall not use a specific physical agent modality device that he or she has not been trained to use until he or she is familiar with the device's proper use and contraindications. Failure to comply with this section shall be deemed professional misconduct and may subject a licensed occupational therapist to the penalties.

Delegation and Supervision of an OTA

A licensed occupational therapy assistant may use the superficial thermal agent and mechanical device modalities under the supervision of a licensed occupational therapist consistent with the supervision requirements.

A licensed occupational therapy assistant may use the advanced physical agent modalities under the supervision of a licensed occupational therapist consistent with the requirements of this section.

Prior to using advanced physical agent modalities, a licensed occupational therapy assistant shall have completed a training course that meets the requirements.

OT Training Requirements

A licensed occupational therapy assistant shall use advanced physical agent modalities only under the supervision of a licensed occupational therapist who has:

    • Met the experience requirements of N.J.A.C. 13:44K-6.2(g); and
    • Completed a training course that meets the requirements of N.J.A.C. 13:44K-5.4(e) or who holds a current certification from the Hand Therapy Certification Commission or any other national organization that utilizes substantially similar certification standards consistent with the requirements of N.J.A.C. 13:44K-5.4(f).

Supervision

A licensed occupational therapist shall supervise the use of advanced physical agent modalities by a licensed occupational therapy assistant consistent with the following:

The supervising occupational therapist shall provide close supervision of the licensed occupational therapy assistant, during which time the occupational therapist shall directly observe the occupational therapy assistant's application of each type of modality in a patient treatment setting no fewer than five times. Documentation of such supervision shall be maintained by the supervising occupational therapist consistent with the requirements and by the licensed occupational therapy assistant consistent with the supervision requirements.

Following the five (5) instances of direct observation of the licensed occupational therapy assistant's application of a particular type of modality, the supervising occupational therapist shall determine the level of supervision required of the occupational therapy assistant.

    • The occupational therapist shall continue to provide close supervision for any occupational therapy assistant who has been engaged in the practice of occupational therapy for less than one year on a full-time basis, consistent with the supervision requirements; and

The supervising occupational therapist shall satisfy all supervisor responsibilities.

A supervising occupational therapist shall not delegate the close supervision of an occupational therapy assistant's use of advanced physical agent modalities, including the direct observation of the occupational therapy assistant's application of the modalities, to anyone other than a licensed occupational therapist.

A licensed occupational therapy assistant shall retain documentation relating to his or her completion of the training course and shall make such documentation available to the Council upon request. The documentation shall include, if applicable:

    • The name and address of the person or organization presenting the course;
    • The name and address of the facility where the course was presented;
    • A copy of the course syllabus, which includes a detailed description of the learning objectives and teaching methods employed in the course and the qualifications of the instructor(s); and
    • A certificate of completion from the course sponsor.

A licensed occupational therapy assistant may apply to the Council for approval of a course in the use of advanced physical agent modalities that has not been pre-approved by the Council. The licensee shall submit the documentation above to the Council for review.

    • A licensed occupational therapy assistant who uses advanced physical agent modalities without having satisfied the requirements of this section shall be deemed to have engaged in professional misconduct and may be subject to the penalties set forth in N.J.S.A. 45:1-21 et seq.

Notwithstanding the fact that a licensed occupational therapy assistant is permitted to use advanced physical agent modalities because he or she has satisfied the training requirements, a licensed occupational therapy assistant shall not use a specific advanced physical agent modality that he or she has not been trained to use until he or she is familiar with the device's proper use and contraindications, and until he or she has been directly observed under close supervision by a supervising occupational therapist in the application of the modality at least five (5) times in a patient treatment setting. Following such direct observation, the licensed occupational therapy assistant may use the modality under the supervision of a licensed occupational therapist consistent with the requirements above. Failure to comply with this section shall be deemed professional misconduct and may subject a licensed occupational therapy assistant to the penalties.

Citations

N.J.A.C. § 13:44K‐5.4

N.J.A.C. § 13:44K‐5.5


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