What are the different levels of supervision?

"Supervision" means the responsible and direct involvement of a licensed OT with an OTA, a temporary licensed OT, a temporary licensed OTA or an occupational therapy student fulfilling the required fieldwork component of his or her educational training, for the development of an occupational therapy treatment plan and the periodic review of the implementation of that plan. Such supervision shall be close, routine or general, consistent with the following:

• "Close supervision" means daily, face-to-face contact with and frequent observation of the performance of the individual at the location where he or she is rendering services.

• "Routine supervision" means face-to-face contact with and observation of the performance of the individual at least once a week at the location where he or she is rendering services.

• "General supervision" means face-to-face contact with and observation of the performance of the individual at least once every two weeks at the location where he or she is rendering services.

Which services can only be performed by a licensed occupational therapist?

The provision of direct, indirect and/or consultative services to a client affected by physical, psycho-social, cognitive, congenital and/or developmental disorders or the aging process, to improve and/or prevent loss of physical or mental functioning and to promote wellness.

The administration of standardized and/or non-standardized assessments and/or the observation of a client and the environment to identify areas of functional abilities or deficits. Areas, which may be assessed shall include the performance of activities of daily living, including recreation, leisure or work related skills, which are affected by sensory, motor, developmental, perceptual, cognitive and/ or psycho-social abilities.

The interpretation of the results of the assessment process, to determine the need for an intervention plan for the client. Such a plan shall be developed and administered by the occupational therapist in collaboration with the client, the client's family and related medical, health, educational or social agencies or professionals.

The development and utilization of, and education and training in, purposeful, task oriented activities for the client to improve, restore and/or maintain optimal performance of life skills, roles and functions including work, recreation, leisure skills and activities of daily living.

The design, fabrication, application and/or selection of adaptive equipment, prosthetics and/or orthotic devices, except dental devices.

Consultation concerning the adaptation of physical environments/

 The utilization of physical agent modalities, as an adjunct to, or in preparation for, purposeful activities to enhance occupational performance with which the licensee is familiar as a result of training and experience.

What are the responsibilities of the OT when delegating?

In delegating selected occupational therapy services, the licensed OT shall be responsible for exercising that degree of judgment and knowledge reasonably expected to assure that a proper delegation has been made. A licensed OT shall not delegate the performance of an occupational therapy service to persons who have not been adequately prepared by verified training and education. No task may be delegated which is within the scope of practice of the OT and requires:

• The substantial knowledge and skill derived from completion of an occupational therapy education program and the specialized skill, judgment and knowledge of a licensed occupational therapist; and
• An understanding of occupational therapy principles necessary to recognize and manage complications which may result in harm to the health and safety of the client.

The licensed OT shall be responsible for the proper supervision of persons to whom delegation of occupational therapy services is made. Such supervision shall be close, routine, or general supervision. The degree of supervision exercised over such persons shall be determined by the licensed occupational therapist consistent with the requirements and based on an evaluation of:

• The condition of the client;
• The education, skill and training of the person to whom delegation is being made; and
• The nature of the tasks and the activities being delegated.

Delegation of supervision responsibilities to an OTA

A designated supervisor providing close supervision of an OTA, a temporary licensed occupational therapy assistant or an occupational therapy student, may delegate his or her supervisory responsibility for the daily, face-to-face contact with and frequent observation of the performance of the OTA, the temporary licensed OTA or the occupational therapy student, to an OTA who, in the professional judgment of the supervising OT, has been adequately prepared by verified training and education in the provision of occupational therapy services consistent with the requirements.

No designated supervisor shall delegate his or her responsibilities for close supervision of an OTA to an OTA who has less than 3,600 hours of work experience obtained within a five (5) year period in the particular practice area in which services are being provided.

A licensed OTA who has been delegated supervision responsibilities shall not supervise more than three (3) persons at one time.

A licensed OT shall not supervise more than seven (7) persons at one time, pursuant to the provisions of N.J.A.C. 13:44K-6.2.

When supervision of an OTA, a temporary licensed OTA or an occupational therapy student is delegated, the supervising occupational therapist shall retain responsibility for all occupational therapy care of the client.

Reference

N.J.S.A. § 45:9-37.53

N.J.A.C. § 13:44K-1.2

N.J.A.C. § 13:44K-5.1

N.J.A.C. § 13:44K-5.3

N.J.A.C. § 13:44K-6.6