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Tennessee OT Limited Permits

A limited permit may be issued by the board to an applicant who has applied for a license, has successfully completed the educational and field experience requirements and is scheduled to take the examination.

Duration

An applicant who has received a limited permit shall take the examination within ninety (90) days of the date the applicant received the limited permit. If the applicant does not take the examination within that ninety (90) day period, the limited permit expires at the end of the ninety-day period.

 An applicant may obtain a limited permit only once.

Exam Failure

If an applicant fails the examination, the applicant's limited permit expires upon the board's receipt of notice that the applicant failed the examination.

Graduates and Supervision

 A limited permit allows an applicant to engage in occupational therapy practice under the supervision of a licensed occupational therapist.

OT on a Limited Permit

Supervision of an Occupational Therapist on a limited permit must include initial and routine inspection of written evaluations, written treatment plans, patient/client notes and routine evaluation of performance. The supervision must be conducted in person, by a licensed occupational therapist and must be as follows:

    • Routine supervision with direct contact every two (2) weeks at the site of treatment, with interim supervision occurring by other methods such as the telephone, conferences, written communication, and e-mail.
    • Supervision must include observation of the individual treatment under a limited permit in order to assure service competency in carrying out evaluation, treatment planning and treatment implementation.
    • The frequency of the face to face collaboration between the person treating under a limited permit and the supervising therapist should exceed direct contact every two (2) weeks if the condition of the patient/client, complexity of treatment, evaluation procedures, and proficiencies of the person practicing under the limited permit warrants it.

Therapists must maintain documentation of each supervisory visit, and must identify a plan for continued supervision. Records must include, at a minimum, the following information:

    • Location of visit; a method of identifying clients discussed
    • Current plan for supervision (daily, weekly, bi-monthly)
    • Identification of type(s) of interventions observed. These include but are not limited to:
      • Interventions
      • Training
      • Consultations
    • Other supervisory actions. These include but are not limited to:
      • Discussion/recommendation for interventions and/or goals
      • Discussion/training in documentation
      • Demonstration/training in intervention techniques
      • Assessment/re-assessment/discharge
      • Additional Comments
    • An agreement statement signed and dated by both parties, that the supervisory visit did occur and met the needs of the supervisor and supervisee.
    • It is the responsibility of the supervising occupational therapist to provide and the limited permit holder to seek a quality and frequency of supervision that ensures safe and effective occupational therapy service delivery. Both parties (supervisor and supervisee) must keep copies of the supervisory records. Visit records must be maintained for three (3) years, and must be provided to the Board and/or its representative, upon request.

A co-signature by supervising Occupational Therapist is required on evaluations, treatment plans, and discharge summaries.

OTA of a Limited Permit

Supervision of an Occupational Therapy Assistant on a limited permit means initial direction and routine inspection of the service delivery and provision of relevant in-service training. The supervising occupational therapist must provide additional supervision, if the patient’s required level of care is beyond the level of skill of an entry level Occupational Therapy Assistant on a limited permit. This decision is based on client’s level of care, OTA caseload, experience and demonstrated performance competency.

Supervision of an Occupational Therapy Assistant on a limited permit must include initial and routine inspection of patient notes and routine evaluation of performance. The supervision must be conducted in person by a licensed occupational therapist and must be as follows:

    • The Occupational Therapist shall be responsible for the evaluation of the patient and development of the patient/client treatment plan. The Occupational Therapy Assistant on a limited permit may contribute information from observations and standardized test procedures to the evaluation and the treatment plans.
    • The Occupational Therapy Assistant can implement and coordinate intervention plan under supervision of a licensed Occupational Therapist.
    • The Occupational Therapy Assistant can provide direct services that follow a documented routine and accepted procedure under the supervision of the licensed Occupational Therapist.
    • The Occupational Therapy Assistant can adapt activities, media, environment according to needs of patient/client under supervision of the licensed Occupational Therapist.
    • Documentation provided by the Occupational Therapy Assistant while on a limited permit must be co-signed by a licensed Occupational Therapist.

Therapists must maintain documentation of each supervisory visit, and must identify a plan for continued supervision. Records must include, at a minimum, the following information:

    • Location of visit; a method of identifying clients discussed
    • Current plan for supervision (daily, weekly, bi-monthly)
    • Identification of type(s) of interventions observed. These include but are not limited to:
      • Interventions
      • Training
      • Consultations
    • Other supervisory actions. These include but are not limited to:
      • Discussion/recommendation for interventions and/or goals
      • Discussion/training in documentation
      • Demonstration/training in intervention techniques
      • Assessment/re-assessment/discharge (v) Additional Comments
    • An agreement statement signed and dated by both parties, that the supervisory visit did occur and met the needs of the supervisor and supervisee.
    • It is the responsibility of the supervising occupational therapist to provide and the limited permit holder to seek a quality and frequency of supervision that ensures safe and effective occupational therapy service delivery. Both parties (supervisor and supervisee) must keep copies of the supervisory records. Visit records must be maintained for three (3) years, and must be provided to the Board and/or its representative, upon request.

Citation

Tenn. Code Ann. ยง 63-13-205

Tenn. Comp. R. & Regs. 1150-02-.10

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