Proposed rules 2014
If you have any questions or wish to submit comments for the Board to consider, contact the Director.
339 – 010 – 0006
Standards of Practice for Telehealth
(1) "Telehealth" is defined as the use of interactive audio and video, in real time telecommunication technology or store-and-forward technology, to deliver health care services when the occupational therapist and patient/client are not at the same physical location. Its uses include diagnosis, consultation, treatment, prevention, transfer of health or medical data, and continuing education.
(2) In order to provide occupational therapy services via telehealth to a patient/client in Oregon, the occupational therapist providing services to a patient/client must have a valid and current license issued by the Oregon OT Licensing Board.
(a) Oregon licensed Occupational Therapists using telehealth technology with a patient/client in another state may also be required to be licensed in the state in which the patient/client receives those services and must adhere to those state licensure laws.
(3) Occupational therapists shall obtain informed consent of the delivery of service via telehealth from the patient/client prior to initiation of occupational therapy services via telehealth and maintain documentation in the patient's or client's health record.
(4) Occupational therapists shall secure and maintain the confidentiality of medical information of the patient/client as required by HIPAA and state and federal law.
(5) Prior to providing occupational therapy services via telehealth, an occupational therapist shall determine whether an in-person evaluation is necessary and ensure that a local therapist is available if an on-site visit is required.
(a) If it is determined in-person interventions are necessary, an on-site occupational therapist or occupational therapy assistant shall provide the appropriate interventions.
(b) The obligation of the occupational therapist to determine whether an in-person re-evaluation or intervention is necessary continues during the course of treatment.
(6) In making the determination whether an in-person evaluation or intervention are necessary, an occupational therapist shall consider:
(a) the complexity of the patient's/client's condition;
(b) his or her own knowledge skills and abilities;
(c) the patient's/client's context and environment;
(d) the nature and complexity of the intervention;
(e) the pragmatic requirements of the practice setting; and
(f) the capacity and quality of the technological interface.
(7) An occupational therapist or occupational therapy assistant providing occupational
therapy services via telehealth must:
(a) Exercise the same standard of care when providing occupational therapy services via
telehealth as with any other mode of delivery of occupational therapy services;
(b) Provide services consistent the AOTA Code of Ethics and Ethical Standards of Practice;
and comply with provisions of the Occupational Therapy Practice Act and its regulations.
(8) When an Occupational Therapist has determined that telehealth is an appropriate delivery of services, the therapist must ensure that, if required, there is an adequately trained person available to set up and help with hands on delivery of services to the patient/client and who works under the direction of the therapist.
(9) Supervision of Occupational Therapy Assistant under 339-010-0035 for routine and general supervision, can be done through telehealth, but cannot be done when close supervision as defined in 229-010-0005 is required. The same considerations in (6) (A) through (F) must be considered in determining whether telehealth should be used.
(10) An Occupational Therapist who is supervising a fieldwork student must follow the ACOTE standards and other accreditation requirements.
(11) Failure to comply with these regulations shall be considered unprofessional conduct under OAR 339-010-0020.
Occupational Therapy in Mental Health Practice
Pursuant to ORS 675.210 defining the practice of Occupational Therapy, occupational therapists use analysis and purposeful activity with individuals across their lifespan who are limited by psycho-social dysfunctions or mental disabilities.
(1) Occupational therapists address barriers to optimal functioning at the all levels with:
(a) Individuals (body functions, cognitive functions, values, beliefs, spirituality, motor skills,
cognitive skills, and social skills);
(b) Groups (collective individuals, e.g. families, workers, students, or community); and
(c) Populations (collective groups of individuals living in a similar locale, e.g., city, state, or country residents, people sharing same or like concerns).
(2) Occupational Therapists perform evaluations and interventions that focus on enhancing
existing skills, creating opportunities, promoting wellness, remediating or restoring skills, modifying or adapting the environment or activity, and preventing relapse.
(3) Occupational therapists use a recovery model to increase the ability of individuals, groups,
and populations to be engaged with daily life activities that are meaningful; lead to productive daily roles, habits, and routines; and promote living as independently as possible.
(4) Services for individuals with mental illness are client centered and may be provided to
individuals in the community, hospitals, correctional institutions, homes, schools or other educational programs, workplace, or any other setting.
(5) Occupational therapists may provide behavioral and mental health preliminary “diagnosis”
using standard terminology and taxonomy such as DSM or ICD, through observation of symptoms and mental health assessment, confirmed by prescribing physician and health care team.
Continuing Education in cultural Competency
Continuing Education in cultural competency is considered relevant for the current practice of all licensees and may be used toward satisfying the required Continuing Education hours.