Occupational Therapy Licensing Board

Any person who is licensed in Oregon as an occupational therapy assistant is required to file a statement of supervision form with the OT Licensing Board.  It must be signed by your OT supervisor. 
 
You can mail in the form, scan and email, or fax it in at 971-673-0226.  We will record your supervisor in the database and send you a confirmation email.  If you don't receive the confirmation email, assume that we did not receive it and re-send.
 
 
Here is the rule:
 
OAR 339-010-0035(2) requires a signed Statement of Supervision Form

(1) Any person who is licensed as an occupational therapy assistant may assist in the practice of occupational therapy only under the supervision of a licensed occupational therapist.
(2) Before an occupational therapy assistant assists in the practice of occupational therapy, he/she must file with the Board a signed, current statement of supervision of the licensed occupational therapist who will supervise the occupational therapy assistant.
(3) An occupational therapy assistant always requires at least general supervision.
(4) The supervising occupational therapist shall provide closer supervision where professionally appropriate.
(5) The supervisor, in collaboration with the supervisee, is responsible for setting and evaluating the standard of work performed.
 
The definition of “general supervision” is found in OAR 339-010-0005: 

(1) "Supervision," is a process in which two or more people participate in a joint effort to promote, establish, maintain and/or evaluate a level of performance. The occupational therapist is responsible for the practice outcomes and documentation to accomplish the goals and objectives. Levels of supervision:

(a) "Close supervision" requires daily, direct contact in person at the work site;

(b) "Routine supervision" requires the supervisor to have direct contact in person at least every two weeks at the work site or via telehealth as defined in OAR 339-010-0006(9) with interim supervision occurring by other methods, such as telephone or written communication;

(c) "General supervision" requires the supervisor to have at least monthly direct contact in person with the supervisee at the work site or via telehealth as defined in OAR 339-010-0006(9) with supervision available as needed by other methods. 



 
 
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AOTA's Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services have been adopted the Oregon OT Licensing Board.
This document contains four sections that direct the delivery of occupational therapy services. These sections are General Supervision, Supervision of Occupational Therapists and Occupational Therapy Assistants, Roles and Responsibilities of Occupational Therapists and Occupational Therapy Assistants During the Delivery of Occupational Therapy Services, and Supervision of Occupational Therapy Aides.
General Supervision
These guidelines provide a definition of supervision and outline parameters regarding effective supervision as it relates to the delivery of occupational therapy services. These supervision guidelines are to assist in the appropriate and effective provision of occupational therapy services. The guidelines themselves cannot be interpreted to constitute a standard of supervision in any particular locality. Occupational therapists, occupational therapy assistants, and occupational therapy aides are expected to meet applicable state and federal regulations, adhere to relevant workplace policies and the Occupational Therapy Code of Ethics (AOTA, 2005) and participate in ongoing professional development activities to maintain continuing competency.
In these guidelines, supervision is viewed as a cooperative process in which two or more people participate in a joint effort to establish, maintain, and or elevate a level of competence and performance. Supervision is based on mutual understanding between the supervisor and the supervisee about each other’s competence, experience, education, and credentials. It fosters growth and development, promotes effective utilization of resources, encourages creativity and innovation, and provides education and support to achieve a goal (AOTA, 2004). Within the scope of occupational therapy practice, supervision is a process aimed at ensuring the safe and effective delivery of occupational therapy services and fostering professional competence and development.
Supervision of Occupational Therapists and Occupational Therapy Assistants
Occupational Therapists
Based on their education and training, occupational therapists, after initial certification, are autonomous practitioners who are able to deliver occupational therapy services independently. Occupational therapists are responsible for all aspects of occupational therapy service delivery and are accountable for the safety and effectiveness of the occupational therapy service delivery process. Occupational therapists are encouraged to seek supervision and mentoring to develop best practice approaches and promote professional growth.
Occupational Therapy Assistants
Based on their education and training, occupational therapy assistants must receive supervision from an occupational therapist to deliver occupational therapy services. Occupational therapy assistants deliver occupational therapy services under the supervision of and in partnership with occupational therapists.  Occupational therapists and occupational therapy assistants are responsible for collaboratively developing a plan for supervision.
General Principles
1. Supervision involves guidance and oversight related to the delivery of occupational therapy services and the facilitation of professional growth and competence. It is the responsibility of occupational therapists and occupational therapy assistants to seek the appropriate quality and frequency of supervision to ensure safe and effective occupational therapy service delivery.
2. To ensure safe and effective occupational therapy services, it is the responsibility of occupational therapists and occupational therapy assistants to recognize when supervision is needed and to seek supervision that supports current and advancing levels of competence.
3. The specific frequency, methods, and content of supervision may vary by practice setting and are dependent on the
a. Complexity of client needs,
b. Number and diversity of clients,
c. Skills of the occupational therapist and the occupational therapy assistant,
d. Type of practice setting,
e. Requirements of the practice setting, and
f. Other regulatory requirements.
4. Supervision that is more frequent than the minimum level required by the practice setting or regulatory agencies may be necessary when
a. The needs of the client and the occupational therapy process are complex and changing,
b. The practice setting provides occupational therapy services to a large number of clients with diverse needs, or
c. The occupational therapist and occupational therapy assistant determine that additional supervision is necessary to ensure safe and effective delivery of occupational therapy services.
5. A variety of types and methods of supervision should be used. Methods may include direct, face-to-face contact and indirect contact. Examples of methods or types of supervision that involve direct face-to face contact include observation, modeling, co-treatment, discussions, teaching, and instruction. Examples of methods or types of supervision that involve indirect contact include phone conversations, written correspondence, and electronic exchanges.
6. Occupational therapists and occupational therapy assistants must abide by agency and state requirements regarding the documentation of a supervision plan and supervision contacts. Documentation may include the
a. Frequency of supervisory contact,
b. Method(s) or type(s) of supervision,
c. Content areas addressed,
d. Evidence to support areas and levels of competency, and
e. Names and credentials of the persons participating in the supervisory process.
7. Supervision related to professional growth, such as leadership and advocacy development, may differ from that needed to provide occupational therapy services. The person providing this supervision, as well as the frequency, method, and content of supervision, should be responsive to the supervisee's advancing levels of professional growth.
Supervision Outside the Delivery of Occupational Therapy Services
The education and expertise of occupational therapists and occupational therapy assistants prepare them for employment in arenas other than those related to the delivery of occupational therapy. In these other arenas, supervision may be provided by non–occupational therapy professionals.
1. The guidelines of the setting, regulatory agencies, and funding agencies direct the supervision requirements.
2. The occupational therapist and occupational therapy assistant should obtain and use credentials or job titles commensurate with their roles in these other employment arenas.
3. The following are used to determine whether the services provided are related to the delivery of occupational therapy:
a. State practice acts;
b. Regulatory agency standards and rules;
c. Domain of occupational therapy practice; and
d. Written and verbal agreement among the occupational therapist, the occupational therapy assistant, the client, and the agency or payer about the services provided.  
Roles and Responsibilities of Occupational Therapists and Occupational Therapy
Assistants During the Delivery of Occupational Therapy Services
General Statement
The focus of occupational therapy is to support the client’s “health and participation in life through engagement in occupation” (AOTA, 2008, p. 626). Occupational therapy addresses the needs and goals of the client related to engaging in areas of occupation and considers the performance skills, performance patterns, context and environment, activity demands, and client factors that may influence performance in various areas of occupation.
1. The occupational therapist is responsible for all aspects of occupational therapy service delivery and is accountable for the safety and effectiveness of the occupational therapy service delivery process. The occupational therapy service delivery process involves evaluation, intervention planning, intervention, implementation, intervention review, and outcome evaluation.
2. The occupational therapist must be directly involved in the delivery of services during the initial evaluation and regularly throughout the course of intervention and outcome evaluation.
3. The occupational therapy assistant delivers occupational therapy services under the supervision of and in partnership with the occupational therapist.
4. It is the responsibility of the occupational therapist to determine when to delegate responsibilities to an occupational therapy assistant. It is the responsibility of the occupational therapy assistant who performs the delegated responsibilities to demonstrate service competency.
5. The occupational therapist and the occupational therapy assistant demonstrate and document service competency for clinical reasoning and judgment during the service delivery process as well as for the performance of specific techniques, assessments, and intervention methods used.
When delegating aspects of occupational therapy services, the occupational therapist considers the following factors:
a. Complexity of the client’s condition and needs;
b. Knowledge, skill, and competence of the occupational therapy practitioner;
c. Nature and complexity of the intervention; and
d. Needs and requirements of the practice setting.
Roles and Responsibilities
Regardless of the setting in which occupational therapy services are delivered, occupational therapists and occupational therapy assistants assume the following generic responsibilities during evaluation, intervention, and outcomes evaluation.
Evaluation
1. The occupational therapist directs the evaluation process.
2. The occupational therapist is responsible for directing all aspects of the initial contact during the occupational therapy evaluation, including
a. Determining the need for service,
b. Defining the problems within the domain of occupational therapy that need to be addressed,
c. Determining the client’s goals and priorities,
d. Establishing intervention priorities,
e. Determining specific further assessment needs, and
f. Determining specific assessment tasks that can be delegated to the occupational therapy assistant.
3. The occupational therapist initiates and directs the evaluation, interprets the data, and develops the intervention plan.
4. The occupational therapy assistant contributes to the evaluation process by implementing delegated assessments and by providing verbal and written reports of observations and client capacities to the occupational therapist.
5. The occupational therapist interprets the information provided by the occupational therapy assistant and integrates that information into the evaluation and decision-making process.
Intervention Planning
1. The occupational therapist has overall responsibility for the development of the occupational therapy intervention plan.
2. The occupational therapist and the occupational therapy assistant collaborate with the client to develop the plan.
3. The occupational therapy assistant is responsible for being knowledgeable about evaluation results and for providing input into the intervention plan, based on client needs and priorities.
Intervention Implementation
1. The occupational therapist has overall responsibility for implementing the intervention.
2. When delegating aspects of the occupational therapy intervention to the occupational therapy assistant, the occupational therapist is responsible for providing appropriate supervision.
3. The occupational therapy assistant is responsible for being knowledgeable about the client’s occupational therapy goals.
4. The occupational therapy assistant selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, client goals, and the requirements of the practice setting.
Intervention Review
1. The occupational therapist is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
2. The occupational therapy assistant contributes to this process by exchanging information with and providing documentation to the occupational therapist about the client’s responses to and communications during intervention.
Outcome Evaluation
1. The occupational therapist is responsible for selecting, measuring, and interpreting outcomes that are related to the client’s ability to engage in occupations.
2. The occupational therapy assistant is responsible for being knowledgeable about the client’s targeted occupational therapy outcomes and for providing information and documentation related to outcome achievement.
3. The occupational therapy assistant may implement outcome measurements and provide needed client discharge resources.
Supervision of Occupational Therapy Aides
An aide, as used in occupational therapy practice, is an individual who provides supportive services to the occupational therapist and the occupational therapy assistant. Aides do not provide skilled occupational therapy services. An aide is trained by an occupational therapist or an occupational therapy assistant to perform specifically delegated tasks. The occupational therapist is responsible for the overall use and actions of the aide. An aide first must demonstrate competency to be able to perform the assigned, delegated client and non-client tasks.
1. The occupational therapist must oversee the development, documentation, and implementation of a plan to supervise and routinely assess the ability of the occupational therapy aide to carry out non-client-and client-related tasks. The occupational therapy assistant may contribute to the development and documentation of this plan.
2. The occupational therapy assistant can supervise the aide.
3. Non-client-related tasks include clerical and maintenance activities and preparation of the work area or equipment.
4. Client-related tasks are routine tasks during which the aide may interact with the client. The following factors must be present when an occupational therapist or occupational therapy assistant delegates a selected client-related task to the aide:
Depending on the setting in which service is provided; aides may be referred to by various names. Examples include, but are not limited to, rehabilitation aides, restorative aides, extenders, paraprofessionals, and rehab techs
a. The outcome anticipated for the delegated task is predictable.
b. The situation of the client and the environment is stable and will not require that judgment, interpretations, or adaptations be made by the aide.
c. The client has demonstrated some previous performance ability in executing the task.
d. The task routine and process have been clearly established.
5. When performing delegated client-related tasks, the supervisor must ensure that the aide
a. Is trained and able to demonstrate competency in carrying out the selected task and using equipment, if appropriate;
b. Has been instructed on how to specifically carry out the delegated task with the specific client; and
c. Knows the precautions, signs, and symptoms for the particular client that would indicate the need to seek assistance from the occupational therapist or occupational therapy assistant.
6. The supervision of the aide needs to be documented. Documentation includes information about frequency and methods of supervision used the content of supervision and the names and credentials of all persons participating in the supervisory process.
Summary
These guidelines about supervision, roles, and responsibilities are to assist in the appropriate utilization of occupational therapists, occupational therapy assistants, and occupational therapy aides and in the appropriate and effective provision of occupational
therapy services. It is expected that occupational therapy policies, the Occupational Therapy Code of Ethics (AOTA, 2005), and continuing competency and professional development guidelines.
References
American Occupational Therapy Association. (2004). Guidelines for supervision, roles, and responsibilities during the delivery of occupational therapy services. American Journal of Occupational Therapy, 58, 663–667.
American Occupational Therapy Association. (2005). Occupational therapy code of ethics (2005). American Journal of Occupational Therapy, 59, 639–642.
American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625–683.
Additional Reading
American Occupational Therapy Association. (2005). Standards of practice for occupational therapy.  American Journal of Occupational Therapy, 59, 663–665.
Authors
Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson, 2002–2005
Gloria Frolek Clark, MS, OTR/L, FAOTA
Janet V. DeLany, DEd, OTR/L
Eileen R. Garza, PhD, OTR, ATP
Mary V. Radomski, MA, OTR/L, FAOTA
Ruth Ramsey, MS, OTR/L
Carol Siebert, MS, OTR/L
Kristi Voelkerding, BS, COTA/L
Patricia D. LaVesser, PhD, OTR/L, SIS Liaison
Lenna Aird, ASD Liaison
Deborah Lieberman, MHSA, OTR/L, FAOTA, AOTA Headquarters Liaison for The Commission on Practice
Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson
Adopted by the Representative Assembly 2004C24
Edited by the Commission on Practice 2009
This replaces the 2004 document Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (previously published and copyrighted in 2004 in the American Journal of Occupational Therapy, 58, 663–667).
Copyright © 2009 by the American Occupational Therapy Association.
A signed "Statement of Supervision" must be filed in the OTLB office prior to working under Limited Permits.  It can be faxed to 971-673-0226 or scanned and emailed.  See Application Forms section for more information regarding obtaining a Limited Permit.
 
 
Oregon laws on Limited Permit holders  
 
675.320 Powers of board; fees; rules. The Occupational Therapy Licensing Board shall have the following powers in addition to powers otherwise granted under ORS 675.210 to 675.340 or necessary to carry out the provisions of ORS 675.210 to 675.340:
     
(11) To establish minimum requirements for limited permit to be complied with by all applicants prior to issuance of limited permit. A limited permit shall be issued to a person at the discretion of the board upon application and payment of a permit fee of $25.
    
339-010-0040 Limited Permit  (1) Students who have successfully completed the educational and field work requirements and students who receive their eligibility to take the NBCOT certification examination, but do not yet have their test results, may apply for a limited permit to practice occupational therapy under at least routine supervision (as defined in OAR 339-010-0005(1)(b)) of an Oregon licensed occupational therapist. …
(4) An Oregon licensed occupational therapist must sign the limited permit application verifying a supervisory role to the applicant.
(5) A limited permit may not be issued to applicants who have taken and failed the certification examination, and limited permits may not be renewed.
(6) A person who fails the exam must immediately surrender the limited permit upon receipt of examination scores.
(7) The Board may grant an extension of a limited permit to persons who, because of extenuating circumstances, are unable to take the scheduled certification examination. Request must be made in writing.
 
Supervision under OAR 339-010-0005(1)(b) : 

(1) "Supervision," is a process in which two or more people participate in a joint effort to promote, establish, maintain and/or evaluate a level of performance. The occupational therapist is responsible for the practice outcomes and documentation to accomplish the goals and objectives. Levels of supervision:

(a) "Close supervision" requires daily, direct contact in person at the work site;

(b) "Routine supervision" requires the supervisor to have direct contact in person at least every two weeks at the work site or via telehealth as defined in OAR 339-010-0006(9) with interim supervision occurring by other methods, such as telephone or written communication;

(c) "General supervision" requires the supervisor to have at least monthly direct contact in person with the supervisee at the work site or via telehealth as defined in OAR 339-010-0006(9) with supervision available as needed by other methods. 

 
From the AOTA Supervision guidelines: 
 
1. Purpose:  The purpose of this Model State Regulation for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services is to provide a template for use by state agencies and occupational therapy regulatory boards when drafting or revising regulations to govern the clinical supervision of occupational therapy assistants, limited permit holders, and aides. The model is intended to help safeguard the public health, safety and welfare by establishing guidelines that are consistent with professional standards and accepted practice in the profession. . . .
2. Definitions  A.  In this section, the following terms have the meanings indicated.
(1)          Board” means the Oregon Occupational Therapy Licensing Board.
(2)         Competence” refers to an individual’s capacity to perform job responsibilities.
(3)         Competency” refers to an individual’s actual performance in a specific situation.
(4)         Limited permit holder” means an individual who has completed the academic and fieldwork requirements of this Act for occupational therapists or occupational therapy assistants, has not yet taken or received the results of the entry-level certification examination, and has applied for and been granted limited permit status.
(5)         "Occupational therapist" means an occupational therapist who is licensed by the Board.
(7) "Occupational therapy assistant" means an occupational therapy assistant who is licensed by the Board to provide occupational therapy services under the supervision of and in partnership with a licensed occupational therapist.
(8) "Supervision” means a cooperative process in which two or more people participate in a joint effort to establish, maintain, and/or elevate a level of competence and performance. Within the scope of occupational therapy practice, supervision is aimed at ensuring the safe and effective delivery of occupational therapy services and fostering professional competence and development.
 
 
5. Supervision of a Limited Permit Holder
A.  An occupational therapist limited permit holder or occupational therapy assistant limited permit holder who has not yet taken or received the results of the entry-level certification examination shall practice under the supervision of an occupational therapist.  It is the responsibility of the supervising occupational therapist to provide and the limited permit holder to seek the appropriate quality and frequency of supervision to ensure safe and effective occupational therapy service delivery.
 

Rules on Supervision of Occupational Therapy Aides

 

339-010-0055

Occupational Therapy Aides Tasks

(1) An "aide" is a person who provides support services to an occupational therapist and occupational therapy assistant, but is not licensed by the Occupational Therapy Licensing Board. Any aide who is working with or supporting patients, and is performing activities covered under the occupational therapy plan of treatment, is considered an occupational therapy aide. The occupational therapy practitioner is responsible for the overall use and actions of the aide, and must ensure the competency of the aide performing the assigned tasks.

(2) An occupational therapist or occupational therapy assistant may supervise the aide. When the aide is performing treatment related tasks, the supervising occupational therapy practitioner must be within sight or earshot of the aide, and must be immediately available at all times to provide in-person direction, assistance, advice, or instruction to the aide.

(3) Treatment related tasks that the aide may assist with under the direct supervision of the occupational therapy practitioner include:

(a) Routine transfers;

(b) Routine care of patient's personal needs during the course of treatment;

(c) Execution of a well-established routine activity and/or exercise;

(d) Assisting the occupational therapy practitioner as directed during the course of treatment.

(4) Non-treatment related tasks that may be performed by the occupational therapy aide include:

(a) Clerical;

(b) Secretarial;

(c) Housekeeping;

(d) Supply ordering;

(e) Equipment maintenance;

(f) Fabrication of generic strapping material for splints;

(g) Transporting patients;

(h) Preparation of the work area or equipment.

(5) An aide does not provide skilled occupational therapy services in any practice setting. These rules do not apply to school aides and occupational therapists working in school settings. The rules on aides in the education setting are found in OAR 339-010-0050.

 

​Fieldwork Students must have supervision.  In Oregon, Pacific University, School of OT has a fieldwork Co-coordinator.  Generally questions should go there first.  The OT Licensing Board does get some questions on supervision, and often those questions come to the board because the question really deals with co-signing notes for reimbursement.  Those questions deal with Medicare/Medicaid issues.
 
For information about fieldwork supervision please refer to the school through which you are doing your fieldwork, and the AOTA guidelines.  They are found at: www.aota.org.
 
For some specific information you can click on the link you want below: 
 
Guide lines for level II Field Work for OT students. for more on AOTA Guidelines for student fieldwork or for information on Medicare Reimbursement for Students Issues.