Occupational Therapy Licensing Board

OAR 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) Telehealth is considered the same as Telepractice for Occupational Therapists working in education settings; and Teletherapy and Telerehab in other settings.

 

(3) 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. 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.

 

(4) 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.

 

(5) Occupational therapists shall secure and maintain the confidentiality of medical information of the patient/client as required by HIPAA and state and federal law.

 

(6) When providing occupational therapy services via telehealth, an occupational therapist shall determine whether an in-person evaluation is necessary and make every attempt to ensure that a therapist is available if an on-site visit is required.

(a) If it is determined in-person interventions are necessary, every attempt must be made to ensure that 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.

 

(7) In making the determination whether an in-person evaluation or intervention are necessary, an occupational therapist shall consider at a minimum:

(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.

 

(8) 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.

 

(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 339-010-0005 is required. The same considerations in (7) (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.​

 Q and A:  Telehealth

 

 Q. What is telehealth?

 

"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.

 

Q. What are the Standards of Practice for Telehealth?

An occupational therapist or occupational therapy assistant providing occupational therapy services via telehealth must exercise the same standard of care when providing occupational therapy services via telehealth as with any other mode of delivery of occupational therapy services and 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.

 

Q. What is required to provide occupational therapy services via telehealth in Oregon?

 

 An occupational therapist or occupational therapy assistant providing occupational therapy services via teleheath to a client in Oregon must have a valid and current license issued by the Oregon Occupational Therapy Licensing Board.

 

Q. I am from out-of-state. Do I need an Oregon license to provide Occupational Therapy services to a client in Oregon?

 

 A. Yes, a license by the Oregon Occupational Therapy Licensing Board is required.

 

Q. Do I need to reside within the state of Oregon in order to provide telehealth services to a client who resides in Oregon?

 

 A. No, you are not required to reside in Oregon but you are required to have an Oregon license and follow all the provisions of laws and regulations governing occupational therapy.

 

Q. What is consent?

 

A. Consent is the process (and document) by which an occupational therapist discloses appropriate information to a competent client so that the client may make a voluntary choice to accept or refuse treatment. It originates from the legal and ethical right the patient has to direct what happens to his or her body and from the ethical duty of the occupational therapist to involve the patient in his or her health care.

 

Q. What else must be considered before providing occupational therapy services via telehealth?

 

 A. OAR 339-010-0006 (6)(a) of the regulations requires the occupational therapist to determine whether an in-person evaluation is necessary and make every attempt to ensure that a therapist be available if an onsite visit is required. (7) requires an occupational therapist should consider at a minimum the criteria set forth in (7) (a)-(f) when determining whether an in-person evaluation or intervention are necessary.

 

Q. How does an occupational therapist determine if an in-person evaluation or in-person interventions are necessary?

 

A. OAR 339-010-0006 (7) (a)-(f) requires the occupational therapist to consider at a minimum the following factors: (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.

 

Q. Do evaluations and interventions have to take place in person?

 

A.  No. OAR 339-010-0006 does not require an occupational therapist to be present, with the client, unless a determination is made that an in-person evaluation or interventions are warranted and necessary. OAR 339-010-0006 requires the occupational therapist consider the factors set forth in OAR 339-010-0006 (7) (a)-(f) to determine whether services, including the evaluation or interventions can be (safely and appropriately) delivered via telehealth or whether the evaluation or interventions should be provided in-person. The occupational therapist that is considering rendering services, including providing an evaluation or interventions via telehealth, must make the determination whether services must be provided in-person or services can be safely delivered via telehealth.

 

Q. After consideration of the criteria in OAR 339-010-0006 (7) (a)-(f) what if a therapist is not available to perform an onsite evaluation or intervention?

A. Delivering services via telehealth may increase access to care, however, that care cannot be at the risk of a patient’s safety. The occupational therapist must determine whether the evaluation or interventions can be (safely and appropriately) delivered via telehealth or whether services, the evaluation or interventions must be provided in-person. If an "on-site" occupational therapist is not available, alternative options may be provided, such as referring the patient to an out-patient rehabilitation clinic, another local occupational therapist, home health services, etc.

Q. Can telehealth be used for supervision of an occupational therapy assistant?

A. 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 339-010-0005 is required. The same considerations in (7) (A) through (F) must be considered in determining whether telehealth should be used.

 

 ​

​​​​