"Occupational
therapy" means the analysis and use of purposeful activity with
individuals who are limited by physical injury or illness, developmental or
learning disabilities, psycho-social dysfunctions or the aging process in order
to maximize independence, prevent disability and maintain health. The practice of
occupational therapy encompasses evaluation, treatment and consultation.
Specific occupational therapy services includes but is not limited to:
Activities of daily living (ADL); perceptual motor and sensory integrated
activity; development of work and leisure skills; the design, fabrication or
application of selected orthotics or prosthetic devices; the use of
specifically designed crafts; guidance in the selection and use of adaptive
equipment; exercises to enhance functional performance; prevocational evaluation
and training; performing and interpreting manual muscle and range of motion
test; and appraisal and adaptation of environments for people with mental and
physical disabilities. The services are provided individually, in groups, or
through social systems."
The Occupational
Therapy Licensing Board has received inquiries relative to the scope of
occupational therapy practice as defined in ORS 675.210.
The development of
medical advances are continually evolving in order to provide more
comprehensive services to consumers, and services of occupational therapists
are expended into new and alternative models of service delivery systems.
Occupational therapists are sometimes asked to provide services which are not
clearly defined in the practice act (i.e. irrigate supra pubic catheters,
suction a classroom student, feed with nasa gastric tube, etc.), and the Board
has the responsibility to generally supervise the practice of occupational
therapy in this state under ORS 675.320 (10). The Occupational Therapy
Licensing Board therefore has established a position statement to further
interpret the Practice Act as follows:
It is the opinion of
the Occupational Therapy Licensing Board that procedures which are intrusive to
the body be considered medical and/or nursing services unless they are part of
a planned program to teach the client new self-help skills, and are developed
as part of a long-term plan to help a client reach an increased level of
independence.
Physical agent
modalities may be used by occupational therapy practitioners when used as an
adjunct to/or in preparation for purposeful activity to enhance the
occupational therapy performance and when applied by a practitioner who has
documented evidence of possessing the theoretical background and technical
skills for safe and competent integration of the modality into an occupational
therapy intervention plan.
Professional
competency rules under OAR 339-010-0020 state that the OT may be in violation
of the professional conduct under (2) “Unprofessional conduct relating
to professional competency includes:
(a) Engaging in any
professional activities for which licensee is not currently qualified;
(b) Failing to
maintain competency;
(c) Failing to
provide a comprehensive service that is compatible with current research and
within an ethical and professional framework;
(d) Failing to obtain
a physician's referral in situations where an OT is using a modality not
specifically defined in ORS 675.210(3)
(e) Failing to
provide professional occupational therapy based on evaluation of
patient’s/client’s needs and appropriate treatment procedures…".
You do not need
a doctor’s referral to evaluate and treat in Oregon if the service is found in
the Oregon statutory definition and if you have the training, skills and
experience. However, keep in mind that reimbursement agencies may require
the doctor’s referral for reimbursement.