Md. Code Regs. 10.46.01.04

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Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.46.01.04 - Supervision Requirements

A. Occupational Therapist.

(1) A licensed occupational therapist may supervise the clinical practice of the following:

(a) Occupational therapist;

(b) Occupational therapy assistant;

(c) Temporary occupational therapist;

(d) Temporary occupational therapy assistant;

(e) Aide; and

(f) Occupational therapy student or occupational therapy assistant student.

(2) Unless otherwise stated, a supervisor need not be physically present on the premises at all times, but may be available by telephone or by other electronic communication means.

B. Occupational Therapy Assistant.

(1) Subject to the requirements of this section, an occupational therapy assistant may practice limited occupational therapy under the supervision of an occupational therapist provided it is at least periodic supervision.

(2) The supervising occupational therapist working with the occupational therapy assistant shall determine the appropriate amount and type of supervision necessary, taking into consideration:

(a) Skills, experience, and education of the occupational therapy assistant and the occupational therapist;

(b) Change in a client's status;

(c) Complexity of the treatment program; and

(d) Type and requirements of practice setting.

(3) In addition to the other requirements specified by this section, supervision requires that, before the initiation of the treatment program and before a planned discharge, the supervising occupational therapist shall provide direction to the occupational therapy assistant by verbal, written, or electronic communication.

(4) An occupational therapy assistant, under the direction of the occupational therapist, is permitted to be the primary clinical supervisor for the following:

(a) Aide;

(b) Temporary occupational therapy assistant;

(c) Level I fieldwork occupational therapy student; and

(d) Level I and Level II fieldwork occupational therapy assistant student.

(5) The occupational therapy assistant may be utilized to facilitate occupational therapy student and occupational therapy assistant student learning experiences in both Level I and Level II fieldwork under the direction of the occupational therapist.

(6) The supervising occupational therapist and the occupational therapy assistant are jointly responsible for maintaining formal documentation of periodic supervision as set forth in Regulation .05 of this chapter.

C. Temporary License to Practice Occupational Therapy.

(1) A temporary license to practice occupational therapy authorizes the licensee to practice occupational therapy with on-site supervision.

(2) The supervising occupational therapist and the temporary occupational therapist are jointly responsible for maintaining documentation of supervision as set forth in Regulation .05 of this chapter.

D. Temporary License to Practice Limited Occupational Therapy.

(1) A temporary license to practice limited occupational therapy authorizes the licensee to practice limited occupational therapy with on-site supervision.

(2) The supervising occupational therapist or the supervising occupational therapy assistant and the temporary occupational therapy assistant are jointly responsible for maintaining documentation of supervision as set forth in Regulation .05 of this chapter.

E. Aide.

(1) A supervising occupational therapist or occupational therapy assistant working with an aide shall provide direct supervision to the aide when the aide is performing tasks within the occupational therapy treatment program.

(2) The supervising occupational therapist or occupational therapy assistant shall assign to an aide only those tasks that do not require education or training in occupational therapy and that the aide can perform competently.

(3) The supervising occupational therapist or occupational therapy assistant is responsible for ensuring that the aide delivers service in a safe and competent manner.

(4) Prescribed tasks within the treatment program that may be performed by an aide under the direct supervision of an occupational therapist include, but are not limited to:

(a) Guarding;

(b) Positioning;

(c) Holding body parts for splinting or bracing; and

(d) Assisting with group and community reentry activities.

(5) Prescribed tasks within the treatment program that may be performed by an aide under the direct supervision of an occupational therapist or occupational therapy assistant include:

(a) Transfer practice;

(b) Assisting in routine:

(i) Functional activity;

(ii) Functional exercise; and

(iii) Activities of daily living (ADL) program;

(c) Applying assistive devices;

(d) Applying adaptive devices;

(e) Assisting the client with the use of assistive equipment;

(f) Assisting the client with the use of adaptive equipment; and

(g) Reality orientation for the confused client.

(6) Nontreatment activities that may be performed by an aide under the direction of an occupational therapist or occupational therapy assistant include:

(a) Clerical;

(b) Secretarial;

(c) Housekeeping;

(d) Supply maintenance;

(e) Equipment maintenance;

(f) Fabrication of straps for splinting and bracing;

(g) Fabrication of assistive devices that are not worn directly by a client;

(h) Routine transfers for transporting clients;

(i) Transporting clients; and

(j) Activities ancillary to group and individual activities.

F. Occupational Therapy Students. An occupational therapist or occupational therapy assistant supervising a Level I or Level II fieldwork student shall have a minimum of 1 year of experience as a licensed occupational therapist or occupational therapy assistant, excluding temporary licensure.

Md. Code Regs. 10.46.01.04

Regulation .04 adopted effective July 3, 1995 (22:13 Md. R. 968)
Regulation .04 adopted as an emergency provision effective October 1, 2000 (27:21 Md. R. 1973); emergency status extended at 28:7 Md. R. 687; emergency status extended at 28:9 Md. R. 884; adopted permanently effective April 30, 2001 (28:8 Md. R. 761)
Regulation .04 amended effective 42:18 Md. R. 1174, eff.9/14/2015