Chapter 448

448.987(1) (1) Purpose. The purpose of this compact is to facilitate interstate practice of occupational therapy with the goal of improving public access to occupational therapy services. The practice of occupational therapy occurs in the state where the patient/client is located at the time of the patient/client encounter. The compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. This compact is designed to achieve the following objectives:

448.987(1)(a) (a) Increase public access to occupational therapy services by providing for the mutual recognition of other member state licenses;

448.987(1)(b) (b) Enhance the states’ ability to protect the public’s health and safety;

448.987(1)(c) (c) Encourage the cooperation of member states in regulating multi-state occupational therapy practice;

448.987(1)(d) (d) Support spouses of relocating military members;

448.987(1)(e) (e) Enhance the exchange of licensure, investigative, and disciplinary information between member states;

448.987(1)(f) (f) Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state’s practice standards; and

448.987(1)(g) (g) Facilitate the use of telehealth technology in order to increase access to occupational therapy services.

448.987(2) (2) Definitions. As used in this compact, and except as otherwise provided, the following definitions shall apply:

448.987(2)(a) (a) “Active duty military” means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 USC ch. 1209 and 10 USC ch. 1211.

448.987(2)(b) (b) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws which is imposed by a licensing board or other authority against an occupational therapist or occupational therapy assistant, including actions against an individual’s license or compact privilege such as censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee’s practice.

448.987(2)(c) (c) “Alternative program” means a non-disciplinary monitoring process approved by an occupational therapy licensing board.

448.987(2)(d) (d) “Compact privilege” means the authorization, which is equivalent to a license, granted by a remote state to allow a licensee from another member state to practice as an occupational therapist or practice as a occupational therapy assistant in the remote state under its laws and rules. The practice of occupational therapy occurs in the member state where the patient/client is located at the time of the patient/client encounter.

448.987(2)(e) (e) “Continuing competence/education” means a requirement, as a condition of license renewal, to provide evidence of participation in, and/or completion of, educational and professional activities relevant to practice or area of work.

448.987(2)(f) (f) “Current significant investigative information” means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the occupational therapist or occupational therapy assistant to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.

448.987(2)(g) (g) “Data system” means a repository of information about licensees, including but not limited to license status, investigative information, compact privileges, and adverse actions.

448.987(2)(h) (h) “Encumbered license” means a license in which an adverse action restricts the practice of occupational therapy by the licensee or said adverse action has been reported to the National Practitioners Data Bank (NPDB).

448.987(2)(i) (i) “Executive committee” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the commission.

448.987(2)(j) (j) “Home state” means the member state that is the licensee’s primary state of residence.

448.987(2)(k) (k) “Impaired practitioner” means individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions.

448.987(2)(L) (L) “Investigative information” means information, records, and/or documents received or generated by an occupational therapy licensing board pursuant to an investigation.

448.987(2)(m) (m) “Jurisprudence requirement” means the assessment of an individual’s knowledge of the laws and rules governing the practice of occupational therapy in a state.

448.987(2)(n) (n) “Licensee” means an individual who currently holds an authorization from the state to practice as an occupational therapist or as an occupational therapy assistant.

448.987(2)(o) (o) “Member state” means a state that has enacted the compact.

448.987(2)(p) (p) “Occupational therapist” means an individual who is licensed by a state to practice occupational therapy.

448.987(2)(q) (q) “Occupational therapy assistant” means an individual who is licensed by a state to assist in the practice of occupational therapy.

448.987(2)(r) (r) “Occupational therapy,” “occupational therapy practice,” and the “practice of occupational therapy” mean the care and services provided by an occupational therapist or an occupational therapy assistant as set forth in the member state’s statutes and regulations.

448.987(2)(s) (s) “Occupational therapy compact commission” or “commission” means the national administrative body whose membership consists of all states that have enacted the compact.

448.987(2)(t) (t) “Occupational therapy licensing board” or “licensing board” means the agency of a state that is authorized to license and regulate occupational therapists and occupational therapy assistants.

448.987(2)(u) (u) “Primary state of residence” means the state (also known as the home state) in which an occupational therapist or occupational therapy assistant who is not active duty military declares a primary residence for legal purposes as verified by: driver’s license, federal income tax return, lease, deed, mortgage, or voter registration or other verifying documentation as further defined by commission rules.

448.987(2)(v) (v) “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege.

448.987(2)(w) (w) “Rule” means a regulation promulgated by the commission that has the force of law.

448.987(2)(x) (x) “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of occupational therapy.

448.987(2)(y) (y) “Single-state license” means an occupational therapist or occupational therapy assistant license issued by a member state that authorizes practice only within the issuing state and does not include a compact privilege in any other member state.

448.987(2)(z) (z) “Telehealth” means the application of telecommunication technology to deliver occupational therapy services for assessment, intervention and/or consultation.

448.987(3) (3) State participation in the compact.

448.987(3)(a) (a) To participate in the compact, a member state shall:

448.987(3)(a)1. 1. License occupational therapists and occupational therapy assistants;

448.987(3)(a)2. 2. Participate fully in the commission’s data system, including but not limited to using the commission’s unique identifier as defined in rules of the commission;

448.987(3)(a)3. 3. Have a mechanism in place for receiving and investigating complaints about licensees;

448.987(3)(a)4. 4. Notify the commission, in compliance with the terms of the compact and rules, of any adverse action or the availability of investigative information regarding a licensee;

448.987(3)(a)5. 5. Implement or utilize procedures for considering the criminal history records of applicants for an initial compact privilege. These procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant’s criminal history record information from the federal bureau of investigation and the agency responsible for retaining that state’s criminal records;

448.987(3)(a)5.a. a. A member state shall, within a time frame established by the commission, require a criminal background check for a licensee seeking/applying for a compact privilege whose primary state of residence is that member state, by receiving the results of the federal bureau of investigation criminal record search, and shall use the results in making licensure decisions.

448.987(3)(a)5.b. b. Communication between a member state, the commission or among member states regarding the verification of eligibility for licensure through the compact shall not include any information received from the federal bureau of investigation relating to a federal criminal records check performed by a member state under P.L. 92-544.

448.987(3)(a)6. 6. Comply with the rules of the commission;

448.987(3)(a)7. 7. Utilize only a recognized national examination as a requirement for licensure pursuant to the rules of the commission; and

448.987(3)(a)8. 8. Have continuing competence/education requirements as a condition for license renewal.

448.987(3)(b) (b) A member state shall grant the compact privilege to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the compact and rules.

448.987(3)(c) (c) Member states may charge a fee for granting a compact privilege.

448.987(3)(d) (d) A member state shall provide for the state’s delegate to attend all occupational therapy compact commission meetings.

448.987(3)(e) (e) Individuals not residing in a member state shall continue to be able to apply for a member state’s single-state license as provided under the laws of each member state. However, the single-state license granted to these individuals shall not be recognized as granting the compact privilege in any other member state.

448.987(3)(f) (f) Nothing in this compact shall affect the requirements established by a member state for the issuance of a single-state license.

448.987(4) (4) Compact privilege.

448.987(4)(a) (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall:

448.987(4)(a)1. 1. Hold a license in the home state;

448.987(4)(a)2. 2. Have a valid United States social security number or national practitioner identification number;

448.987(4)(a)3. 3. Have no encumbrance on any state license;

448.987(4)(a)4. 4. Be eligible for a compact privilege in any member state in accordance with pars. (d), (f), (g), and (h);

448.987(4)(a)5. 5. Have paid all fines and completed all requirements resulting from any adverse action against any license or compact privilege, and 2 years have elapsed from the date of such completion;

448.987(4)(a)6. 6. Notify the commission that the licensee is seeking the compact privilege within a remote state(s);

448.987(4)(a)7. 7. Pay any applicable fees, including any state fee, for the compact privilege;

448.987(4)(a)8. 8. Complete a criminal background check in accordance with sub. (3) (a) 5.;

448.987(4)(a)8.a. a. The licensee shall be responsible for the payment of any fee associated with the completion of a criminal background check.

448.987(4)(a)9. 9. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and

448.987(4)(a)10. 10. Report to the commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken.

448.987(4)(b) (b) The compact privilege is valid until the expiration date of the home state license. The licensee must comply with the requirements of par. (a) to maintain the compact privilege in the remote state.

448.987(4)(c) (c) A licensee providing occupational therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state.

448.987(4)(d) (d) Occupational therapy assistants practicing in a remote state shall be supervised by an occupational therapist licensed or holding a compact privilege in that remote state.

448.987(4)(e) (e) A licensee providing occupational therapy in a remote state is subject to that state’s regulatory authority. A remote state may, in accordance with due process and that state’s laws, remove a licensee’s compact privilege in the remote state for a specific period of time, impose fines, and/or take any other necessary actions to protect the health and safety of its citizens. The licensee may be ineligible for a compact privilege in any state until the specific time for removal has passed and all fines are paid.

448.987(4)(f) (f) If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:

448.987(4)(f)1. 1. The home state license is no longer encumbered; and

448.987(4)(f)2. 2. Two years have elapsed from the date on which the home state license is no longer encumbered in accordance with subd. 1.

448.987(4)(g) (g) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of par. (a) to obtain a compact privilege in any remote state.

448.987(4)(h) (h) If a licensee’s compact privilege in any remote state is removed, the individual may lose the compact privilege in any other remote state until the following occur:

448.987(4)(h)1. 1. The specific period of time for which the compact privilege was removed has ended;

448.987(4)(h)2. 2. All fines have been paid and all conditions have been met;

448.987(4)(h)3. 3. Two years have elapsed from the date of completing requirements under subds. 1. and 2; and

448.987(4)(h)4. 4. The compact privileges are reinstated by the commission and the compact data system is updated to reflect reinstatement.

448.987(4)(i) (i) If a licensee’s compact privilege in any remote state is removed due to an erroneous charge, privileges shall be restored through the compact data system.

448.987(4)(j) (j) Once the requirements of par. (h) have been met, the license must meet the requirements in par. (a) to obtain a compact privilege in a remote state.

448.987(5) (5) Obtaining a new home state license by virtue of compact privilege.

448.987(5)(a) (a) An occupational therapist or occupational therapy assistant may hold a home state license, which allows for compact privileges in member states, in only one member state at a time.

448.987(5)(b) (b) If an occupational therapist or occupational therapy assistant changes primary state of residence by moving between two member states:

448.987(5)(b)1. 1. The occupational therapist or occupational therapy assistant shall file an application for obtaining a new home state license by virtue of a compact privilege, pay all applicable fees, and notify the current and new home state in accordance with applicable rules adopted by the commission.

448.987(5)(b)2. 2. Upon receipt of an application for obtaining a new home state license by virtue of compact privilege, the new home state shall verify that the occupational therapist or occupational therapy assistant meets the pertinent criteria outlined in sub. (4) via the data system, without need for primary source verification except for:

448.987(5)(b)2.a. a. An FBI fingerprint based criminal background check if not previously performed or updated pursuant to applicable rules adopted by the commission in accordance with P.L. 92-544;

448.987(5)(b)2.b. b. Other criminal background check as required by the new home state; and

448.987(5)(b)2.c. c. Submission of any requisite jurisprudence requirements of the new home state.

448.987(5)(b)3. 3. The former home state shall convert the former home state license into a compact privilege once the new home state has activated the new home state license in accordance with applicable rules adopted by the commission.