Chapter OT 4

OT 4.03(6) (6) Discontinuation of services.

OT 4.03(6)(a) (a) Occupational therapy services shall be discontinued when the individual has achieved the program goals or has achieved maximum benefit from occupational therapy.

OT 4.03(6)(b) (b) A comparison of the initial and current state of functional abilities and deficits in occupational performance skills, and occupational performance patterns, affecting performance in the individual’s occupations shall be made and documented.

OT 4.03(6)(c) (c) A discharge plan shall be prepared, consistent with the interventions provided, the individual’s goals, and the expected prognosis. Consideration shall be given to the individual’s occupational performance contexts and environments including appropriate community resources for referral, and environmental factors or barriers that may need modification.

OT 4.03(6)(d) (d) Sufficient time shall be allowed for the coordination and effective implementation of the discharge plan.

OT 4.03(6)(e) (e) Recommendations for follow-up or reevaluation shall be documented.

OT 4.03 History History: CR 02-026: cr. Register December 2002 No. 564, eff. 1-1-03; correction in (2) (e) made under s. 13.92 (4) (b) 6., Stats., Register November 2011 No. 671; CR 13-109: am. (1) (a), (2) (title), (a), (c) to (e), (3) (a), (b), (f), (4) (d), (5) (b), (c), (6) (b), (c) Register September 2014 No. 705, eff. 10-1-14; CR 15-053: am. (2) (title), r. (2) (a), am. (2) (b), r. (2) (c) to (e), am. (3) (a), (f) Register August 2016 No. 728, eff. 9-1-16; renum. (2) (b) to (2) under s. 13.92 (4) (b) 1., Stats., Register August 2016 No. 728.

OT 4.04 OT 4.04 Supervision and practice of occupational therapy assistants.

OT 4.04(1) (1) An occupational therapy assistant must practice under the supervision of an occupational therapist. Supervision is an interactive process that requires both the occupational therapist and the occupational therapy assistant to share responsibility for communication between the supervisor and the supervisee. The occupational therapist is responsible for the overall delivery of occupational therapy services and shall determine which occupational therapy services to delegate to the occupational therapy assistant or non-licensed personnel based on the establishment of service competence between supervisor and supervisee, and is accountable for the safety and effectiveness of the services provided.

OT 4.04(2) (2) Supervision of an occupational therapy assistant by an occupational therapist shall be either close or general. The supervising occupational therapist shall have responsibility for the outcome of the performed service.

OT 4.04(3) (3) When close supervision is required, the supervising occupational therapist shall have daily contact on the premises with the occupational therapy assistant. The occupational therapist shall provide direction in developing the plan of treatment and shall periodically inspect the actual implementation of the plan. The occupational therapist shall cosign evaluation contributions and intervention documents prepared by the occupational therapy assistant.

OT 4.04(4) (4) 

OT 4.04(4)(ad) (ad) In this subsection, “direct contact” means face-to-face communication or communication by means of telephone, electronic communication, or group conference.

OT 4.04(4)(ah) (ah) When general supervision is allowed, the supervising occupational therapist shall, except as provided under par. (ap), have direct contact with the occupational therapy assistant and face-to-face contact with the client by every tenth session of occupational therapy and no less than once per calendar month.

OT 4.04(4)(ap) (ap) When general supervision is allowed, and occupational therapy services are provided to a client once per calendar month or less frequently than once per calendar month, the supervising occupational therapist shall have direct contact with the occupational therapy assistant and face-to-face contact with the client no less than every other session of occupational therapy.

OT 4.04(4)(at) (at) Direct contact with the occupational therapy assistant under pars. (ah) and (ap) shall include reviewing the progress and effectiveness of treatment, and may occur simultaneously or separately from face-to-face contact with the client.

OT 4.04(4)(b) (b) The occupational therapist shall record in writing a specific description of the supervisory activities undertaken for each occupational therapy assistant. The written record shall include client name, status and plan for each client discussed.

OT 4.04(5) (5) Close supervision is required for all rehabilitation, neonate, early intervention, and school system services provided by an entry level occupational therapy assistant. All other occupational therapy services provided by an occupational therapy assistant may be performed under general supervision, if the supervising occupational therapist determines, under the facts of the individual situation, that general supervision is appropriate using established professional guidelines.

OT 4.04 History History: CR 02-026: cr. Register December 2002 No. 564, eff. 1-1-03; CR 08-050: am. (3), renum. (4) to be (4) (a) and am., cr. (4) (b) and (c) Register January 2009 No. 637, eff. 2-1-09; CR 19-108: renum.(4) (a) to (4) (ah) and am., cr. (4) (ap), (at), renum. (4) (c) to (4) (ad) and am. Register February 2020 No. 770, eff. 3-1-20.

OT 4.05 OT 4.05 Supervision of non-licensed personnel and therapy aides.

OT 4.05(1) (1) An occupational therapist or occupational therapy assistant must provide direct supervision of non-licensed personnel at all times. Direct supervision requires that the supervising occupational therapist or occupational therapy assistant be available to assist, either on premises or through technology and equipment meeting the requirements of s. OT 6.03.

OT 4.05(2) (2) When an occupational therapist or occupational therapy assistant delegates to non-licensed personnel maintenance or restorative services to clients, the occupational therapist or occupational therapy assistant must be within audible and visual range of the client and the non-licensed personnel, either on premises in the immediate area or through technology and equipment meeting the requirements of s. OT 6.03.

OT 4.05(3) (3) An occupational therapist or occupational therapy assistant may delegate to non-licensed personnel only non-skilled, specific tasks which are neither evaluative, assessive, task selective nor recommending in nature, and only after ensuring that the non-licensed person has been appropriately trained for the performance of the task.

OT 4.05(4) (4) Occupational therapists and occupational therapy assistants must exercise their professional judgment when determining the number of non-licensed persons they can safely and effectively supervise to ensure that quality care is provided at all times. A limit of 2 is recommended.

OT 4.05(5) (5) Any duties assigned to non-licensed personnel must be determined and appropriately supervised by an occupational therapist or occupational therapy assistant and must not exceed the level of training, knowledge, skill and competence of the individual being supervised. The licensed occupational therapist or occupational therapy assistant is responsible for the acts or actions performed by any non-licensed person functioning in the occupational therapy setting.

OT 4.05(6) (6) An occupational therapist or occupational therapy assistant may delegate to non-licensed personnel duties or functions, including the following services:

OT 4.05(6)(a) (a) Transportation of clients.

OT 4.05(6)(b) (b) Preparation or setting up of treatment equipment and work area.

OT 4.05(6)(c) (c) Attending to clients’ personal needs during treatment.

OT 4.05(6)(d) (d) Clerical, secretarial or administrative duties.

OT 4.05(7) (7) Duties or functions that an occupational therapist or occupational therapy assistant may not delegate to non-licensed personnel include, but are not limited to, the following:

OT 4.05(7)(a) (a) Interpretation of referrals or orders for occupational therapy services.

OT 4.05(7)(b) (b) Evaluative procedures.

OT 4.05(7)(c) (c) Development, planning, adjusting or modification of treatment procedures.

OT 4.05(7)(d) (d) Acting on behalf of the occupational therapist or occupational therapy assistant in any matter related to direct client care which requires judgment or decision making.

OT 4.05 History History: CR 02-026: cr. Register December 2002 No. 564, eff. 1-1-03; CR 13-109: am. (6) (intro.), (7) (a) Register September 2014 No. 705, eff. 10-1-14; CR 21-033: am. (1), (2) Register July 2023 No. 811, eff. 8-1-23.