Report Title:

Occupational Therapists



Establishes licensing procedures and regulations for occupational therapists.



H.B. NO.









relating to occupational therapists.



SECTION 1. The purpose of this Act is to regulate occupational therapists and those persons performing services that constitute occupational therapy to:

(1) Safeguard the public health, safety, and welfare;

(2) Protect those seeking occupational therapy services from incompetent and unscrupulous persons, and persons unauthorized to perform these services;

(3) Assure the highest degree of professional conduct on the part of occupational therapists; and

(4) Assure the availability of high quality occupational therapy services.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:



    -1 Definitions. As used in this chapter unless the context otherwise requires:

"Assessment" means the use of skilled observation or evaluation by the administration and interpretation of standardized or nonstandardized tests and measurements to identify areas for occupational therapy services.

"Association" means the Occupational Therapy Association of Hawaii.

"Department" means the department of commerce and consumer affairs.

"Director" means the director of commerce and consumer affairs.

"Occupational therapist" means a person licensed to practice occupational therapy under this chapter.

"Occupational therapy" means the therapeutic and meaningful use of purposeful activity or interventions designed to achieve functional outcomes that promote health, prevent injury or disability, and which develop, improve, sustain, or restore the highest possible level of independence of any individual who has an injury, illness, cognitive impairment, psychosocial dysfunction, mental illness, developmental or learning disability, physical disability, or other disorder or condition.

"Occupational therapy services" include:

(1) The assessment and provision of treatment in consultation with the individual, family, or other appropriate persons;

(2) Interventions directed toward developing, improving, ascertaining, or restoring daily living skills, including self-care skills and activities that involve interactions with others and the environment, work readiness or work performance, play skills or leisure capacities; or enhancing educational performance skills;

(3) Developing, improving, sustaining, or restoring sensorimotor, oral-motor, perceptual, or neuromuscular functioning; or emotional, motivational, cognitive, or psychosocial components of performance; and

(4) Education of the individual, family, or other appropriate persons in carrying out appropriate interventions; and

(5) Assessment of needs including:

(A) Design, development, adaption, application, or training in the use of assistive technology devices;

(B) Design, fabrication, or application of rehabilitative technology such as selected orthotic devices;

(C) Training in the use of orthotic or prosthetic devices;

(D) The application of physical agent modalities as an adjunct to, or in preparation for, purposeful activity;

(E) The application of ergonomic principles, and the adaptation of environments and processes to enhance functional performance; and

(F) The promotion of health and wellness.

"Person" means any individual, partnership, unincorporated organization, or corporation.

    -2 License required. Beginning January 1, 2002, no person shall practice occupational therapy or hold oneself out as:

(1) An occupational therapist;

(2) Being able to practice occupational therapy; or

(3) Being able to render occupational therapy services in this State,

unless the person is licensed under this chapter.

    -3 Persons and practices not affected. Nothing in this chapter shall be construed as preventing or restricting the practice, services, or activities of:

(1) Any person licensed in this State by any other law from engaging in the profession or occupation for which the person is licensed;

(2) Any person employed as an occupational therapist by the government of the United States or any of its agencies, if the person provides occupational therapy solely under the direction or control of the organization by which the person is employed;

(3) Any person pursuing a supervised course of study leading to a degree in occupational therapy at an accredited or approved educational program, if the person is designated by a title that clearly indicates the person's status as a student or trainee;

(4) Any person fulfilling the supervised fieldwork experience requirements of section    -5, if the experience constitutes a part of the experience necessary to meet the fieldwork requirement of that section; and

(5) Any person licensed or otherwise regulated by state law to practice occupational therapy by another state who performs occupational therapy as part of an educational demonstration or instructional program or seminar sponsored by an educational institution, hospital, medical care program, the Hawaii chapter of the American Occupational Therapy Association, Inc., or any other similar person or group for the duration of the program or seminar and confined to the purpose of the program or seminar.

    -4 Temporary license. A temporary license may be granted to a person who has completed the education and supervisory fieldwork experience required by this chapter. This temporary license shall be valid for six months and shall allow the person to practice occupational therapy under the direct supervision of a licensed occupational therapist. This temporary license shall expire when the person is issued a license under section    -7. The director may renew a temporary license two consecutive times.

    -5 Requirements for licensure. An applicant applying for a license as an occupational therapist shall file a written application provided by the director or department demonstrating to the satisfaction of the director or department that the person meets the following requirements:

(1) Good moral character;

(2) Successful completion of the academic requirements of an educational program in occupational therapy recognized by the director or department; provided that the applicant:

(A) Holds a baccalaureate degree or higher from a college or university in an occupational therapy educational program accredited by the American Occupational Therapy Association (ADTA) Accreditation Council for Occupational Therapy Education recognized by the U.S. Department of Education; and

(B) Has passed the National Board for Certification in Occupational Therapy, Inc. examination, and within five years prior to application, completed nine hundred and sixty hours of clinical practice in occupational therapy services verified by a licensed health care professional.

(C) Has successfully completed a period of supervised fieldwork experience required by the recognized educational institution where the applicant met the academic requirements described in 5(2)A; and

(D) Passing the National Board for Certification in Occupational Therapy, Inc. certification examination.

    -6 Waiver of requirement and license endorsement. (a) The director may waive the examination, education, or experience requirements and grant a license to an applicant who presents proof of current licensure as an occupational therapist in another state, the District of Columbia, or a territory of the United States that requires standards for licensure considered by the director to be at least equivalent to the requirements for of this chapter.

(b) The director may establish provisions for a temporary license to allow an applicant to work during processing of the license application.

    -7 Issuance of license. The director shall issue a license to any person who meets the requirements of this chapter, upon payment of the prescribed license fee.

    -8 Renewal of license. (a) Every license issued under this chapter shall be renewed biennially on or before January 1, with the first renewal deadline occurring on January 1, 2004. Failure to renew a license shall result in a forfeiture of the license. Licenses which have been forfeited may be restored within one year of the expiration date upon payment of renewal and penalty fees. Failure to restore a forfeited license within one year of the date of its expiration shall result in the automatic termination of the license and the person must reapply as a new applicant and satisfy all licensing requirements.

(b) The director may grant inactive status to a licensee upon request.

    -9 Foreign trained applicants. Occupational therapists trained outside the United States may be eligible to sit for the licensing examination; provided the applicant's education is deemed equivalent to the requirements of this chapter by the National Board for Certification in Occupational Therapy, Inc.

    -10 Fees; disposition. (a) Application, examination, reexamination, license, renewal, late renewal penalty fees, inactive and other reasonable and necessary fees relating to administration of this chapter are not refundable.

(b) Fees assessed shall defray all costs to be incurred by the director to support the operation of the occupational therapist licensing program.

(c) All fees are subject to section 26-9(l) and all rules adopted by the director pursuant to chapter 91.

    -11 Revocation, suspension, denial, or condition of licenses; fines. In addition to any other acts or conditions provided by law, the director may refuse to renew, reinstate, restore, deny, revoke, suspend, or condition the issuance of a license on any of the following acts or conditions on the part of the applicant or licensee:

(1) Obtaining a license by means of fraud, misrepresentation, or concealment of material facts;

(2) Being guilty of unprofessional conduct as defined by rule, violating the code of ethics of the American Occupational Therapy Association;

(3) Recommendations made by the National Board for Certification in occupational therapy regarding sanctions or disciplinary action;

(4) Being convicted of a crime except for petty misdemeanors, violations, or offenses;

(5) Violating any lawful order or rule rendered or adopted by the director; and

(6) Violating any provision of this chapter.

    -12 Prohibited acts; penalties. (a) No person shall:

(1) Use in connection with the person's name any designation tending to imply that the person is a licensed occupational therapist unless the person is duly licensed and authorized under this chapter; or

(2) Represent oneself as a licensed occupational therapist during the time the person's license issued under this chapter is forfeited, inactive, terminated, suspended, or revoked.

(b) Any person who violates this section shall be subject to a fine of not more than $1,000 and each day's violation shall be deemed a separate offense.

    -13 Occupational therapy support personnel. The practice of occupational therapy by a licensed occupational therapist may be supplemented by the use of occupational therapy support personnel including:

(1) Persons who use the title "occupational therapy assistant", "COTA", and who have completed an educational program for occupational therapy assistants that is accredited by the American Occupational Therapy Association (ADTA) Accreditation Council for Occupational Therapy Education or predecessor organizations, has completed a period of supervised fieldwork experience required by the recognized educational institution where the COTA met the academic requirements, passed the certification examination administered by the National Board for Certification in Occupational Therapy for occupational therapy assistants; provided a licensed occupational therapist maintains general supervision over the occupational therapy assistant; and

(2) Any other persons; provided there is direct supervision by a licensed occupational therapist or an occupational therapy assistant, as defined above. In no event shall these persons be permitted to:

(A) Interpret referrals or prescriptions for occupational therapy services;

(B) Interpret or analyze evaluation data;

(C) Develop, plan, adjust, or modify treatment plans;

(D) Act on behalf of the licensed occupational therapist or occupational therapy assistant in any matter related to direct patient/client care that requires judgment or decision-making;

(E) Act independently without the direct supervision of a licensed occupational therapist or occupational therapy assistant; and

(F) Document services represented as occupational therapy."

SECTION 3. Chapter 457G-1, Hawaii Revised Statutes, is repealed.

SECTION 4. This Act shall take effect upon its approval.