<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.46.01.04" title_num="10" subtitle_num="46" chapter_num="01" heading="Supervision Requirements.">
  <paragraph num="A.">
    <text>Occupational Therapist.</text>
    <paragraph num="(1)">
      <text>A licensed occupational therapist may supervise the clinical practice of the following:</text>
      <paragraph num="(a)">
        <text>Occupational therapist;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Occupational therapy assistant;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Temporary occupational therapist;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Temporary occupational therapy assistant;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Aide; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Occupational therapy student or occupational therapy assistant student.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Occupational Therapy Assistant.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The supervising occupational therapist working with the occupational therapy assistant shall determine the appropriate amount and type of supervision necessary, taking into consideration:</text>
      <paragraph num="(a)">
        <text>Skills, experience, and education of the occupational therapy assistant and the occupational therapist;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Change in a client's status;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Complexity of the treatment program; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Type and requirements of practice setting.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>An occupational therapy assistant, under the direction of the occupational therapist, is permitted to be the primary clinical supervisor for the following:</text>
      <paragraph num="(a)">
        <text>Aide;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Temporary occupational therapy assistant;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Level I fieldwork occupational therapy student; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Level I and Level II fieldwork occupational therapy assistant student.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Temporary License to Practice Occupational Therapy.</text>
    <paragraph num="(1)">
      <text>A temporary license to practice occupational therapy authorizes the licensee to practice occupational therapy with on-site supervision.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Temporary License to Practice Limited Occupational Therapy.</text>
    <paragraph num="(1)">
      <text>A temporary license to practice limited occupational therapy authorizes the licensee to practice limited occupational therapy with on-site supervision.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Aide.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The supervising occupational therapist or occupational therapy assistant is responsible for ensuring that the aide delivers service in a safe and competent manner.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>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:</text>
      <paragraph num="(a)">
        <text>Guarding;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Positioning;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Holding body parts for splinting or bracing; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Assisting with group and community reentry activities.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>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:</text>
      <paragraph num="(a)">
        <text>Transfer practice;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Assisting in routine:</text>
        <paragraph num="(i)">
          <text>Functional activity;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Functional exercise; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Activities of daily living (ADL) program;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Applying assistive devices;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Applying adaptive devices;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Assisting the client with the use of assistive equipment;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Assisting the client with the use of adaptive equipment; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Reality orientation for the confused client.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Nontreatment activities that may be performed by an aide under the direction of an occupational therapist or occupational therapy assistant include:</text>
      <paragraph num="(a)">
        <text>Clerical;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Secretarial;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Housekeeping;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Supply maintenance;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Equipment maintenance;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Fabrication of straps for splinting and bracing;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Fabrication of assistive devices that are not worn directly by a client;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Routine transfers for transporting clients;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Transporting clients; and</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Activities ancillary to group and individual activities.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>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.</text>
  </paragraph>
</regulation>