Title of Regulation: 18VAC85-80. Regulations Governing the Licensure of Occupational Therapists (amending 18VAC85-80-71).

Statutory Authority: §§ 54.1-2400 and 54.1-2912.1 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: July 13, 2016.

Effective Date: July 28, 2016.

Agency Contact: William L. Harp, M.D., Executive Director, Board of Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4558, FAX (804) 527-4429, or email william.harp@dhp.virginia.gov.

Basis: Regulations are promulgated under the general authority of Chapter 24 of Title 54.1 of the Code of Virginia. Subdivision 6 of § 54.1-2400 of the Code of Virginia authorizes the Board of Medicine to promulgate regulations to administer effectively the regulatory system.

Purpose: The purpose of the amendments is to (i) clarify that the Continued Competency Activity and Assessment Form must be completed and retained with supporting documentation of continued competency courses or activities, but that the form is not necessary for renewal of an active license and (ii) allow maintenance of National Board of Certification in Occupational Therapy (NBCOT) certification to fulfill the continued competency requirements for a biennium. Since maintenance of NBCOT certification requires completion of evidence-based professional development units, it is likely that the content is equal to or superior to traditional continuing education courses in preparing a licensee to practice with skill and competency and therefore protects public health and safety. In addition, the amendments will eliminate the percentage of licensees that must be audited to determine compliance with continued competency requirements.

Rationale for Using Fast-Track Rulemaking Process: There is no controversy in the adoption of these amendments; the addition of NBCOT certification provides an option for licensees in fulfilling continued competency requirements. The Advisory Board on Occupational Therapy and the staff of the Board of Medicine support the changes.

Substance: The amended regulations (i) clarify that the Continued Competency Activity and Assessment Form must be completed and retained with supporting documentation of continued competency courses or activities, but that the form is not necessary for renewal of an active license; (ii) allow maintenance of NBCOT certification to fulfill the continued competency requirements for a biennium; (iii) eliminate the percentage of licensees that must be audited; and (iv) amend the title of the chapter to be consistent with other professional regulations.

Issues: There are no primary advantages or disadvantages to the public. Simplification of the audit process for verification of continued competency may be an advantage to the agency.  There are no disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Medicine (Board) proposes to: 1) allow occupational therapists and occupational therapy assistants to fulfill licensure continued competency requirements by maintenance of current certification by the National Board of Certification in Occupational Therapy, 2) clarify that licensees must complete and retain the Continued Competency Activity and Assessment Form along with their supporting documentation of courses and activities, and 3) amend the title of this regulation to "Regulations Governing the Practice of Occupational Therapy."

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. Under the current regulations, in order to renew an active license biennially, occupational therapists and occupational therapy assistants must complete at least 20 contact hours of continuing learning activities as follows:

1. A minimum of 10 of the 20 hours shall be in Type 1 activities offered by a sponsor or organization recognized by the profession and may include in-service training, self-study courses, continuing education courses, specialty certification or professional workshops.

2. No more than 10 of the 20 hours may be Type 2 activities, which may include consultation with another therapist, independent reading or research, preparation for a presentation or other such experiences that promote continued learning.

The Board proposes to add language indicating that maintenance of current certification by the National Board of Certification in Occupational Therapy (NBCOT) will fulfill licensure continued competency requirements.

NBCOT certification is a requirement for initial licensure in Virginia, and NBCOT reports that 90% of occupational therapists renew certification every 3 years. Occupational therapists and occupational therapy assistants who have maintained NBCOT certification have likely used NBCOT professional development activities to count toward the 20 contact hours of continuing learning activities that have been required for license renewal. The proposal to accept NBCOT certification to fulfill licensure continued competency requirements will save time and other costs for certificate holders to the extent that their NBCOT activities were not already fulfilling the 20 contact hour requirement. Since NBCOT certification is considered sufficient to ensure competency, this proposed amendment should produce a net benefit.

The proposal to clarify that licensees must complete and retain the Continued Competency Activity and Assessment Form along with their supporting documentation of courses and activities will have no impact on requirements; nonetheless, it may be beneficial in that it may reduce potential confusion and associated time wasted in determining administrative requirements.

Amending the title of the regulation will not have a large impact. The chapter includes regulations for licensure of occupational therapy assistants as well as for occupational therapists. It also regulates the individual and supervisory responsibilities of practitioners and includes the standards of practice for the profession. Thus the proposed title is perhaps a better indicator of its contents.

Businesses and Entities Affected. There are 3,721 persons with a current license as an occupational therapist and 1,268 with a current license as an occupational therapy assistant. Only 2% work in private practices, either in a group or solo practice.¹ All would likely be small businesses.

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments are unlikely to significantly affect employment.

Effects on the Use and Value of Private Property. The proposed amendments are unlikely to significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendments do not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposal to allow occupational therapists and occupational therapy assistants to fulfill licensure continued competency requirements by maintenance of current certification by NBCOT may moderately reduce costs for some small private practices.

Alternative Method that Minimizes Adverse Impact. The proposed amendments do not adversely affect small businesses.

Adverse Impacts:

Businesses. The proposed amendments do not adversely affect businesses.

Localities. The proposed amendments do not adversely affect localities.

Other Entities. The proposed amendments do not adversely affect other entities.

______________________________

¹Data source: Department of Health Professions

Agency's Response to Economic Impact Analysis: The Board of Medicine concurs with the analysis of the Department of Planning and Budget.

Summary:

The amendments (i) allow occupational therapists and occupational therapy assistants to fulfill licensure continued competency requirements by maintenance of current certification by the National Board of Certification in Occupational Therapy, (ii) clarify that licensees are not required to complete the Continued Competency Activity and Assessment Form to renew licensure biennially, and (iii) amend the title of the chapter to "Regulations Governing the Practice of Occupational Therapy."

CHAPTER 80
REGULATIONS GOVERNING THE LICENSURE OF OCCUPATIONAL THERAPISTS PRACTICE OF OCCUPATIONAL THERAPY

18VAC85-80-71. Continued competency requirements for renewal of an active license.

A. In order to renew an active license biennially, a practitioner shall complete the Continued Competency Activity and Assessment Form that is provided by the board and that shall indicate completion of complete at least 20 contact hours of continuing learning activities as follows:

1. A minimum of 10 of the 20 hours shall be in Type 1 activities offered by a sponsor or organization recognized by the profession and may include in-service training, self-study courses, continuing education courses, specialty certification or professional workshops.

2. No more than 10 of the 20 hours may be Type 2 activities, which may include consultation with another therapist, independent reading or research, preparation for a presentation or other such experiences that promote continued learning.

3. The board recognizes the maintenance of current NBCOT certification as fulfilling the requirements of this subsection.

B. A practitioner shall be exempt from the continuing competency requirements for the first biennial renewal following the date of initial licensure in Virginia.

C. The practitioner shall retain in his records the completed form of continuing competency courses and activities with all supporting documentation for a period of six years following the renewal of an active license.

D. The board shall periodically conduct a random audit of at least one to two percent of its active licensees to determine compliance. The practitioners selected for the audit shall provide the completed Continued Competency Activity and Assessment Form and all supporting documentation within 30 days of receiving notification of the audit.

E. Failure to comply with these requirements may subject the licensee to disciplinary action by the board.

F. The board may grant an extension of the deadline for continuing competency requirements for up to one year for good cause shown upon a written request from the licensee prior to the renewal date.

G. The board may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.