History of OT Regulation
The history of regulation of occupational therapy in Colorado includes a long and difficult process for occupational therapy practitioners. Several unsuccessful attempts for a license bill were initiated by OTAC starting in the mid 1980's. In 1996, Title Protection was obtained through a Deceptive Trade Protection Act, which granted protection of the use of the occupational therapist title only. This bill was revised in the year 2002, to include updated language, recent credentialing commissions, and the exclusion of a reference to unreasonable mechanism for OTAs to become OTs.
During the 2008 state legislative session, occupational therapists gained significant ground in a bill granting state registration through the passage of Senate Bill 08-152 the Occupational Therapy Practice Act. As of July 1, 2008 the law to register Occupational Therapists was in effect and process of registration occurred by January 1, 2009. As a result of this legislation a list of occupational therapists is maintained and available to the public.
At this time the current law mandates that anyone registered as an Occupational Therapist may use the titles “occupational therapist registered, registered occupational therapist, occupational therapist, or doctorate of occupational therapy” and/or “OT, OTD or OTR” and must have met the following criteria:
1. Obtained a bachelors, masters, or doctorate degree in Occupational Therapy at a college or university which has been accredited by the American Council on Occupational Therapy Education (ACOTE) or from an institution chartered outside of the United States which has been validated by World Federation of Occupational Therapy and the ACOTE;
2. Successfully completed an internship under the direction of an Occupational Therapist;
3. Passed the entry level certification exam as validated by an initial certificate by the National Board of Certification for Occupational Therapy (NBCOT) or The American Occupational Therapy Certification Board (AOTCB) or AOTA;
4. Applied and obtained state registration.
The registration bill does not cover Occupational Therapy Assistants, but it does indicate supervision requirements. The bill places the responsibility for occupational therapy treatment solely on the occupational therapist, yet it recognizes occupational therapy supervision as a mutual process between the OT and OTA.
OT Licensure Law
As of June 5, 2013, with the signing of the SB13-180 by Gov. Hickenlooper, all OT practiioners obtained licensure in the state of Colorado! We are now considered to be licensed health care providers in upcoming legislation during the Colorado Legislative Session starting January 2014. All occupational therapy practitioners will be able to use the initials OTR/L or OT/L and COTA/L or OTA/L starting June 1, 2014.
The application for Occupational Therapy Assistants licensure will start in April of 2014. For those that are currently registered as Occupational Therapists, the licensing will be done by DORA and will start in January of 2015.
Working Prior to Obtaining Registration
There is no temporary registration in Colorado. The registration law in Colorado stipulates that Occupational Therapists in the State of Colorado must have passed the initial national certification exam. It is not the intent of the bill to restrict qualified providers. As a point of clarification three things need to occur:
1. The individual must have the proper supervision along with the required co-signature by a qualified provider who is an Occupational Therapist. AOTA guidelines can be used however they are very general.
2. The initials OT/L may not be used since the bill requires registration for the use of OTR and OT. Degree initials are not restricted (e.g.; MSOT; BSOT).
3. The billing of third party payers, by this individual, is prohibited. This is especially true of Medicare, and in particular in the outpatient setting, since Medicare requires a qualified provider to provide Occupational Therapy services. The interpretation of who is a qualified provider is clear to Medicare; most other insurance organizations follow the CMS guidelines.
Why is Regulation Necessary?
1. Occupational Therapy Practitioners work extensively with extremely vulnerable and frail populations; in Colorado, it is estimated that 20 percent work with a pediatric population and 53 percent work with individuals over the age of 65. It is especially important to regulate members of this profession in a manner that assures the highest level of consumer protection. Consumers who require the services of Occupational Therapy Practitioners often have serious illnesses, injuries, and disabilities, and may lack the ability to assess whether they are receiving good patient care, or may lack the support that they need to seek assistance if they suspect they are susceptible to poor quality care.
2. Our licensure law will furnish any individual with a readily identifiable point of contact within the state government to file complaints and to seek redress. In addition, it would provide some regulatory framework for effectively addressing current practice issues that impact quality of care and provide a mechanism for assuring the continuing competency of practitioners throughout their careers.
3. Health Providers such as physicians, hospitals, nursing homes, and other rehabilitation professions that refer to, employ, or contract with Occupational Therapy providers generally are able to rely on a state regulatory structure to scrutinize the practitioner’s education credentials, preparation, and qualifications.
Contact the regulatory agencies for information that pertains to the legal practice of occupational therapy in the state of CO.