Florida Senate - 2021              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 990
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to occupational therapy; amending s.
    3         468.203, F.S.; revising and defining terms; amending
    4         s. 468.209, F.S.; revising the fieldwork experience
    5         requirement for certain persons to take the
    6         examination for licensure as an occupational
    7         therapist; amending s. 468.215, F.S.; authorizing
    8         licensed occupational therapists to use a specified
    9         title and initials; amending s. 468.223, F.S.;
   10         prohibiting certain persons from using a specified
   11         title and initials; providing criminal penalties;
   12         amending s. 468.225, F.S.; providing construction;
   13         reenacting ss. 1002.385(5)(c) and 1002.66(2)(c), F.S.,
   14         relating to the Gardiner Scholarship and specialized
   15         instructional services for children with disabilities,
   16         respectively, to incorporate the amendment made to s.
   17         468.203, F.S., in references thereto; providing an
   18         effective date.
   20  Be It Enacted by the Legislature of the State of Florida:
   22         Section 1. Subsection (4) of section 468.203, Florida
   23  Statutes, is amended to read:
   24         468.203 Definitions.—As used in this act, the term:
   25         (4) “Occupational therapy” means the therapeutic use of
   26  occupations with individuals, groups, or populations, along with
   27  their families or organizations to support participation,
   28  performance, and function in roles and situations in the home,
   29  school, workplace, community, and other settings for clients who
   30  have or are at risk of developing an illness, injury, disease,
   31  disorder, condition, impairment, disability, activity
   32  limitation, or participation restriction purposeful activity or
   33  interventions to achieve functional outcomes.
   34         (a) For the purposes of this subsection:
   35         1. “Activities of daily living” means functions and tasks
   36  for self-care which are performed on a daily or routine basis,
   37  including functional mobility, bathing, dressing, eating and
   38  swallowing, personal hygiene and grooming, toileting, and other
   39  similar tasks “Achieving functional outcomes” means to maximize
   40  the independence and the maintenance of health of any individual
   41  who is limited by a physical injury or illness, a cognitive
   42  impairment, a psychosocial dysfunction, a mental illness, a
   43  developmental or a learning disability, or an adverse
   44  environmental condition.
   45         2. “Assessment” means the use of skilled observation or the
   46  administration and interpretation of standardized or
   47  nonstandardized tests and measurements to identify areas for
   48  occupational therapy services.
   49         3. “Behavioral health services” means the promotion of
   50  occupational performance through services to support positive
   51  mental health by providing direct individual and group
   52  interventions to improve the client’s participation in daily
   53  occupations.
   54         4. “Health management” means activities related to
   55  developing, managing, and maintaining health and wellness,
   56  including self-management, with the goal of improving or
   57  maintaining health to support participation in occupations.
   58         5. “Instrumental activities of daily living” means daily or
   59  routine activities a person must perform to live independently
   60  within the home and community.
   61         6. “Mental health services” means the promotion of
   62  occupational performance related to mental health, coping,
   63  resilience, and well-being by providing individual, group, and
   64  population level supports and services to improve the client’s
   65  participation in daily occupations for those who are at risk of,
   66  experiencing, or in recovery from these conditions, along with
   67  their families and communities.
   68         7. “Occupations” means meaningful and purposeful everyday
   69  activities performed and engaged in by individuals, groups,
   70  populations, families, or communities which occur in contexts
   71  and over time, such as activities of daily living, instrumental
   72  activities of daily living, health management, rest and sleep,
   73  education, work, play, leisure, and social participation. The
   74  term includes more specific occupations and execution of
   75  multiple activities that are influenced by performance patterns,
   76  performance skills, and client factors.
   77         8. “Occupational performance” means the ability to
   78  perceive, desire, recall, plan, and carry out roles, routines,
   79  tasks, and subtasks for the purposes of self-maintenance, self
   80  preservation, productivity, leisure, and rest, for oneself or
   81  others, in response to internal or external demands of
   82  occupations and contexts.
   83         (b) The practice of occupational therapy includes services
   84  include, but is are not limited to:
   85         1. Assessment, treatment, and education of, and
   86  consultation with, individuals, groups, and populations whose
   87  abilities to participate safely in occupations, including
   88  activities of daily living, instrumental activities of daily
   89  living, rest and sleep, education, work, play, leisure, and
   90  social participation, are impaired or at risk for impairment due
   91  to issues related to, but not limited to, developmental
   92  deficiencies, the aging process, learning disabilities, physical
   93  environment and sociocultural context, physical injury or
   94  disease, cognitive impairments, and psychological and social
   95  disabilities The assessment, treatment, and education of or
   96  consultation with the individual, family, or other persons.
   97         2. Methods or approaches to determine abilities and
   98  limitations related to performance of occupations, including,
   99  but not limited to, the identification of physical, sensory,
  100  cognitive, emotional, or social deficiencies Interventions
  101  directed toward developing daily living skills, work readiness
  102  or work performance, play skills or leisure capacities, or
  103  enhancing educational performance skills.
  104         3. Specific occupational therapy techniques used for
  105  treatment which involve, but are not limited to, training in
  106  activities of daily living; environmental modification;
  107  assessment of the need for the use of interventions such as the
  108  design, fabrication, and application of orthotics or orthotic
  109  devices; selecting, applying, and training in the use of
  110  assistive technology and adaptive devices; sensory, motor, and
  111  cognitive activities; therapeutic exercises; manual techniques;
  112  physical agent modalities; behavioral health services; and
  113  mental health services Providing for the development of:
  114  sensory-motor, perceptual, or neuromuscular functioning; range
  115  of motion; or emotional, motivational, cognitive, or
  116  psychosocial components of performance.
  118  These services may require assessment of the need for use of
  119  interventions such as the design, development, adaptation,
  120  application, or training in the use of assistive technology
  121  devices; the design, fabrication, or application of
  122  rehabilitative technology such as selected orthotic devices;
  123  training in the use of assistive technology; orthotic or
  124  prosthetic devices; the application of physical agent modalities
  125  as an adjunct to or in preparation for purposeful activity; the
  126  use of ergonomic principles; the adaptation of environments and
  127  processes to enhance functional performance; or the promotion of
  128  health and wellness.
  129         (c) The use of devices subject to 21 C.F.R. s. 801.109 and
  130  identified by the board is expressly prohibited except by an
  131  occupational therapist or occupational therapy assistant who has
  132  received training as specified by the board. The board shall
  133  adopt rules to carry out the purpose of this provision.
  134         Section 2. Subsection (2) of section 468.209, Florida
  135  Statutes, is amended to read:
  136         468.209 Requirements for licensure.—
  137         (2) An applicant who has practiced as a state-licensed or
  138  American Occupational Therapy Association-certified occupational
  139  therapy assistant for 4 years and who, before prior to January
  140  24, 1988, completed a minimum of 24 weeks 6 months of supervised
  141  occupational-therapist-level fieldwork experience may take the
  142  examination to be licensed as an occupational therapist without
  143  meeting the educational requirements for occupational therapists
  144  made otherwise applicable under paragraph (1)(b).
  145         Section 3. Subsection (2) of section 468.215, Florida
  146  Statutes, is amended to read:
  147         468.215 Issuance of license.—
  148         (2) Any person who is issued a license as an occupational
  149  therapist under the terms of this act may use the words
  150  “occupational therapist,” “licensed occupational therapist,”
  151  “occupational therapist doctorate,” or “occupational therapist
  152  registered,” or he or she may use the letters “O.T.,” “L.O.T.,”
  153  “O.T.D.,” or “O.T.R.,” in connection with his or her name or
  154  place of business to denote his or her registration hereunder.
  155         Section 4. Section 468.223, Florida Statutes, is amended to
  156  read:
  157         468.223 Prohibitions; penalties.—
  158         (1) A person may not:
  159         (a) Practice occupational therapy unless such person is
  160  licensed pursuant to ss. 468.201-468.225;
  161         (b) Use, in connection with his or her name or place of
  162  business, the words “occupational therapist,” “licensed
  163  occupational therapist,” “occupational therapist doctorate,”
  164  “occupational therapist registered,” “occupational therapy
  165  assistant,” “licensed occupational therapy assistant,”
  166  “certified occupational therapy assistant”; the letters “O.T.,”
  167  “L.O.T.,” “O.T.D.,” “O.T.R.,” “O.T.A.,” “L.O.T.A.,” or
  168  “C.O.T.A.”; or any other words, letters, abbreviations, or
  169  insignia indicating or implying that he or she is an
  170  occupational therapist or an occupational therapy assistant or,
  171  in any way, orally or in writing, in print or by sign, directly
  172  or by implication, to represent himself or herself as an
  173  occupational therapist or an occupational therapy assistant
  174  unless the person is a holder of a valid license issued pursuant
  175  to ss. 468.201-468.225;
  176         (c) Present as his or her own the license of another;
  177         (d) Knowingly give false or forged evidence to the board or
  178  a member thereof;
  179         (e) Use or attempt to use a license that which has been
  180  suspended, revoked, or placed on inactive or delinquent status;
  181         (f) Employ unlicensed persons to engage in the practice of
  182  occupational therapy; or
  183         (g) Conceal information relative to any violation of ss.
  184  468.201-468.225.
  185         (2) Any person who violates any provision of this section
  186  commits a misdemeanor of the second degree, punishable as
  187  provided in s. 775.082 or s. 775.083.
  188         Section 5. Paragraph (e) is added to subsection (1) of
  189  section 468.225, Florida Statutes, to read:
  190         468.225 Exemptions.—
  191         (1) Nothing in this act shall be construed as preventing or
  192  restricting the practice, services, or activities of:
  193         (e)Any person fulfilling an occupational therapy doctoral
  194  capstone experience that involves clinical practice or projects.
  195         Section 6. For the purpose of incorporating the amendment
  196  made by this act to section 468.203, Florida Statutes, in a
  197  reference thereto, paragraph (c) of subsection (5) of section
  198  1002.385, Florida Statutes, is reenacted to read:
  199         1002.385 The Gardiner Scholarship.—
  200         (5) AUTHORIZED USES OF PROGRAM FUNDS.—Program funds must be
  201  used to meet the individual educational needs of an eligible
  202  student and may be spent for the following purposes:
  203         (c) Specialized services by approved providers or by a
  204  hospital in this state which are selected by the parent. These
  205  specialized services may include, but are not limited to:
  206         1. Applied behavior analysis services as provided in ss.
  207  627.6686 and 641.31098.
  208         2. Services provided by speech-language pathologists as
  209  defined in s. 468.1125.
  210         3. Occupational therapy services as defined in s. 468.203.
  211         4. Services provided by physical therapists as defined in
  212  s. 486.021.
  213         5. Services provided by listening and spoken language
  214  specialists and an appropriate acoustical environment for a
  215  child who is deaf or hard of hearing and who has received an
  216  implant or assistive hearing device.
  218  A provider of any services receiving payments pursuant to this
  219  subsection may not share, refund, or rebate any moneys from the
  220  Gardiner Scholarship with the parent or participating student in
  221  any manner. A parent, student, or provider of any services may
  222  not bill an insurance company, Medicaid, or any other agency for
  223  the same services that are paid for using Gardiner Scholarship
  224  funds.
  225         Section 7. For the purpose of incorporating the amendment
  226  made by this act to section 468.203, Florida Statutes, in a
  227  reference thereto, paragraph (c) of subsection (2) of section
  228  1002.66, Florida Statutes, is reenacted to read:
  229         1002.66 Specialized instructional services for children
  230  with disabilities.—
  231         (2) The parent of a child who is eligible for the
  232  prekindergarten program for children with disabilities may
  233  select one or more specialized instructional services that are
  234  consistent with the child’s individual educational plan. These
  235  specialized instructional services may include, but are not
  236  limited to:
  237         (c) Occupational therapy as defined in s. 468.203.
  238         Section 8. This act shall take effect July 1, 2021.