Florida Senate - 2021                                     SB 990
       By Senator Bradley
       5-00602A-21                                            2021990__
    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  at school, in the workplace, in the community, and in other
   30  settings. The term also includes services provided for
   31  habilitation, rehabilitation, and the promotion of health and
   32  wellness for clients with disability and nondisability-related
   33  needs, including, but not limited to, acquisition and
   34  preservation of occupational identity for clients who have or
   35  are at risk of developing an illness, injury, disease, disorder,
   36  condition, impairment, disability, activity limitation, or
   37  participation restriction. Through engagement in everyday
   38  activities, occupational therapy supports occupational
   39  performance in persons who have, or are at risk of experiencing,
   40  a range of developmental, physical, cognitive, behavioral,
   41  mental health, and other disorders and disabilities purposeful
   42  activity or interventions to achieve functional outcomes.
   43         (a) For the purposes of this subsection:
   44         1. “Activities of daily living” means functions and tasks
   45  for self-care which are performed on a daily or routine basis,
   46  including functional mobility, bathing, dressing, eating and
   47  swallowing, personal hygiene and grooming, toileting, and other
   48  similar tasks “Achieving functional outcomes” means to maximize
   49  the independence and the maintenance of health of any individual
   50  who is limited by a physical injury or illness, a cognitive
   51  impairment, a psychosocial dysfunction, a mental illness, a
   52  developmental or a learning disability, or an adverse
   53  environmental condition.
   54         2. “Assessment” means the use of skilled observation or the
   55  administration and interpretation of standardized or
   56  nonstandardized tests and measurements to identify areas for
   57  occupational therapy services.
   58         3.“Behavioral health services” means the promotion of
   59  occupational performance and participation through services to
   60  support and facilitate the prevention and treatment of, and for
   61  the management of and recovery from, mental health and substance
   62  abuse disorders, within the scope of practice of occupational
   63  therapy. These include services to support positive mental
   64  health, prevention of mental health disorders, and direct
   65  individual and group interventions for the purpose of improving
   66  occupational participation and performance.
   67         4.“Health management” means activities related to
   68  developing, managing, and maintaining health and wellness,
   69  including self-management, with the goal of improving or
   70  maintaining health to support participation in occupations.
   71         5.“Instrumental activities of daily living” means daily or
   72  routine activities a person must perform to live independently
   73  within the home and community.
   74         6.“Mental health services” means the promotion of
   75  occupational performance and participation related to mental
   76  health, coping, resilience, and well-being. These services
   77  include the treatment of mental health and substance abuse
   78  disorders by providing individual, group, and population level
   79  supports and services to those who are at risk of, experiencing,
   80  or in recovery from these conditions, along with their families
   81  and communities, within the scope of practice of occupational
   82  therapy.
   83         7.“Occupations” means meaningful and purposeful everyday
   84  activities performed and engaged in by individuals, groups,
   85  populations, families, or communities which occur in contexts
   86  and over time, being broadly categorized as activities of daily
   87  living, instrumental activities of daily living, health
   88  management, rest and sleep, education, work, play, leisure, and
   89  social participation. The term includes more specific
   90  occupations and execution of multiple activities that are
   91  influenced by performance patterns, performance skills, and
   92  client factors, resulting in varied outcomes.
   93         8.“Occupational performance” means the ability to
   94  perceive, desire, recall, plan, and carry out roles, routines,
   95  tasks, and subtasks for the purpose of self-maintenance, self
   96  preservation, productivity, leisure, and rest, for oneself or
   97  others, in response to internal or external demands of
   98  occupations and contexts.
   99         (b) The practice of occupational therapy includes services
  100  include, but is are not limited to:
  101         1. Evaluation of factors that affect activities of daily
  102  living, instrumental activities of daily living, health
  103  management, rest and sleep, education, work, play, leisure, and
  104  social participation, including context, performance patterns,
  105  performance skills, and client factors The assessment,
  106  treatment, and education of or consultation with the individual,
  107  family, or other persons.
  108         2. Methods or approaches selected to direct the process of
  109  interventions, including, but not limited to:
  110         a.Establishment, remediation, or restoration of a skill or
  111  ability that has not yet developed, is impaired, or is in
  112  decline.
  113         b.Compensation, modification, or adaptation of activity
  114  contexts to improve or enhance performance.
  115         c.Maintenance of capabilities without which performance in
  116  everyday life occupations would decline.
  117         d.Health promotion and wellness, including the use of
  118  self-management strategies, to enable or enhance performance in
  119  everyday life activities and quality of life.
  120         e.Prevention of the occurrence or emergence of barriers to
  121  performance and participation, including injury and disability
  122  prevention, and occupational deprivation Interventions directed
  123  toward developing daily living skills, work readiness or work
  124  performance, play skills or leisure capacities, or enhancing
  125  educational performance skills.
  126         3. Interventions and procedures to promote or enhance
  127  safety and performance in activities of daily living,
  128  instrumental activities of daily living, health management, rest
  129  and sleep, education, work, play, leisure, and social
  130  participation, including, but not limited to:
  131         a.Therapeutic use of occupations, exercises, and
  132  activities.
  133         b.Training in self-care, self-management, health
  134  management and maintenance, home management, community or work
  135  reintegration, and school activities and work performance.
  136         c.Identification, development, remediation, or
  137  compensation of neuromusculoskeletal, sensory-perceptual,
  138  emotional regulation, visual, mental, and cognitive functions,
  139  pain tolerance and management, mental and behavioral health,
  140  praxis, developmental skills, and behavioral skills.
  141         d.Education and training of individuals, including family
  142  members, caregivers, groups, and other populations.
  143         e.Care coordination, case management, transition services,
  144  and consultative services to individuals, groups, or
  145  populations, along with their families and communities or
  146  organizations.
  147         f.Group interventions facilitating learning, skills
  148  acquisition, and occupational performance of groups,
  149  populations, or organizations across the life course.
  150         g.Mental health services and behavioral health services
  151  for the promotion of occupational performance and participation.
  152         h.Facilitating occupational performance of individuals,
  153  groups, or populations through modification of contexts and
  154  adaptation of processes, including the application of ergonomic
  155  principles.
  156         i.Assessment, design, fabrication, application, fitting,
  157  and training in seating and positioning of assistive technology,
  158  adaptive devices, orthotic devices, and custom orthoses, and
  159  training in the use of prosthetic devices.
  160         j.Assessment, recommendation, and training in techniques
  161  to enhance functional mobility, including management of
  162  wheelchairs and other mobility devices.
  163         k.Remediation and compensation of visual deficits
  164  including low rehabilitation.
  165         l.Driving skills rehabilitation and community mobility.
  166         m.Management of feeding, eating, and swallowing to enable
  167  eating and feeding performance.
  168         n.Application of physical agent and mechanical modalities
  169  and use of a range of therapeutic procedures to enhance
  170  performance skills.
  171         o.Efforts directed toward promoting occupational justice
  172  and empowering clients to seek and obtain resources to fully
  173  participate in occupations Providing for the development of:
  174  sensory-motor, perceptual, or neuromuscular functioning; range
  175  of motion; or emotional, motivational, cognitive, or
  176  psychosocial components of performance.
  178  These services may require assessment of the need for use of
  179  interventions such as the design, development, adaptation,
  180  application, or training in the use of assistive technology
  181  devices; the design, fabrication, or application of
  182  rehabilitative technology such as selected orthotic devices;
  183  training in the use of assistive technology; orthotic or
  184  prosthetic devices; the application of physical agent modalities
  185  as an adjunct to or in preparation for purposeful activity; the
  186  use of ergonomic principles; the adaptation of environments and
  187  processes to enhance functional performance; or the promotion of
  188  health and wellness.
  189         (c) The use of devices subject to 21 C.F.R. s. 801.109 and
  190  identified by the board is expressly prohibited except by an
  191  occupational therapist or occupational therapy assistant who has
  192  received training as specified by the board. The board shall
  193  adopt rules to carry out the purpose of this provision.
  194         Section 2. Subsection (2) of section 468.209, Florida
  195  Statutes, is amended to read:
  196         468.209 Requirements for licensure.—
  197         (2) An applicant who has practiced as a state-licensed or
  198  American Occupational Therapy Association-certified occupational
  199  therapy assistant for 4 years and who, before prior to January
  200  24, 1988, completed a minimum of 24 weeks 6 months of supervised
  201  occupational-therapist-level fieldwork experience may take the
  202  examination to be licensed as an occupational therapist without
  203  meeting the educational requirements for occupational therapists
  204  made otherwise applicable under paragraph (1)(b).
  205         Section 3. Subsection (2) of section 468.215, Florida
  206  Statutes, is amended to read:
  207         468.215 Issuance of license.—
  208         (2) Any person who is issued a license as an occupational
  209  therapist under the terms of this act may use the words
  210  “occupational therapist,” “licensed occupational therapist,”
  211  “occupational therapist doctorate,” or “occupational therapist
  212  registered,” or he or she may use the letters “O.T.,” “L.O.T.,”
  213  “O.T.D.,” or “O.T.R.,” in connection with his or her name or
  214  place of business to denote his or her registration hereunder.
  215         Section 4. Section 468.223, Florida Statutes, is amended to
  216  read:
  217         468.223 Prohibitions; penalties.—
  218         (1) A person may not:
  219         (a) Practice occupational therapy unless such person is
  220  licensed pursuant to ss. 468.201-468.225;
  221         (b) Use, in connection with his or her name or place of
  222  business, the words “occupational therapist,” “licensed
  223  occupational therapist,” “occupational therapist doctorate,”
  224  “occupational therapist registered,” “occupational therapy
  225  assistant,” “licensed occupational therapy assistant,”
  226  “certified occupational therapy assistant”; the letters “O.T.,”
  227  “L.O.T.,” “O.T.D.,” “O.T.R.,” “O.T.A.,” “L.O.T.A.,” or
  228  “C.O.T.A.”; or any other words, letters, abbreviations, or
  229  insignia indicating or implying that he or she is an
  230  occupational therapist or an occupational therapy assistant or,
  231  in any way, orally or in writing, in print or by sign, directly
  232  or by implication, to represent himself or herself as an
  233  occupational therapist or an occupational therapy assistant
  234  unless the person is a holder of a valid license issued pursuant
  235  to ss. 468.201-468.225;
  236         (c) Present as his or her own the license of another;
  237         (d) Knowingly give false or forged evidence to the board or
  238  a member thereof;
  239         (e) Use or attempt to use a license that which has been
  240  suspended, revoked, or placed on inactive or delinquent status;
  241         (f) Employ unlicensed persons to engage in the practice of
  242  occupational therapy; or
  243         (g) Conceal information relative to any violation of ss.
  244  468.201-468.225.
  245         (2) Any person who violates any provision of this section
  246  commits a misdemeanor of the second degree, punishable as
  247  provided in s. 775.082 or s. 775.083.
  248         Section 5. Paragraph (e) is added to subsection (1) of
  249  section 468.225, Florida Statutes, to read:
  250         468.225 Exemptions.—
  251         (1) Nothing in this act shall be construed as preventing or
  252  restricting the practice, services, or activities of:
  253         (e)Any person fulfilling an occupational therapy doctoral
  254  capstone experience that involves clinical practice or projects.
  255         Section 6. For the purpose of incorporating the amendment
  256  made by this act to section 468.203, Florida Statutes, in a
  257  reference thereto, paragraph (c) of subsection (5) of section
  258  1002.385, Florida Statutes, is reenacted to read:
  259         1002.385 The Gardiner Scholarship.—
  260         (5) AUTHORIZED USES OF PROGRAM FUNDS.—Program funds must be
  261  used to meet the individual educational needs of an eligible
  262  student and may be spent for the following purposes:
  263         (c) Specialized services by approved providers or by a
  264  hospital in this state which are selected by the parent. These
  265  specialized services may include, but are not limited to:
  266         1. Applied behavior analysis services as provided in ss.
  267  627.6686 and 641.31098.
  268         2. Services provided by speech-language pathologists as
  269  defined in s. 468.1125.
  270         3. Occupational therapy services as defined in s. 468.203.
  271         4. Services provided by physical therapists as defined in
  272  s. 486.021.
  273         5. Services provided by listening and spoken language
  274  specialists and an appropriate acoustical environment for a
  275  child who is deaf or hard of hearing and who has received an
  276  implant or assistive hearing device.
  278  A provider of any services receiving payments pursuant to this
  279  subsection may not share, refund, or rebate any moneys from the
  280  Gardiner Scholarship with the parent or participating student in
  281  any manner. A parent, student, or provider of any services may
  282  not bill an insurance company, Medicaid, or any other agency for
  283  the same services that are paid for using Gardiner Scholarship
  284  funds.
  285         Section 7. For the purpose of incorporating the amendment
  286  made by this act to section 468.203, Florida Statutes, in a
  287  reference thereto, paragraph (c) of subsection (2) of section
  288  1002.66, Florida Statutes, is reenacted to read:
  289         1002.66 Specialized instructional services for children
  290  with disabilities.—
  291         (2) The parent of a child who is eligible for the
  292  prekindergarten program for children with disabilities may
  293  select one or more specialized instructional services that are
  294  consistent with the child’s individual educational plan. These
  295  specialized instructional services may include, but are not
  296  limited to:
  297         (c) Occupational therapy as defined in s. 468.203.
  298         Section 8. This act shall take effect July 1, 2021.