Florida Senate - 2021                              CS for SB 990
       By the Committee on Health Policy; and Senator Bradley
       588-02668-21                                           2021990c1
    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; the
  107  designing, fabrication, and application of orthotics or orthotic
  108  devices; selecting, applying, and training in the use of
  109  assistive technology and adaptive devices; sensory, motor, and
  110  cognitive activities; therapeutic exercises; manual therapy;
  111  physical agent modalities; behavioral health services; and
  112  mental health services Providing for the development of:
  113  sensory-motor, perceptual, or neuromuscular functioning; range
  114  of motion; or emotional, motivational, cognitive, or
  115  psychosocial components of performance.
  117  These services may require assessment of the need for use of
  118  interventions such as the design, development, adaptation,
  119  application, or training in the use of assistive technology
  120  devices; the design, fabrication, or application of
  121  rehabilitative technology such as selected orthotic devices;
  122  training in the use of assistive technology; orthotic or
  123  prosthetic devices; the application of physical agent modalities
  124  as an adjunct to or in preparation for purposeful activity; the
  125  use of ergonomic principles; the adaptation of environments and
  126  processes to enhance functional performance; or the promotion of
  127  health and wellness.
  128         (c) The use of devices subject to 21 C.F.R. s. 801.109 and
  129  identified by the board is expressly prohibited except by an
  130  occupational therapist or occupational therapy assistant who has
  131  received training as specified by the board. The board shall
  132  adopt rules to carry out the purpose of this provision.
  133         Section 2. Subsection (2) of section 468.209, Florida
  134  Statutes, is amended to read:
  135         468.209 Requirements for licensure.—
  136         (2) An applicant who has practiced as a state-licensed or
  137  American Occupational Therapy Association-certified occupational
  138  therapy assistant for 4 years and who, before prior to January
  139  24, 1988, completed a minimum of 24 weeks 6 months of supervised
  140  occupational-therapist-level fieldwork experience may take the
  141  examination to be licensed as an occupational therapist without
  142  meeting the educational requirements for occupational therapists
  143  made otherwise applicable under paragraph (1)(b).
  144         Section 3. Subsection (2) of section 468.215, Florida
  145  Statutes, is amended to read:
  146         468.215 Issuance of license.—
  147         (2) Any person who is issued a license as an occupational
  148  therapist under the terms of this act may use the words
  149  “occupational therapist,” “licensed occupational therapist,”
  150  “occupational therapist doctorate,” or “occupational therapist
  151  registered,” or he or she may use the letters “O.T.,” “L.O.T.,”
  152  “O.T.D.,” or “O.T.R.,” in connection with his or her name or
  153  place of business to denote his or her registration hereunder.
  154         Section 4. Section 468.223, Florida Statutes, is amended to
  155  read:
  156         468.223 Prohibitions; penalties.—
  157         (1) A person may not:
  158         (a) Practice occupational therapy unless such person is
  159  licensed pursuant to ss. 468.201-468.225;
  160         (b) Use, in connection with his or her name or place of
  161  business, the words “occupational therapist,” “licensed
  162  occupational therapist,” “occupational therapist doctorate,”
  163  “occupational therapist registered,” “occupational therapy
  164  assistant,” “licensed occupational therapy assistant,”
  165  “certified occupational therapy assistant”; the letters “O.T.,”
  166  “L.O.T.,” “O.T.D.,” “O.T.R.,” “O.T.A.,” “L.O.T.A.,” or
  167  “C.O.T.A.”; or any other words, letters, abbreviations, or
  168  insignia indicating or implying that he or she is an
  169  occupational therapist or an occupational therapy assistant or,
  170  in any way, orally or in writing, in print or by sign, directly
  171  or by implication, to represent himself or herself as an
  172  occupational therapist or an occupational therapy assistant
  173  unless the person is a holder of a valid license issued pursuant
  174  to ss. 468.201-468.225;
  175         (c) Present as his or her own the license of another;
  176         (d) Knowingly give false or forged evidence to the board or
  177  a member thereof;
  178         (e) Use or attempt to use a license that which has been
  179  suspended, revoked, or placed on inactive or delinquent status;
  180         (f) Employ unlicensed persons to engage in the practice of
  181  occupational therapy; or
  182         (g) Conceal information relative to any violation of ss.
  183  468.201-468.225.
  184         (2) Any person who violates any provision of this section
  185  commits a misdemeanor of the second degree, punishable as
  186  provided in s. 775.082 or s. 775.083.
  187         Section 5. Paragraph (e) is added to subsection (1) of
  188  section 468.225, Florida Statutes, to read:
  189         468.225 Exemptions.—
  190         (1) Nothing in this act shall be construed as preventing or
  191  restricting the practice, services, or activities of:
  192         (e)Any person fulfilling an occupational therapy doctoral
  193  capstone experience that involves clinical practice or projects.
  194         Section 6. For the purpose of incorporating the amendment
  195  made by this act to section 468.203, Florida Statutes, in a
  196  reference thereto, paragraph (c) of subsection (5) of section
  197  1002.385, Florida Statutes, is reenacted to read:
  198         1002.385 The Gardiner Scholarship.—
  199         (5) AUTHORIZED USES OF PROGRAM FUNDS.—Program funds must be
  200  used to meet the individual educational needs of an eligible
  201  student and may be spent for the following purposes:
  202         (c) Specialized services by approved providers or by a
  203  hospital in this state which are selected by the parent. These
  204  specialized services may include, but are not limited to:
  205         1. Applied behavior analysis services as provided in ss.
  206  627.6686 and 641.31098.
  207         2. Services provided by speech-language pathologists as
  208  defined in s. 468.1125.
  209         3. Occupational therapy services as defined in s. 468.203.
  210         4. Services provided by physical therapists as defined in
  211  s. 486.021.
  212         5. Services provided by listening and spoken language
  213  specialists and an appropriate acoustical environment for a
  214  child who is deaf or hard of hearing and who has received an
  215  implant or assistive hearing device.
  217  A provider of any services receiving payments pursuant to this
  218  subsection may not share, refund, or rebate any moneys from the
  219  Gardiner Scholarship with the parent or participating student in
  220  any manner. A parent, student, or provider of any services may
  221  not bill an insurance company, Medicaid, or any other agency for
  222  the same services that are paid for using Gardiner Scholarship
  223  funds.
  224         Section 7. For the purpose of incorporating the amendment
  225  made by this act to section 468.203, Florida Statutes, in a
  226  reference thereto, paragraph (c) of subsection (2) of section
  227  1002.66, Florida Statutes, is reenacted to read:
  228         1002.66 Specialized instructional services for children
  229  with disabilities.—
  230         (2) The parent of a child who is eligible for the
  231  prekindergarten program for children with disabilities may
  232  select one or more specialized instructional services that are
  233  consistent with the child’s individual educational plan. These
  234  specialized instructional services may include, but are not
  235  limited to:
  236         (c) Occupational therapy as defined in s. 468.203.
  237         Section 8. This act shall take effect July 1, 2021.