Florida Senate - 2022                              CS for SB 632
       By the Committee on Health Policy; and Senator Bradley
       588-01611-22                                           2022632c1
    1                        A bill to be entitled                      
    2         An act relating to occupational therapy; amending s.
    3         468.203, F.S.; defining and revising terms; amending
    4         s. 468.209, F.S.; revising eligibility requirements
    5         for the occupational therapist licensure examination;
    6         amending s. 468.215, F.S.; authorizing certain
    7         licensed occupational therapists to use a specified
    8         title and the associated initials; amending s.
    9         468.223, F.S.; prohibiting certain persons from using
   10         a specified title and the associated initials;
   11         providing criminal penalties; amending ss. 468.225,
   12         490.014, and 491.014, F.S.; revising construction;
   13         reenacting s. 490.012(1)(c), F.S., relating to
   14         violations, penalties, and injunctions, to incorporate
   15         the amendment made to s. 490.014, F.S., in a reference
   16         thereto; amending s. 1002.394, F.S.; conforming a
   17         provision to changes made by the act; reenacting s.
   18         1002.66(2)(c), F.S., relating to specialized
   19         instructional services for children with disabilities,
   20         to incorporate the amendments made to s. 468.203,
   21         F.S., in a reference thereto; providing an effective
   22         date.
   24  Be It Enacted by the Legislature of the State of Florida:
   26         Section 1. Subsection (4) of section 468.203, Florida
   27  Statutes, is amended to read:
   28         468.203 Definitions.—As used in this act, the term:
   29         (4) “Occupational therapy” means the therapeutic use of
   30  occupations through habilitation, rehabilitation, and the
   31  promotion of health and wellness with individuals, groups, or
   32  populations, along with their families or organizations, to
   33  support participation, performance, and function in the home, at
   34  school, in the workplace, in the community, and in other
   35  settings for clients who have, or who have been identified as
   36  being at risk of developing, an illness, an injury, a disease, a
   37  disorder, a condition, an impairment, a disability, an activity
   38  limitation, or a participation restriction purposeful activity
   39  or interventions to achieve functional outcomes.
   40         (a) For the purposes of this subsection:
   41         1. “Activities of daily living” means functions and tasks
   42  for self-care which are performed on a daily or routine basis,
   43  including functional mobility, bathing, dressing, eating and
   44  swallowing, personal hygiene and grooming, toileting, and other
   45  similar tasks “Achieving functional outcomes” means to maximize
   46  the independence and the maintenance of health of any individual
   47  who is limited by a physical injury or illness, a cognitive
   48  impairment, a psychosocial dysfunction, a mental illness, a
   49  developmental or a learning disability, or an adverse
   50  environmental condition.
   51         2. “Assessment” means the use of skilled observation or the
   52  administration and interpretation of standardized or
   53  nonstandardized tests and measurements to identify areas for
   54  occupational therapy services.
   55         3.“Health management” means therapeutic services designed
   56  to develop, manage, and maintain health and wellness routines,
   57  including self-management, performed with the goal of improving
   58  or maintaining health to support participation in occupations.
   59         4.“Instrumental activities of daily living” means daily or
   60  routine activities a person must perform to live independently
   61  within the home and community.
   62         5.“Occupational performance” means the ability to
   63  perceive, desire, recall, plan, and carry out roles, routines,
   64  tasks, and subtasks for the purpose of self-maintenance, self
   65  preservation, productivity, leisure, and rest, for oneself or
   66  for others, in response to internal or external demands of
   67  occupations and contexts.
   68         6.“Occupational therapy services in mental health” means
   69  occupation-based interventions and services for individuals,
   70  groups, populations, families, or communities to improve
   71  participation in daily occupations for individuals who are
   72  experiencing, are in recovery from, or are identified as being
   73  at risk of developing mental health conditions.
   74         7.“Occupations” means meaningful and purposeful everyday
   75  activities performed and engaged in by individuals, groups,
   76  populations, families, or communities which occur in contexts
   77  and over time, such as activities of daily living, instrumental
   78  activities of daily living, health management, rest and sleep,
   79  education, work, play, leisure, and social participation. The
   80  term includes more specific occupations and the execution of
   81  multiple activities that are influenced by performance patterns,
   82  performance skills, and client factors, and that result in
   83  varied outcomes.
   84         (b) The practice of occupational therapy includes services
   85  include, but is are not limited to, the following services:
   86         1. The Assessment, treatment, and education of or
   87  consultation with individuals, groups, and populations whose
   88  abilities to participate safely in occupations, including
   89  activities of daily living, instrumental activities of daily
   90  living, rest and sleep, education, work, play, leisure, and
   91  social participation, are impaired or have been identified as
   92  being at risk of impairment due to issues related to, but not
   93  limited to, developmental deficiencies, the aging process,
   94  learning disabilities, physical environment and sociocultural
   95  context, physical injury or disease, cognitive impairments, or
   96  psychological and social disabilities the individual, family, or
   97  other persons.
   98         2. Methods or approaches used to determine abilities and
   99  limitations related to performance of occupations, including,
  100  but not limited to, the identification of physical, sensory,
  101  cognitive, emotional, or social deficiencies Interventions
  102  directed toward developing daily living skills, work readiness
  103  or work performance, play skills or leisure capacities, or
  104  enhancing educational performance skills.
  105         3. Specific occupational therapy techniques used for
  106  treatment which include, but are not limited to, training in
  107  activities of daily living; environmental modification;
  108  assessment of the need for the use of interventions such as the
  109  design, fabrication, and application of orthotics or orthotic
  110  devices; selecting, applying, and training in the use of
  111  assistive technology and adaptive devices; sensory, motor, and
  112  cognitive activities; therapeutic exercises; manual techniques;
  113  physical agent modalities; and occupational therapy services in
  114  mental health Providing for the development of: sensory-motor,
  115  perceptual, or neuromuscular functioning; range of motion; or
  116  emotional, motivational, cognitive, or psychosocial components
  117  of performance.
  119  These services may require assessment of the need for use of
  120  interventions such as the design, development, adaptation,
  121  application, or training in the use of assistive technology
  122  devices; the design, fabrication, or application of
  123  rehabilitative technology such as selected orthotic devices;
  124  training in the use of assistive technology; orthotic or
  125  prosthetic devices; the application of physical agent modalities
  126  as an adjunct to or in preparation for purposeful activity; the
  127  use of ergonomic principles; the adaptation of environments and
  128  processes to enhance functional performance; or the promotion of
  129  health and wellness.
  130         (c) The use of devices subject to 21 C.F.R. s. 801.109 and
  131  identified by the board is expressly prohibited except by an
  132  occupational therapist or occupational therapy assistant who has
  133  received training as specified by the board. The board shall
  134  adopt rules to carry out the purpose of this provision.
  135         Section 2. Subsection (2) of section 468.209, Florida
  136  Statutes, is amended to read:
  137         468.209 Requirements for licensure.—
  138         (2) An applicant who has practiced as a state-licensed or
  139  American Occupational Therapy Association-certified occupational
  140  therapy assistant for 4 years and who, before prior to January
  141  24, 1988, completed a minimum of 24 weeks 6 months of supervised
  142  occupational-therapist-level fieldwork experience may take the
  143  examination to be licensed as an occupational therapist without
  144  meeting the educational requirements for occupational therapists
  145  made otherwise applicable under paragraph (1)(b).
  146         Section 3. Subsection (2) of section 468.215, Florida
  147  Statutes, is amended to read:
  148         468.215 Issuance of license.—
  149         (2)(a) Any person who is issued a license as an
  150  occupational therapist under the terms of this act may use the
  151  words “occupational therapist,” “licensed occupational
  152  therapist,” or “occupational therapist registered,” or he or she
  153  may use the letters “O.T.,” “L.O.T.,” or “O.T.R.,” in connection
  154  with his or her name or place of business to denote his or her
  155  registration hereunder.
  156         (b)Any person who is issued a license as an occupational
  157  therapist under the terms of this act and holds a doctorate
  158  degree in occupational therapy may also use the words
  159  “occupational therapist doctorate” and the letters “O.T.D.” in
  160  connection with his or her name or place of business to denote
  161  his or her registration hereunder.
  162         Section 4. Section 468.223, Florida Statutes, is amended to
  163  read:
  164         468.223 Prohibitions; penalties.—
  165         (1) A person may not:
  166         (a) Practice occupational therapy unless such person is
  167  licensed pursuant to ss. 468.201-468.225;
  168         (b) Use, in connection with his or her name or place of
  169  business, the words “occupational therapist,” “licensed
  170  occupational therapist,” “occupational therapist doctorate,”
  171  “occupational therapist registered,” “occupational therapy
  172  assistant,” “licensed occupational therapy assistant,”
  173  “certified occupational therapy assistant”; the letters “O.T.,”
  174  “L.O.T.,” “O.T.D.,” “O.T.R.,” “O.T.A.,” “L.O.T.A.,” or
  175  “C.O.T.A.”; or any other words, letters, abbreviations, or
  176  insignia indicating or implying that he or she is an
  177  occupational therapist or an occupational therapy assistant or,
  178  in any way, orally or in writing, in print or by sign, directly
  179  or by implication, to represent himself or herself as an
  180  occupational therapist or an occupational therapy assistant
  181  unless the person is a holder of a valid license issued pursuant
  182  to ss. 468.201-468.225;
  183         (c) Present as his or her own the license of another;
  184         (d) Knowingly give false or forged evidence to the board or
  185  a member thereof;
  186         (e) Use or attempt to use a license that which has been
  187  suspended, revoked, or placed on inactive or delinquent status;
  188         (f) Employ unlicensed persons to engage in the practice of
  189  occupational therapy; or
  190         (g) Conceal information relative to any violation of ss.
  191  468.201-468.225.
  192         (2) Any person who violates any provision of this section
  193  commits a misdemeanor of the second degree, punishable as
  194  provided in s. 775.082 or s. 775.083.
  195         Section 5. Subsection (2) of section 468.225, Florida
  196  Statutes, is amended, and paragraph (e) is added to subsection
  197  (1) of that section, to read:
  198         468.225 Exemptions.—
  199         (1) Nothing in this act shall be construed as preventing or
  200  restricting the practice, services, or activities of:
  201         (e)Any person fulfilling an occupational therapy doctoral
  202  capstone experience that involves clinical practice or projects.
  203  To benefit from an exemption under this paragraph, a person must
  204  register with the department in a manner determined by
  205  department rule before commencing the capstone experience.
  206         (2) No provision of this act shall be construed to prohibit
  207  physicians, physician assistants, nurses, physical therapists,
  208  osteopathic physicians or surgeons, clinical psychologists,
  209  clinical social workers, marriage and family therapists, mental
  210  health counselors, speech-language pathologists, or audiologists
  211  from using occupational therapy as a part of or incidental to
  212  their profession, when they practice their profession under the
  213  statutes applicable to their profession.
  214         Section 6. Paragraph (b) of subsection (1) of section
  215  490.014, Florida Statutes, is amended to read:
  216         490.014 Exemptions.—
  217         (1)
  218         (b) No provision of this chapter shall be construed to
  219  limit the practice of nursing, clinical social work, marriage
  220  and family therapy, mental health counseling, occupational
  221  therapy, or other recognized businesses or professions, or to
  222  prevent qualified members of other professions from doing work
  223  of a nature consistent with their training, so long as they do
  224  not hold themselves out to the public as psychologists or use a
  225  title or description protected by this chapter. Nothing in this
  226  subsection shall be construed to exempt any person from the
  227  provisions of s. 490.012.
  228         Section 7. Subsection (2) of section 491.014, Florida
  229  Statutes, is amended to read:
  230         491.014 Exemptions.—
  231         (2) No provision of this chapter shall be construed to
  232  limit the practice of nursing, school psychology, or psychology,
  233  or occupational therapy, or to prevent qualified members of
  234  other professions from doing work of a nature consistent with
  235  their training and licensure, so long as they do not hold
  236  themselves out to the public as possessing a license,
  237  provisional license, registration, or certificate issued
  238  pursuant to this chapter or use a title protected by this
  239  chapter.
  240         Section 8. For the purpose of incorporating the amendment
  241  made by this act to section 490.014, Florida Statutes, in a
  242  reference thereto, paragraph (c) of subsection (1) of section
  243  490.012, Florida Statutes, is reenacted to read:
  244         490.012 Violations; penalties; injunction.—
  245         (1)
  246         (c) No person shall hold herself or himself out by any
  247  title or description incorporating the words, or permutations of
  248  them, “psychology,” “psychological,” or “psychodiagnostic,” or
  249  describe any test or report as psychological, unless such person
  250  holds a valid, active license under this chapter or is exempt
  251  from the provisions of this chapter.
  252         Section 9. Paragraph (b) of subsection (4) of section
  253  1002.394, Florida Statutes, is amended to read:
  254         1002.394 The Family Empowerment Scholarship Program.—
  256         (b) Program funds awarded to a student with a disability
  257  determined eligible pursuant to paragraph (3)(b) may be used for
  258  the following purposes:
  259         1. Instructional materials, including digital devices,
  260  digital periphery devices, and assistive technology devices that
  261  allow a student to access instruction or instructional content
  262  and training on the use of and maintenance agreements for these
  263  devices.
  264         2. Curriculum as defined in subsection (2).
  265         3. Specialized services by approved providers or by a
  266  hospital in this state which are selected by the parent. These
  267  specialized services may include, but are not limited to:
  268         a. Applied behavior analysis services as provided in ss.
  269  627.6686 and 641.31098.
  270         b. Services provided by speech-language pathologists as
  271  defined in s. 468.1125(8).
  272         c. Occupational therapy services as defined in s. 468.203.
  273         d. Services provided by physical therapists as defined in
  274  s. 486.021(8).
  275         e. Services provided by listening and spoken language
  276  specialists and an appropriate acoustical environment for a
  277  child who has a hearing impairment, including deafness, and who
  278  has received an implant or assistive hearing device.
  279         4. Tuition or fees associated with full-time or part-time
  280  enrollment in a home education program, an eligible private
  281  school, an eligible postsecondary educational institution or a
  282  program offered by the postsecondary educational institution, a
  283  private tutoring program authorized under s. 1002.43, a virtual
  284  program offered by a department-approved private online provider
  285  that meets the provider qualifications specified in s.
  286  1002.45(2)(a), the Florida Virtual School as a private paying
  287  student, or an approved online course offered pursuant to s.
  288  1003.499 or s. 1004.0961.
  289         5. Fees for nationally standardized, norm-referenced
  290  achievement tests, Advanced Placement Examinations, industry
  291  certification examinations, assessments related to postsecondary
  292  education, or other assessments.
  293         6. Contributions to the Stanley G. Tate Florida Prepaid
  294  College Program pursuant to s. 1009.98 or the Florida College
  295  Savings Program pursuant to s. 1009.981 for the benefit of the
  296  eligible student.
  297         7. Contracted services provided by a public school or
  298  school district, including classes. A student who receives
  299  services under a contract under this paragraph is not considered
  300  enrolled in a public school for eligibility purposes as
  301  specified in subsection (6).
  302         8. Tuition and fees for part-time tutoring services
  303  provided by a person who holds a valid Florida educator’s
  304  certificate pursuant to s. 1012.56, a person who holds an
  305  adjunct teaching certificate pursuant to s. 1012.57, a person
  306  who has a bachelor’s degree or a graduate degree in the subject
  307  area in which instruction is given, a person who has
  308  demonstrated a mastery of subject area knowledge pursuant to s.
  309  1012.56(5), or a person certified by a nationally or
  310  internationally recognized research-based training program as
  311  approved by the department. As used in this paragraph, the term
  312  “part-time tutoring services” does not qualify as regular school
  313  attendance as defined in s. 1003.01(13)(e).
  314         9. Fees for specialized summer education programs.
  315         10. Fees for specialized after-school education programs.
  316         11. Transition services provided by job coaches.
  317         12. Fees for an annual evaluation of educational progress
  318  by a state-certified teacher under s. 1002.41(1)(f), if this
  319  option is chosen for a home education student.
  320         13. Tuition and fees associated with programs offered by
  321  Voluntary Prekindergarten Education Program providers approved
  322  pursuant to s. 1002.55 and school readiness providers approved
  323  pursuant to s. 1002.88.
  324         14. Fees for services provided at a center that is a member
  325  of the Professional Association of Therapeutic Horsemanship
  326  International.
  327         15. Fees for services provided by a therapist who is
  328  certified by the Certification Board for Music Therapists or
  329  credentialed by the Art Therapy Credentials Board, Inc.
  330         Section 10. For the purpose of incorporating the amendment
  331  made by this act to section 468.203, Florida Statutes, in a
  332  reference thereto, paragraph (c) of subsection (2) of section
  333  1002.66, Florida Statutes, is reenacted to read:
  334         1002.66 Specialized instructional services for children
  335  with disabilities.—
  336         (2) The parent of a child who is eligible for the
  337  prekindergarten program for children with disabilities may
  338  select one or more specialized instructional services that are
  339  consistent with the child’s individual educational plan. These
  340  specialized instructional services may include, but are not
  341  limited to:
  342         (c) Occupational therapy as defined in s. 468.203.
  343         Section 11. This act shall take effect July 1, 2022.