21 NCAC 38 .0103             DEFINITIONS

The definitions in G.S. 90-270.67 apply to this Chapter. The following definitions also apply to the Chapter:

(1)           "Activities of daily living" (ADL) means self-care activities.

(2)           "Assessment" means the tools or instruments that are used during the evaluation process.

(3)           "Client" means a person, group, program, organization, or community for whom the occupational therapy practitioner is providing services.

(4)           "Entry-level" means a person who has no experience in a specific position, such as a new graduate, a person new to the position, or a person in a new setting with no previous experience in that area of practice.

(5)           "Evaluation" means the process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results.

(6)           "Instrumental activities of daily living" (IADL) means multi-step activities to care for self and others, such as household management, financial management, and childcare.

(7)           "Intervention" means treatment.

(8)           "Intervention plan" is the program established by the occupational therapist for the delivery of occupational therapy services. It may also be referred to as treatment plan, individualized education plan (IEP), individualized family service plan (IFSP), plan of care, or other terminology as determined by the occupational therapy service delivery setting.

(9)           "Level I Fieldwork" provides introductory level clinical training opportunities.

(10)         "Level II Fieldwork" provides clinical training in preparation for entry-level practice.

(11)         "Neglect of duty" occurs when a Board member fails to attend a majority of the official meetings of the Board within any 12 month period.

(12)         "Occupational Therapy", as defined in G.S. 90-270.67(4), may include evaluation of activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation.

(13)         "Occupational Therapy evaluation, treatment, and consultation" include the following:

(a)           remediation or restitution of performance abilities that are limited due to impairment in biological, physiological, psychosocial, and developmental process;

(b)           adaptation of skills, process or environment, or the teachings of compensatory techniques in order to enhance performance;

(c)           disability prevention methods and techniques that facilitate the development or safe application of performance skills;

(d)           promotion of health and wellness to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction; and

(e)           interpretation of the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

(14)         "Occupational therapy practitioner" means an individual licensed by the Board as an occupational therapist or an occupational therapy assistant.

(15)         "Occupational therapy services" include the following:

(a)           Methods or strategies selected to direct the process of interventions such as:

(i)            Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired;

(ii)           Compensation, modification, or adaptation of activity or environment to enhance performance;

(iii)          Maintenance and enhancement of capabilities without which performance in everyday life activities would decline;

(iv)          Health promotion and wellness to enable or enhance performance in everyday life activities; and

(v)           Prevention of barriers to performance, including disability prevention.

(b)           Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:

(i)            Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinary systems);

(ii)           Habits, routines, roles, and behavior patterns;

(iii)          Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance; and

(iv)          Performance skills, including motor, process, and communication/interaction skills.

(c)           Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure and social participation, including:

(i)            Therapeutic use of occupations, exercises, and activities;

(ii)           Training in self-care, self-management, home management, and community or work reintegration;

(iii)          Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills;

(iv)          Therapeutic use of self, including one's personality, insights, perceptions, and judgments, as part of the therapeutic process;

(v)           Education and training of individuals, including family members, caregivers, and others;

(vi)          Care coordination, case management, and transition services;

(vii)         Consultative services to groups, programs, organizations, or communities;

(viii)        Modification of home, work, school, or community environments and adaptation of processes, including the application of ergonomic principles;

(ix)          Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices;

(x)           Assessment, recommendation, and training in techniques to enhance functional mobility, including wheelchair management;

(xi)          Driver rehabilitation and community mobility;

(xii)         Management of feeding, eating, and swallowing to enable eating and feeding performance; and

(xiii)        Application of physical agent modalities and use of a range of specific therapeutic procedures to enhance performance skills.

(16)         "Occupational therapy student" means an individual enrolled in an occupational therapist or occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).

(17)         "Practice Act" refers to the North Carolina Occupational Therapy Practice Act found in G.S. 90-270.65 et. seq.

(18)         "Screening" means obtaining and reviewing data relevant to a potential client to determine the need for further evaluation and intervention.

(19)         "Service Competency" is the ability to provide occupational therapy services in a safe and effective manner. It means that two practitioners can perform the same or equivalent procedure and obtain the same result.

(20)         "Skilled occupational" therapy services when rendered by an occupational therapist or occupational therapy assistant means functions that require the exercise of professional occupational therapy judgment, including the interpretation of referrals, screening, assessment, evaluation, development or modification of intervention plans, implementation of intervention, reassessment, or discharge planning.

(21)         "Supervision" is the process by which two or more people participate in joint effort to establish, maintain, and elevate a level of performance to ensure the safety and welfare of clients during occupational therapy. Supervision is structured according to the supervisee's qualifications, position, level of preparation, depth of experience and the environment within which the supervisee functions. Levels of supervision are:

(a)           "General supervision," which is required for all occupational therapy assistants by an occupational therapist. It includes a variety of types and methods of supervision and may include observation, modeling, co-treatment, discussions, teaching, instruction, phone conversations, videoconferencing, written correspondence, electronic exchanges, and other telecommunication technology. Methods of observation include face-to-face, synchronous or asynchronous videoconferencing. The specific frequency, methods, and content of supervision may vary by practice setting and are dependent on the complexity of client needs, number and diversity of clients, demonstrated service competency of the occupational therapist and the occupational therapy assistant, type of practice setting, requirements of the practice setting, and federal and state regulatory requirements. General supervision shall be required at least monthly; and

(b)           "Direct supervision," which is required for all unlicensed personnel and volunteers. It means the Occupational Therapy supervisor must be within audible and visual range of the client and unlicensed personnel and available for immediate physical intervention. Videoconferencing is not allowed for direct supervision.

(22)         "Unlicensed personnel" means individuals within an occupational therapy setting who provide supportive services to the occupational therapist and the occupational therapy assistant and who function only under the guidance, responsibility, and supervision of the licensed occupational therapist or occupational therapy assistant to provide only specifically selected client-related or non-client related tasks for which the unlicensed personnel has been trained and has demonstrated competence.

History Note:        Authority G.S. 90‑270.67; 90‑270.69(4);

Eff. July 1, 1985;

Amended Eff. July 1, 2007; May 1, 1989; May 1, 1987;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. July 23, 2016;

Amended Eff. July 1, 2018.