DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
OCCUPATIONAL THERAPISTS – GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16141, 16145, 16148, 16174, 16175, 16178, 16186, 16186a, 16204,  
16205, 16215, 16287, 18307, 18309, and 18313 of the public health code, 1978 PA 368,  
MCL 333.16141, 333.16145, 333.16148, 333.16174, 333.16175, 333.16178, 333.16186,  
333.16186a, 333.16204, 333.16205, 333.16215, 333.16287, 333.18307, 333.18309, and  
333.18313, and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-  
4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)  
R 338.1191 Rescinded.  
History: 1993 AACS; 2014 AACS.  
R 338.1192 Rescinded.  
History: 1993 AACS; 2014 AACS.  
R 338.1194 Rescinded.  
History: 1993 AACS; 1997 AACS; 2014 AACS.  
R 338.1196 Rescinded.  
History: 1993 AACS; 1997 AACS; 2014 AACS.  
R 338.1197 Rescinded.  
History: 1997 AACS; 2014 AACS.  
R 338.1197a Rescinded.  
History: 1997 AACS; 2014 AACS.  
R 338.1198 Rescinded.  
History: 1993 AACS; 2014 AACS.  
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R 338.1200 Rescinded.  
History: 1993 AACS; 2014 AACS.  
PART 1. GENERAL PROVISIONS  
R 338.1211 Definitions.  
Rule 11. (1) As used in these rules:  
(a) “ACOTE” means Accreditation Council for Occupational Therapy Education.  
(b) “AOTA” means American Occupational Therapy Association.  
(c) "Board" means the board of occupational therapists.  
(d) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(e) "Department" means the department of licensing and regulatory affairs.  
(f) “Direct supervision” means that the occupational therapist is physically present or  
present via telemedicine with the individual being supervised or immediately available  
for direction and onsite supervision when the limited assessment, task, intervention, or  
interaction with the client is performed.  
(g) “General supervision” means that the occupational therapist is not required to be  
physically present on site or present during a telemedicine visit but is continuously  
available when the limited assessment, task, intervention, or interaction with the client is  
performed. Continuously available includes availability by telecommunication or another  
electronic device.  
(h) “NBCOT” means National Board for Certification in Occupational Therapy.  
(i) “WFOT” means World Federation of Occupational Therapists.  
(2) Unless otherwise defined in these rules, the terms defined in the code have the same  
meaning when used in these rules.  
History: 2014 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
PART 2. GENERAL PROVISIONS  
R 338.1212 Grounds for disciplinary action.  
Rule 12. The conduct included in section 16221 of the code, MCL 333.16221, is  
prohibited conduct, and may be grounds for disciplinary action against a licensee,  
registrant, or an applicant.  
History: 2014 AACS; 2021 AACS.  
R 338.1213 Rescinded.  
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History: 2014 AACS; 2021 AACS.  
R 338.1215 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 15. (1) Under section 16148 of the code, MCL 333.16148, an individual seeking  
licensure or that is licensed shall have completed training in identifying victims of human  
trafficking that satisfies the following standards:  
(a) Training content must cover all of the following:  
(i) Understanding the types and venues of human trafficking in the United States.  
(ii) Identifying victims of human trafficking in healthcare settings.  
(iii) Identifying the warning signs of human trafficking in healthcare settings for adults  
and minors.  
(iv) Identifying resources for reporting suspected victims of human trafficking.  
(b) Acceptable providers or methods of training including any of the following:  
(i) Training offered by a nationally recognized or state-recognized, health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training in an educational program that has been approved by the advisory  
committee for initial license or registration, or by a college or university.  
(iv) Reading an article related to the identification of human trafficking that meets the  
requirements of subdivision (a) of this subrule and is published in a peer-review journal,  
healthcare journal, or professional or scientific article.  
(c) Acceptable modalities of training including any of the following:  
(i) Teleconference or webinar.  
(ii) Online presentation.  
(iii) Live presentation.  
(iv) Printed or electronic media.  
(2) The department may select and audit an individual and request documentation of  
proof of completion of training. If audited by the department, the individual shall provide  
an acceptable proof of completion of training, including either of the following:  
(a) Proof of completion certificate issued by the training provider that includes the date,  
provider name, name of training, and the individual’s name.  
(b) A self-certification statement by the individual. The certification statement must  
include the individual’s name and 1 of the following:  
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,  
training provider name, and name of training.  
(ii) For training completed pursuant to subrule (1)(b)(iv) of this rule, the title of the  
article, author, publication name of the peer-review journal, healthcare journal, or  
professional or scientific journal, and the date, volume, and issue of publication, as  
applicable.  
History: 2017 AACS; 2023 MR 8, Eff. April 26, 2023.  
PART 3. OCCUPATIONAL THERAPISTS  
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R 338.1221 Educational program standards; occupational therapist; adoption  
by reference.  
Rule 21. (1) The board approves and adopts by reference the standards for  
accrediting occupational therapist educational programs in the documents entitled "2018  
Accreditation Council for Occupational Therapy Education (ACOTE) Standards and  
Interpretive Guide," adopted by ACOTE, which were effective July 31, 2020. Copies of  
these standards are available at no cost from the ACOTE website at  
https://acoteonline.org/accreditation-explained/standards/. Copies of the standards are  
also available for inspection and distribution at 10 cents per page from the Michigan  
Board of Occupational Therapists, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan  
48909.  
(2) Any educational program for occupational therapists that is accredited by the  
ACOTE qualifies as an occupational therapist educational program approved by the  
board.  
(3) The board approves and adopts by reference the standards in the document  
entitled "Minimum Standards for the Education of Occupational Therapists, Revised  
2016” published by the WFOT. Copies of these standards are available at no cost on the  
WFOT website at http://www.wfot.org. The standards are also available for inspection at  
10 cents per page from the Michigan Board of Occupational Therapists, Bureau of  
Professional Licensing, Department of Licensing and Regulatory Affairs, 611 West  
Ottawa, P.O. Box 30670, Lansing, Michigan 48909.  
(4) Any educational program for occupational therapists that is approved by the  
WFOT qualifies as an occupational therapist educational program approved by the board.  
(5) Any bachelor’s level educational program for occupational therapists that was  
operating before December 31, 2006, and accredited by the ACOTE or approved by the  
WFOT qualifies as an occupational therapist educational program approved by the board.  
History: 2014 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1222 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1223 Application for occupational therapist license; requirements.  
Rule 23. An applicant for an occupational therapist license shall submit the required  
fee and a completed application on a form provided by the department. In addition to  
meeting the requirements of the code, R 338.7001 to R 338.7005, any other rules  
promulgated under the code, and section 16174 of the code, MCL 333.16174, an  
applicant shall meet all of the following requirements:  
(a) Graduate from an occupational therapist education program that is accredited by  
the ACOTE or approved by the WFOT, or their predecessor organizations that meets the  
standards adopted by the board under R 338.1222 or meets the requirements of R  
338.1225.  
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(b) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the occupational therapist  
licensure examination adopted in R 338.1224.  
(c) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the examination on laws and  
rules related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1223a Rescinded.  
History: 2014 AACS; 2017 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1224 Examinations; occupational therapist; adoption and approval;  
passing scores.  
Rule 24. (1) The board approves and adopts the certification examination for  
occupational therapists that was developed, administered, and scored by the NBCOT as  
the licensure examination for occupational therapists in this state. The board shall adopt  
the passing score recommended by the NBCOT for the certification examination.  
(2) The board approves the examination on laws and rules related to the practice of  
occupational therapy in this state that is developed and administered by the department,  
or an entity approved by the department. The passing score on the laws and rules  
examination is a converted score of not less than 75.  
(3) An applicant that fails to achieve a passing score on the examination required in  
subrule (2) of this rule may retake the examination without limitation.  
History: 2014 AACS; 2017 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1225 Graduate of non-accredited postsecondary institution; occupational  
therapist; equivalency of education; NBCOT examination.  
Rule 25. An applicant for an occupational therapist license who graduated from a  
non-accredited postsecondary institution shall submit the required fee and a completed  
application on a form provided by the department. In addition to meeting the  
requirements of the code, R 338.7001 to R 338.7005, any other rules promulgated under  
the code, and section 16174 of the code, MCL 333.16174, an applicant shall meet all of  
the following requirements:  
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(a) Establish to the board that the applicant completed an occupational therapist  
educational program that is substantially equivalent to an occupational therapist program  
that is accredited by the ACOTE or approved by the WFOT as provided in R 338.1222.  
(b) Have documentation sent directly to the department from the NBCOT verifying  
the applicant passed the NBCOT certification examination for occupational therapists  
adopted in R 338.1224 within 3 years before the application for licensure and not more  
than 2 years after the application for licensure.  
(c) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the examination on laws and  
rules related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
History: 2014 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1226 Licensure by endorsement; occupational therapist; requirements.  
Rule 26. (1) An applicant for an occupational therapist license by endorsement shall  
submit the required fee and a completed application on a form provided by the  
department. An applicant meets the requirements of section 16186 of the code, MCL  
333.16186, if the applicant meets the requirements of the code, R 338.7001 to R  
338.7005, any other rules promulgated under the code, and section 16174 of the code,  
MCL 333.16174, and satisfies the following requirements, as applicable.  
(2) If an applicant is actively registered or licensed as an occupational therapist in  
another state for 5 years or more and is in good standing within 30 days before filing an  
application for an occupational therapist license in this state, then the applicant shall  
comply with both of the following:  
(a) Have previously taken and passed the NBCOT certification examination for  
occupational therapists with a score adopted by the board under R 338.1224(1) or the  
predecessor examination that was administered by the AOTA.  
(b) Within 3 years preceding the application for endorsement and not more than 2  
years after the application for endorsement, the applicant must pass the examination on  
state laws and rules related to the practice of occupational therapy that is developed and  
administered by the department or an entity approved by the department with a minimum  
converted score of 75.  
(3) If an applicant is actively registered or licensed as an occupational therapist in  
another state for less than 5 years and is in good standing within 30 days before filing an  
application for an occupational therapist license in this state, then the applicant shall  
comply with both of the following:  
(a) Graduate from an occupational therapist education program that is accredited by  
the ACOTE, or approved by the WFOT, or their predecessor organizations that meets the  
standards adopted by the board in R 338.1222.  
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(b) Meet the requirements of subrule (2) of this rule.  
(4) In addition to meeting the requirements of subrule (1) and either subrule (2) or  
(3) of this rule, an applicant shall meet both of the following requirements:  
(a) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(b) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1227 Requirements for relicensure; occupational therapist.  
Rule 27. (1) An applicant for relicensure as an occupational therapist, who has let  
his or her license or registration from this state lapse, under section 16201(3) or (4) of the  
code, MCL 333.16201, as applicable, may be relicensed by complying with the following  
requirements as noted by (√):  
For an occupational therapist who has let his or  
her registration or license from this state lapse:  
Registered in this  
state before Januarylapsed lesslapsed  
1, 2009, with lapsedthan 3 years. years  
Licensed  
Licensed  
3
or  
registration, and did  
not apply for  
more.  
licensure before June  
11, 2015.  
(a) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(b) Establish that the applicant is of good moral  
character as defined in, and determined under, 1974  
PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
√
√
√
√
(d) Submit proof of having completed the  
continuing education required under R 338.1252,  
which was earned within the 3-year period  
immediately before the application for relicensure. If  
the continuing education hours submitted with the  
application are deficient, the applicant has 2 years  
after the date of the application to complete the  
deficient hours. The application must be held, and the  
license may not be issued until the continuing  
education requirements are met.  
√
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(e) Maintain certification as an occupational  
therapist by NBCOT after the registration lapsed and  
graduated from an occupational therapist education  
program that is accredited by ACOTE or approved by  
WFOT, or their predecessor organizations that meets  
the standards adopted by the board under R 338.1222  
or meets the requirements of R 338.1225.  
√
(f) Complete a 1-time training in identifying  
victims of human trafficking that meets the standards  
in R 338.1215.  
(g) Meet the English language requirement under  
R 338.7002b and the implicit bias training required in  
R 338.7004.  
√
√
√
√
√
√
(h) Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, pass the examination on  
laws and rules related to the practice of occupational  
therapy in this state that is developed and  
administered by the department, or an entity approved  
by the department.  
√
√
(i) Satisfy 1 of the following:  
(i)Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, take and pass the NBCOT  
certification examination for occupational therapists,  
with a score adopted by the board under R  
338.1224(1), and complete supervised practice  
experience pursuant to subrule (2) of this rule.  
(ii) Present evidence to the department that the  
applicant was actively registered or licensed as an  
occupational therapist in another state during the 3-  
year period and in good standing within 30 days,  
before filing the application for relicensure.  
√
√
(j) An applicant that is or has been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States military,  
the federal government, or another country, shall do  
both of the following:  
√
√
√
(i) Disclose on the application form each license,  
registration, or certification.  
(ii) Satisfy the requirements of section 16174(2)  
of the code, MCL 333.16174, including verification  
from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and  
sanctions are not in force at the time of application.  
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(2) An applicant that has had a lapsed registration or license for 3 years or more and  
meets the requirements of subrule (1)(i)(i) of this rule shall complete a supervised  
practice experience that meets the requirements of R 338.1228. The applicant shall have a  
limited license from the department while participating in the supervised practice  
experience. The duration of the experience must be as follows:  
(a) If the applicant’s license has lapsed for not less than 3 years but less than 7  
years, the applicant shall complete not less than 200 hours of supervised practice  
experience.  
(b) If the applicant’s license has lapsed for 7 years or more but less than 15 years,  
the applicant shall complete not less than 400 hours of supervised practice experience.  
(c) If the applicant’s license has lapsed for more than 15 years, the applicant shall  
complete not less than 600 hours of supervised practice experience.  
(3) For purposes of meeting the requirements of subrule (2) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(4) A limited license granted under subrule (3) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1228  
requirements.  
Supervised practice experience; occupational therapist;  
Rule 28. (1) The supervised practice experience required for relicensure under R  
338.1227 must comply with both of the following:  
(a) The supervised practice experience must be obtained under the supervision of a  
licensed occupational therapist having 3 or more years clinical experience and no past or  
pending disciplinary actions.  
(b) The supervising occupational therapist shall provide the board with verification  
of the applicant's completion of the supervised practice experience on a form provided by  
the department.  
(2) The supervised practice experience must consist of, at a minimum, professional  
and clinical instruction in all of the following areas:  
(a) Referral process.  
(b) Screening process.  
(c) Evaluations.  
(d) Intervention plans.  
(e) Intervention strategies.  
(f) Discontinuation; referral for other services.  
History: 2014 AACS; 2021 AACS.  
R 338.1229 Delegation of limited assessments, tasks or interventions to an  
occupational therapy assistant; supervision of an occupational therapy assistant;  
requirements.  
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Rule 29. (1) An occupational therapist who delegates the performance of limited  
assessments, tasks, or interventions to an occupational therapy assistant as allowed under  
section 16215 of the code, MCL 333.16215, shall supervise the occupational therapy  
assistant consistent with section 16109(2) of the code, MCL 333.16109, and satisfy the  
requirements of this rule. As used in this rule, “limited assessment” means those parts of  
an evaluation that an occupational therapy assistant is qualified by education and training  
to perform while under the supervision of an occupational therapist.  
(2) Before an occupational therapist delegates limited assessments, tasks, or  
interventions to an occupational therapy assistant, the occupational therapist shall  
evaluate the qualifications of the occupational therapy assistant, including verification of  
the occupational therapy assistant’s training, education, and licensure.  
(3) An occupational therapist who delegates limited assessments, tasks, or  
interventions to an occupational therapy assistant shall determine and provide the  
appropriate level of supervision required for the occupational therapy assistant’s  
performance of the delegated limited assessment, task, or intervention. The appropriate  
level of supervision must be determined based on the occupational therapy assistant’s  
education, training, and experience. The level of supervision must be either general  
supervision or direct supervision.  
(4) An occupational therapist who delegates limited assessments, tasks, or  
interventions under this rule shall also comply with all of the following:  
(a) Initiate and direct the evaluation of the patient or client before delegating limited  
assessments.  
(b) Complete the evaluation of the patient or client before delegating tasks or  
interventions to be performed by an occupational therapy assistant.  
(c) Supervise an occupational therapy assistant to whom limited assessments, tasks,  
or interventions are delegated.  
(d) Provide predetermined procedures and protocols for limited assessments, tasks,  
or interventions that are delegated.  
(e) Monitor an occupational therapy assistant’s practice of assigned limited  
assessments, tasks, or interventions.  
(f) Maintain a record of the names of the occupational therapy assistants to whom  
limited assessments, tasks, or interventions have been delegated pursuant to section  
16215 of the code, MCL 333.16215.  
(g) Meet using live, synchronous contact at least once per month with the  
occupational therapy assistant to whom limited assessments, tasks, or interventions have  
been delegated to accomplish all of the following:  
(i) Evaluate the occupational therapy assistant’s performance.  
(ii) Review the patient or client.  
(iii) Educate the occupational therapy assistant on the limited assessments, tasks, or  
interventions that have been delegated to facilitate professional growth and development.  
(h) The occupational therapist shall maintain documentation of the meeting, which  
must be signed by both the occupational therapist and occupational therapist assistant.  
Compliance with this subdivision must not be used as a substitute for the ongoing  
supervision required under this subrule and subrule (3) of this rule.  
(5) An occupational therapist shall not delegate the performance of either of the  
following to an occupational therapy assistant:  
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(a) The sole development of a treatment plan.  
(b) The sole evaluation and interpretation of evaluation results.  
(6) An occupational therapist shall not supervise more than 4 occupational therapy  
assistants who are providing services to patients at the same time.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1229a Delegation of tasks to an unlicensed individual; direct supervision  
of an unlicensed individual; requirements.  
Rule 29a. (1) An occupational therapist who delegates the performance of selected  
tasks to an unlicensed individual as allowed under section 16215 of the code, MCL  
333.16215, shall supervise the unlicensed individual consistent with section 16109(2) of  
the code, MCL 333.16109, and satisfy the requirements of this rule. As used in this rule,  
“unlicensed individual” means an individual who does not hold an occupational therapist  
license, an occupational therapy assistant license, or another health professional license  
and who may be able to perform the tasks identified in this rule.  
(2) An occupational therapist who delegates tasks to an unlicensed individual shall  
provide direct supervision of the unlicensed individual.  
(3) An occupational therapist who delegates tasks under subrule (2) of this rule shall  
also comply with all of the following:  
(a) Before delegating a task, the occupational therapist shall evaluate the  
qualifications of the unlicensed individual under the occupational therapist’s direct  
supervision, including verification of the unlicensed individual’s training and education.  
(b) Examine and evaluate the patient or client before delegating tasks to be  
performed by an unlicensed individual.  
(c) Provide predetermined procedures and protocols for tasks that are delegated.  
(d) Maintain a record of the unlicensed individuals to whom tasks have been  
delegated, under section 16213 of the code, MCL 333.16213.  
(e) Monitor an unlicensed individual’s practice of assigned tasks.  
(4) An occupational therapist shall not supervise more than 3 unlicensed individuals  
who are providing services to patients or clients at the same time.  
(5) An occupational therapist shall not delegate any of the to an unlicensed  
individual:  
(a) An occupational therapy intervention.  
(b) An assessment.  
(c) An evaluation.  
(6) Under section 16171 of the code, MCL 333.16171, the requirements of subrules  
(2), (3)(b), and (5) of this rule do not apply to a student enrolled in an ACOTE accredited  
or WFOT approved occupational therapist educational program or an ACOTE accredited  
occupational therapy assistant educational program approved by the board.  
History: 2014 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
PART 4. OCCUPATIONAL THERAPY ASSISTANTS  
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R 338.1231 Educational program standards; occupational therapy assistant;  
adoption by reference.  
Rule 31. (1) The board approves and adopts by reference the standards for  
accrediting occupational therapy assistant educational programs in the document entitled  
“2018 Accreditation Council for Occupational Therapy Education (ACOTE) Standards  
and Interpretive Guide," adopted by the ACOTE, which were effective July 31, 2020.  
Copies of these standards are available at no cost from the ACOTE website at  
https://acoteonline.org/accreditation-explained/standards/. Copies of the standards are  
also available for inspection and distribution at 10 cents per page from the Michigan  
Board of Occupational Therapists, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan  
48909.  
(2) Any educational program for occupational therapy assistants that is accredited by  
the ACOTE qualifies as an occupational therapy assistant educational program approved  
by the board.  
History: 2014 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1232 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1233  
requirements.  
Application for occupational therapy assistant license;  
Rule 33. An applicant for an occupational therapy assistant license shall submit the  
required fee and a completed application on a form provided by the department. In  
addition to meeting the requirements of the code, R 338.7001 to R 338.7005, any other  
rules promulgated under the code, and section 16174 of the code, MCL 333.16174, an  
applicant shall meet all of the following requirements:  
(a) Graduate from an accredited occupational therapy assistant educational program  
that meets the standards adopted by the board under R 338.1232.  
(b) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the occupational therapy  
assistant licensure examination in R 338.1234.  
(c) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the examination on laws and  
rules related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
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History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1233a Rescinded.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1234 Examinations; occupational therapy assistant; adoption and  
approval; passing scores.  
Rule 34. (1) Under R 338.1233(b), the board approves and adopts the certification  
examination for occupational therapy assistants that was developed, administered, and  
scored by the NBCOT as the licensure examination for occupational therapy assistants in  
this state. The board adopts the passing score recommended by the NBCOT for the  
certification examination.  
(2) The board approves the examination on laws and rules related to the practice of  
occupational therapy in this state that is developed and administered by the department or  
an entity approved by the department. The passing score on the laws and rules  
examination is a converted score of not less than 75.  
(3) An applicant who fails to achieve a passing score on the examination required in  
subrule (2) of this rule may retake the examination without limitation.  
History: 2014 AACS; 2017 AACS; 2021 AACS.  
R 338.1234a  
Graduate of non-accredited postsecondary institution;  
occupational therapy assistant; equivalency of education; NBCOT examination.  
Rule 34a. An applicant for an occupational therapy assistant license who graduated  
from a non-accredited postsecondary institution shall submit the required fee and a  
completed application on a form provided by the department. In addition to meeting the  
requirements of the code, R 338.7001 to R 338.7005, any other rules promulgated under  
the code, and section 16174 of the code, MCL 333.16174, an applicant shall meet all of  
the following requirements:  
(a) Establish to the board that the applicant completed an occupational therapy  
assistant educational program that is substantially equivalent to an occupational therapist  
assistant program that is accredited by the ACOTE, as provided in R 338.1232.  
(b) Have documentation sent directly to the department from the NBCOT verifying  
the applicant passed the NBCOT certification examination for occupational therapy  
assistants adopted in R 338.1234 within 3 years before the application for licensure and  
not more than 2 years after the application for licensure.  
(c) Within 3 years before the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass the examination on laws and  
rules related to the practice of occupational therapy in this state, that is developed and  
administered by the department, or an entity approved by the department.  
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(d) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
History: 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1235 Licensure by endorsement of occupational therapy assistant;  
requirements.  
Rule 35. (1) An applicant for an occupational therapy assistant license by  
endorsement shall submit the required fee and a completed application on a form  
provided by the department. An applicant meets the requirements of section 16186 of the  
code, MCL 333.16186, if the applicant satisfies all the requirements of the code, R  
338.7001 to R 338.7005, any other rules promulgated under the code, and satisfies the  
following requirements, as applicable.  
(2) If an applicant is actively registered or licensed in another state for 5 years or  
more and is in good standing as an occupational therapy assistant within 30 days before  
filing an application for an occupational therapy assistant license in this state, then the  
applicant shall comply with both of the following:  
(a) Have previously taken and passed the NBCOT certification examination for  
occupational therapy assistants with a score adopted by the board under R 338.1234(1).  
(b) Within 3 years preceding the application for endorsement and not more than 2  
years after the application for endorsement, the applicant shall pass the examination on  
state laws and rules related to the practice of occupational therapy that is developed and  
administered by the department or an entity approved by the department. The passing  
score on the laws and rules examination is a converted score of not less than 75.  
(3) If an applicant is actively registered or licensed as an occupational therapist  
assistant in another state for less than 5 years and is in good standing within 30 days  
before filing an application for an occupational therapy assistant license in this state, then  
the applicant shall comply with both of the following:  
(a) Graduate from an occupational therapy assistant education program that is  
accredited by the ACOTE, or its predecessor organization that meets the standards  
adopted by the board in R 338.1232.  
(b) Meet the requirements of subrule (2) of this rule.  
(4) In addition to meeting the requirements of subrule (1) and either subrule (2) or  
(3) of this rule, an applicant shall meet both of the following requirements:  
(a) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(b) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
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R 338.1236 Requirements for relicensure; occupational therapy assistant.  
Rule 36. (1) An applicant for relicensure as an occupational therapy assistant, who  
has let his or her license or registration from this state lapse, under section 16201(3) or  
(4) of the code, MCL 333.16201, as applicable, may be relicensed by complying with the  
following requirements as noted by (√):  
For an occupational therapy assistant who has let  
Registered in this  
Licensed  
Licensed  
his or her registration or license from this state lapse: state before Januarylapsed lesslapsed  
1, 2009, with lapsedthan 3 years. years  
3
or  
registration, and did  
not apply for  
more.  
licensure before June  
11, 2015.  
(a) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(b) Establish that the applicant is of good moral  
character as defined in, and determined under, 1974  
PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
√
√
√
√
(d) Submit proof of having completed the  
continuing education required under R 338.1252,  
which was earned within the 3-year period  
immediately before the application for relicensure. If  
the continuing education hours submitted with the  
application are deficient, the applicant has 2 years  
after the date of the application to complete the  
deficient hours. The application must be held, and the  
license may not be issued until the continuing  
education requirements are met.  
√
(e) Maintain certification as an occupational  
therapy assistant by the NBCOT after the registration  
lapsed and graduated from an accredited occupational  
therapy assistant educational program that meets the  
standards adopted by the board under R 338.1232 or  
meets the requirements of R 338.1234a.  
√
(f) Complete a 1-time training in identifying  
victims of human trafficking that meets the standards  
in R 338.1215.  
(g) Meet the English language requirement under  
R 338.7002b and the implicit bias training required in  
R 338.7004.  
√
√
√
√
√
√
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(h) Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, pass the examination on  
laws and rules related to the practice of occupational  
therapy in this state that is developed and  
administered by the department, or an entity approved  
by the department.  
√
√
√
(i) Satisfy 1 of the following:  
(i)Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, the applicant shall  
take and pass the NBCOT certification  
examination for occupational therapy assistants with  
a score adopted by the board under R 338.1234(1),  
and after passing the examination complete  
supervised practice experience pursuant to subrule (2)  
of this rule.  
√
(ii) Present evidence to the department that the  
applicant was actively registered or licensed as an  
occupational therapy assistant in another state during  
the 3-year period and in good standing within 30 days  
before filing the application for relicensure.  
(j) An applicant that is or has been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States military,  
the federal government, or another country, shall do  
both of the following:  
√
√
√
(i) Disclose on the application form each license,  
registration, or certification.  
(ii) Satisfy the requirements of section 16174(2)  
of the code, MCL 333.16174, including verification  
from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and  
sanctions are not in force at the time of application.  
(2) An applicant that has a lapsed registration or license for 3 years or more and  
meets the requirements of subrule (1)(i)(i) of this rule shall complete a supervised  
practice experience that meets the requirements of R 338.1237. The duration of the  
experience must be as follows:  
(a) If the applicant’s license has lapsed for 3 years or more but less than 7 years, the  
applicant shall complete not less than 200 hours of supervised practice experience.  
(b) If the applicant’s license has lapsed for 7 years or more but less than 15 years,  
the applicant shall complete not less than 400 hours of supervised practice experience.  
(c) If the applicant’s license has lapsed for more than 15 years, the applicant shall  
complete not less than 600 hours of supervised practice experience.  
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(3) For purposes of meeting the requirements of subrule (2) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(4) A limited license granted under subrule (3) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1237 Supervised practice experience; occupational therapy assistant;  
requirements.  
Rule 37. (1) The supervised practice experience required for relicensure under R  
338.1236 shall comply with all of the following:  
(a) The supervised practice experience must be obtained under the supervision of a  
licensed occupational therapist having 3 or more years clinical experience and no past or  
pending disciplinary actions.  
(b) The supervising occupational therapist shall provide the board with verification  
of the applicant's completion of the supervised practice experience on a form provided by  
the department.  
(2) The supervised practice experience must consist of, at a minimum, professional  
and clinical instruction in all of the following areas:  
(a) Referral process.  
(b) Screening process.  
(c) Evaluations.  
(d) Intervention plans.  
(e) Intervention strategies.  
(f) Discontinuation; referral for other services.  
(3) Only experience obtained in an approved supervised practice situation by an  
individual who holds a limited license counts toward the experience requirement.  
History: 2014 AACS; 2017 AACS; 2021 AACS.  
R 338.1238 Rescinded.  
History: 2014 AACS; 2017 AACS.  
PART 4. TELEHEALTH  
R 338.1241 Definitions.  
Rule 41. As used in this part:  
(a) “Telehealth” means the use of electronic information and telecommunication  
technologies to support or promote long-distance clinical healthcare, patient and  
professional health-related education, public health, or health administration. Telehealth  
may include, but is not limited to, telemedicine.  
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(b) “Telehealth service” means a healthcare service that is provided through  
telehealth.  
(c) “Telemedicine” means the use of electronic media to link patients with  
healthcare professionals in different locations. To be considered telemedicine, the  
telemedicine services must be provided by a healthcare professional who is licensed,  
registered, or otherwise authorized to engage in his or her healthcare profession in the  
state where the patient is located.  
History: 2023 MR 8, Eff. April 26, 2023.  
R 338.1243 Consent; scope of practice; standard of care.  
Rule 43. (1) The licensee shall obtain informed consent for treatment before  
providing a telehealth service under section 16284 of the code, MCL 333.16284.  
Informed consent requires all of the following:  
(a) The licensee shall ensure that the patient understands that treatment is provided  
remotely using telehealth.  
(b) At the inception of care, any licensee who has contact with the patient shall  
identify himself or herself to the patient as an occupational therapist, occupational  
therapy assistant, or unlicensed individual.  
(c) The licensee shall ensure that the patient is mentally capable of giving informed  
consent for diagnosis, care, or treatment.  
(d) The licensee shall explain the alternatives, capabilities, and limitations of  
telemedicine and that the patient may decline to receive telehealth services.  
(2) If the patient is less than 18 years of age, or under the care of a legal guardian, a  
parent or legal guardian shall provide informed consent for the patient.  
(3) The licensee shall keep proof of consent for a telehealth service in the patient’s  
up-to-date medical record and satisfy section 16213 of the code, MCL 333.16213.  
(4) A licensee who provides telehealth services shall comply with all of the  
following:  
(a) Act within the scope of his or her practice.  
(b) Exercise the same standard of care applicable to a traditional, in-person  
healthcare service.  
(c) Verify that telemedicine is appropriate to evaluate, diagnose, and treat the  
patient based on his or her unique presentation.  
(5) The licensee shall be able to examine the patient via a health insurance  
portability and accountability act (HIPAA) of 1996, Public Law 104-191, compliant,  
secure interactive audio or video, or both, telecommunications system, or through the use  
of store and forward online messaging.  
(6) Telehealth must be secure and comply with federal and state security and privacy  
regulations.  
History: 2023 MR 8, Eff. April 26, 2023.  
PART 5. CONTINUING EDUCATION  
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R 338.1251 License renewal; occupational therapist; occupational therapy  
assistant; requirements.  
Rule 51. (1) This rule applies to an application for the renewal of an occupational  
therapist license, occupational therapy assistant license, and special retired volunteer  
license under sections 16184 and 16201 of the code, MCL 333.16184 and 333.16201.  
(2) An applicant for license renewal who has been licensed for the 2-year licensing  
period immediately preceding the expiration date of the license shall accumulate not less  
than 20 continuing education contact hours that are approved by the board pursuant to R  
338.1252, during the 2-year licensing period immediately preceding an application for  
renewal.  
(3) Submission of an application for renewal constitutes the applicant’s certification  
of compliance with the requirements of this rule.  
(4) The licensee shall retain documentation of meeting the requirements of this rule  
for a period of 4 years after the date of applying for license renewal. Failure to comply  
with this rule is a violation of section 16221(h) of the code, MCL 333.16221.  
(5) The board may require an applicant or licensee to submit evidence to  
demonstrate compliance with this rule.  
(6) A request for a waiver under section 16205 of the code, MCL 333.16205, must  
be received by the department for the board’s consideration not less than 30 days before  
the last regularly scheduled board meeting before the expiration date of the license. The  
public  
notice  
for  
the  
board  
meetings  
can  
be  
found  
at:  
https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/dental.  
History: 2017 AACS; 2021 AACS; 2023 MR 8, Eff. April 26, 2023.  
R 338.1252  
Acceptable continuing education; occupational therapist;  
occupational therapy assistant; requirements.  
Rule 52. (1) The 20 hours of continuing education required pursuant to R 338.1251  
for the renewal of a license must comply with the following:  
(a) Not more than 10 credit hours may be earned during a 24-hour period for online  
or electronic media, such as videos, internet web-based seminars, video conferences,  
online continuing education programs, and online journal articles that are asynchronous  
and not interactive.  
(b) Except for the 1-time training in human trafficking, which may be used to  
comply with the requirement for the 1-time training and continuing education  
requirements, an applicant may not earn credit for a continuing education program or  
activity that is identical or substantially similar to a program or activity the applicant has  
already earned credit for during that renewal period.  
(c) Pursuant to section 16204 of the code, MCL 333.16204, at least 1 hour of  
continuing education must be earned in the area of pain and symptom management.  
Continuing education hours in pain and symptom management may include, but are not  
limited to, courses in behavior management, psychology of pain, pharmacology, behavior  
modification, stress management, clinical applications, and drug interventions as they  
relate to the practice of occupational therapy.  
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(2) One-half of the required continuing education contact hours must be completed  
by live, synchronous, and interactive courses and programs, either in-person or virtual,  
that provide for the opportunity for direct interaction during the course or program,  
between faculty and participants, including, but not limited to, lectures, symposia, live  
teleconferences, and workshops. The remaining continuing education contact hours may  
be completed in another format.  
(3) The following are acceptable continuing education activities:  
ACCEPTABLE CONTINUING EDUCATION ACTIVITIES  
(a) Completion of an approved continuing  
education program or activity related to the  
practice of occupational therapy. A  
continuing education program or activity is  
approved if it is approved or offered for  
continuing education credit by any of the  
following:  
The number of hours approved by  
the sponsor or the approving  
organization may be earned in each  
renewal period.  
If the activity was not approved for a  
set number of hours, then 1 hour of  
continuing education for each 60  
minutes of participation may be  
earned.  
AOTA.  
International Association for  
Continuing Education and Training  
authorized providers.  
Credit in this category may be  
earned without limitation.  
Michigan Occupational Therapy  
Association.  
NBCOT.  
Another state or provincial board of  
occupational therapy.  
An occupational therapy education  
program approved by the board in R  
338.1222.  
Employer-provided work-place  
training.  
Third-party presentation that  
contributes to professional growth,  
development, and competency of  
occupational therapy practitioners.  
If audited, an applicant shall submit a copy  
of a letter or certificate of completion  
showing the applicant’s name, number of  
credits earned, sponsor name or the name of  
the organization that approved the program  
or activity for continuing education credit,  
and the date the program was held or  
activity completed.  
(b) Completion of academic courses related to  
Five hours of continuing education  
the practice of occupational therapy offered may be earned for each semester  
in an occupational therapy education  
credit hour earned.  
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program approved by the board pursuant to  
R 338.1222.  
Three hours of continuing education  
may be earned for each quarter  
credit hour earned.  
If audited, an applicant shall submit an  
official transcript that reflects completion of  
the academic course and number of semester Credit in this category may be  
or quarter credit hours earned.  
(c) Initial publication of a chapter or an article  
related to the practice of occupational  
therapy in any of the following:  
A peer-reviewed textbook.  
A professional healthcare textbook.  
A peer-reviewed journal or  
periodical.  
earned without limitation.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
Ten hours of continuing education  
may be earned for publishing a peer-  
reviewed textbook, professional  
healthcare textbook, or a peer-  
reviewed journal or periodical.  
A practice area related article in a lay  
publication (community newspaper  
or newsletter).  
A non-peer-reviewed professional  
publication (such as OT Practice, SIS  
Quarterly and Advance).  
Two hours of continuing education  
may be earned for publishing a  
practice related article in a lay  
publication.  
If audited, an applicant shall submit a copy  
of the publication that identifies the  
applicant as the author of the publication or  
a publication acceptance letter.  
Five hours of continuing education  
may be earned for publishing a non  
peer-reviewed professional  
publication.  
(d) Independent reading of peer-reviewed  
articles or viewing or listening to media  
related to the practice of occupational  
therapy that does not include a self-  
assessment part.  
One hour of continuing education  
may be earned for each 60 minutes  
of participation.  
A maximum of 5 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit an  
affidavit attesting to the number of hours the  
applicant spent participating in these  
activities that includes a description of the  
activity.  
(e) Initial presentation of an academic or  
continuing education program that is not a  
part of the applicant’s regular job  
description.  
Three hours of continuing education  
may be earned for each 60 minutes  
of presentation.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit a copy  
of the curriculum and a letter from the  
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program sponsor verifying the length and  
date of the presentation.  
(f) Fieldwork supervision that is not part of the Level I: One hour of continuing  
applicant’s primary job description.  
education, for all supervision  
activities, may be earned per  
student.  
If audited, an applicant shall submit a copy  
of a letter of verification or certificate from  
school including dates of fieldwork and  
name of fieldwork student.  
Level II: One hour of continuing  
education may be earned for each  
week of supervision per student  
supervised.  
A maximum of 12 hours of  
continuing education may be earned  
in each renewal period.  
(g) Participating on a state or national board,  
board of a local chapter, association, or  
committee, or volunteering if the activity  
enhances the participant’s knowledge and  
understanding of the field of occupational  
therapy.  
A maximum of 10 hours of  
continuing education may be earned  
for this activity in each renewal  
period.  
Attendance at a meeting equals 1  
credit hour of continuing education.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
participation in not less than 50% of the  
regularly scheduled meetings of the board.  
Attendance at a volunteering activity  
equals 1 credit hour of continuing  
education.  
(h) Primary or co-primary investigator in  
research activities or outcome studies, or  
externally funded service training projects  
associated with grants or post-graduation  
studies related to the field of occupational  
therapy.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
participation as a primary or co-primary  
investigator or in externally funded service  
training projects associated with grants or  
post-graduation studies related to the field of  
occupational therapy.  
History: 2017 AACS;2021 AACS;2023 MR 8, Eff. April 26, 2023.  
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;