DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
OCCUPATIONAL THERAPISTS – GENERAL RULES  
(By authority conferred on the department of licensing and regulatory affairs by  
sections 16145, 16148, 16204, 18307, 18309, and 18313 of the public health code, 1978  
PA 368, MCL 333.16145, 333.16148, 333.16204, 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R 338.1191 Rescinded.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R 338.1192 Rescinded.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R 338.1194 Rescinded.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R 338.1196 Rescinded.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R 338.1197 Rescinded.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R 338.1197a Rescinded.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R 338.1198 Rescinded.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.  
Page 1  
R 338.1200 Rescinded.  
History: 1993 AACS; 2014 AACS.  
PART 1. DEFINITIONS  
R 338.1211 Definitions.  
Rule 11. (1) As used in these rules:  
(a) "Board" means the board of occupational therapists.  
(b) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to  
333.25211.  
(c) "Department" means the department of licensing and regulatory affairs.  
(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 MR 9, Eff. May 3, 2021.  
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 MR 9, Eff. May 3, 2021.  
R 338.1213 Rescinded.  
History: 2014 AACS; 2021 MR 9, Eff. May 3, 2021.  
R 338.1215 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 15. (1) Pursuant to section 16148 of the code, MCL 333.16148, an individual  
seeking licensure or licensed under article 15 of 1978 PA 368 shall complete training in  
identifying victims of human trafficking that meets all the following standards:  
(a) Training content shall 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 health care settings.  
(iii) Identifying the warning signs of human trafficking in health care settings for  
adults and minors.  
(iv) Identifying resources for reporting suspected victims of human trafficking.  
Page 2  
(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, health care 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 a sample of individuals and request  
documentation of proof of completion of training. If audited by the department, an  
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 individual’s name.  
(b) A self-certification statement by an individual. The certification statement shall  
include the individual’s name and either 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 peer review journal, health care journal, or  
professional or scientific journal, and date, volume, and issue of publication, as  
applicable.  
(3) Pursuant to section 16148 of the code, MCL 333.16148, the requirements  
specified in subrule (1) of this rule apply to license renewal beginning with the first  
renewal cycle after the promulgate of this rule and for initial or licenses issued 5 or more  
years after the promulgation of this rule.  
History: 2017 AACS.  
PART 3. OCCUPATIONAL THERAPISTS  
R 338.1221 License required; use of words, titles, or letters.  
Rule 21. Under section 18303 of the code, a person shall not use the following titles  
or similar words which indicate that the person is a licensed occupational therapist unless  
the person is granted an occupational therapist license under these rules:  
(a) "Occupational therapist."  
(b) "O.T."  
(c) "Occupational therapist licensed."  
(d) "O.T.L."  
Page 3  
(e) "Occupational therapist registered."  
(f) "O.T.R."  
(g) “Occupational therapist registered licensed.”  
(h) “O.T.R.L.”  
History: 2014 AACS.  
R 338.1222 Educational program standards; occupational therapist; adoption  
by reference.  
Rule 22. (1) The board approves and adopts by reference in these rules 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 the Accreditation Council for Occupational Therapy  
Education (ACOTE), which were effective July 31, 2020. Copies of these standards are  
available at no cost from the ACOTE website at https://acoteonline.org/wp-  
content/uploads/2020/07/2018-ACOTE-Standards.pdf. 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 W. 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 in these rules the standards in the  
document entitled "Minimum Standards for the Education of Occupational Therapists,  
Revised 2016” published by the World Federation of Occupational Therapists (WFOT).  
Copies of these standards are available at 10 cents per page on the (WFOT) website at  
http://www.wfot.org. The standards are also available for inspection at cost from the  
department at the address listed in subrule (1) of this rule.  
(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; 2021 MR 9, Eff. May 3, 2021.  
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 and these rules, an applicant must 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, and meets the  
standards adopted by the board under R 338.1222 or meets the requirements of R  
338.1225.  
Page 4  
(b) Within 3 years preceding 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 preceding 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.  
R 338.1223a Application for license; occupational therapist with lapsed registration;  
requirements.  
Rule 23a. (1) An applicant for an occupational therapist license whose registration  
as an occupational therapist in this state lapsed on or before January 13, 2009, shall  
submit the required fee and a completed application on a form, provided by the  
department, before June 11, 2015. An applicant shall meet all of the following  
requirements:  
(a) Maintain certification as an occupational therapist by the National Board for  
Certification in Occupational Therapy (NBCOT) after the registration lapsed.  
(b) Pass the examination on laws and rules related to the practice of occupational  
therapy in this state which is developed and administered by the department or an entity  
approved by the department.  
(c) Complete a supervised practice experience that meets the requirements of R  
338.1228. The duration of the experience must be as follows:  
(i) If the applicant’s registration has lapsed for at least 3 years but less than 7  
years, the applicant shall complete not less than 200 hours of supervised practice  
experience.  
(ii) If the applicant’s registration 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.  
(iii) If the applicant’s registration has lapsed for 15 years or more, the applicant  
shall complete not less than 600 hours of supervised practice experience.  
(2) An applicant’s license or registration must be verified, on a form supplied by the  
department, by the licensing agency of any state in which the applicant holds a current  
license or registration or ever held a license or registration as an occupational therapist. If  
applicable, verification must include the record of any disciplinary action taken or  
pending against the applicant.  
(3) An applicant for licensure who was registered in this state as an occupational  
therapist before January 1, 2009, whose registration had lapsed, and who did not apply  
for licensure prior to June 11, 2015, shall complete the requirements of R 338.1223.  
(4) For purposes of meeting the requirements of subrule (1)(c) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(5) A limited license granted under subrule (4) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
Page 5  
R 338.1223a Application for license; occupational therapist with lapsed  
registration; requirements.  
Rule 23a. (1) An applicant for an occupational therapist license whose registration  
as an occupational therapist in this state lapsed on or before January 13, 2009, shall  
submit the required fee and a completed application on a form, provided by the  
department, prior to June 11, 2015. An applicant shall meet all of the following  
requirements:  
(a) Maintain certification as an occupational therapist by the National Board for  
Certification in Occupational Therapy (NBCOT) after the registration lapsed.  
(b) Pass the examination on laws and rules related to the practice of occupational  
therapy in this state which is developed and administered by the department or an entity  
approved by the department.  
(c) Complete a supervised practice experience that meets the requirements of R  
338.1228. The duration of the experience shall be as follows:  
(i) If the applicant’s registration has lapsed for at least 3 years but less than 7 years,  
the applicant shall complete not less than 200 hours of supervised practice experience.  
(ii) If the applicant’s registration 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.  
(iii) If the applicant’s registration has lapsed for 15 years or more, the applicant  
shall complete not less than 600 hours of supervised practice experience.  
(2) An applicant’s license or registration shall be verified, on a form supplied by the  
department, by the licensing agency of any state in which the applicant holds a current  
license or registration or ever held a license or registration as an occupational therapist. If  
applicable, verification shall include the record of any disciplinary action taken or  
pending against the applicant.  
(3) An applicant for licensure who was registered in this state as an occupational  
therapist before January 1, 2009, whose registration had lapsed, and who did not apply  
for licensure prior to June 11, 2015, shall complete the requirements of subrule (1) of this  
rule and R 338.1223.  
(4) For purposes of meeting the requirements of subrule (1)(c) of this rule, the board  
may grant an applicant a limited license to complete the supervised practice experience.  
(5) A limited license granted under subrule (4) of this rule is valid for 1 year and  
may not be renewed.  
History: 2014 AACS; 2017 AACS.  
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 which is developed and administered by the department  
Page 6  
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.  
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 and these rules, an applicant shall meet all of the following  
requirements:  
(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 preceding the application for licensure and not  
more than 2 years after the application for licensure.  
(c) Effective January 1, 2021, within 3 years preceding 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.  
History: 2014 AACS; 2021 MR 9, Eff. May 3, 2021.  
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. In addition to meeting the requirements of the code and these rules, an  
applicant meets the requirements of section 16186 of the code, MCL 333.16186, if the  
applicant satisfies the requirements of this rule, as applicable.  
(2) If an applicant is actively registered or licensed as an occupational therapist in  
another state of the United States for 5 years or more and is in good standing within 30  
days prior to 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 American Occupational Therapy  
Association (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  
Page 7  
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 of the United States for less than 5 years and is in good standing within 30  
days prior to filing an application for an occupational therapist license in this state, then  
the applicant shall comply with all 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, and meets  
the standards adopted by the board in R 338.1222.  
(b) Meet the requirements of subrule (2)(a) and (b) of this rule.  
(4) In addition to meeting the requirements of subrule (1) and either subrule (2) or  
(3) of this rule, an applicant’s license or registration must be verified, on a form supplied  
by the department, by the licensing agency of any state in which the applicant holds a  
current license or registration or ever held a license or registration as an occupational  
therapist. If applicable, verification shall include the record of any disciplinary action  
taken or pending against the applicant.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
R 338.1227 Requirements for relicensure; occupational therapist.  
Rule 27. (1) An applicant whose license has lapsed for less than 3 years preceding  
the date of application for relicensure may be relicensed under section 16201(3) of the  
code, MCL 333.16201, if the applicant meets all of the following requirements:  
(a) Submits the required fee and a completed application on a form provided by the  
department.  
(b) Establishes that he or she is of good moral character.  
(c) Submits proof of having completed the continuing education required in R  
338.1252 within the 3-year period immediately preceding the date of the application for  
relicensure. However, if the continuing education hours submitted with the application  
are deficient, the applicant has 2 years from the date of the application to complete the  
deficient hours. The application must be held and the license must not be issued until the  
continuing education requirements have been met.  
(2) An applicant for relicensure whose license has lapsed for 3 years or more  
preceding the date of application may be relicensed under section 16201(4) of the code,  
MCL 333.16201, if the applicant meets all of the following requirements:  
(a) Submits the required fee and a completed application on a form provided by the  
department.  
(b) Establishes that he or she is of good moral character.  
(c) Submits fingerprints as set forth in section 16174(3) of the code, MCL  
333.16174.  
(d) Submits proof of having completed the continuing education required in R  
338.1252 within the 3-year period immediately preceding the date of the application for  
relicensure. However, if the continuing education hours submitted with the application  
are deficient, the applicant has 2 years from the date of the application to complete the  
Page 8  
deficient hours. The application must be held and the license must not be issued until the  
continuing education requirements have been met.  
(e) Within 3 years preceding the application for relicensure and not more than 2  
years after the application for relicensure, passes 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.  
(f) Either of the following:  
(i) Within 3 years preceding the application for relicensure and not more than 2  
years after the application for relicensure, takes and passes the NBCOT certification  
examination for occupational therapists, with a score adopted by the board under R  
338.1224(1), and completes supervised practice experience pursuant to subrule (3) of this  
rule.  
(ii) Presents evidence to the department that he or she was actively registered or  
licensed as an occupational therapist in another state during the 3-year period and in good  
standing within 30 days, prior to filing the application for relicensure.  
(3) An applicant who meets the requirements of subrule (2)(f)(i) of this rule shall  
complete a supervised practice experience that meets the requirements of R 338.1228.  
The applicant must have a limited license from the department while he or she  
participates in the supervised practice experience. The duration of the experience must be  
as follows:  
(a) If the applicant’s license has lapsed for at least 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.  
(4) In addition to meeting the requirements of either subrule (1) or subrules (2) and  
(3) of this rule, pursuant to section 16174 of the code, MCL 333.16174, an applicant’s  
license or registration must be verified, on a form supplied by the department, by the  
licensing agency of any state in which the applicant holds a current license or registration  
or ever held a license or registration as an occupational therapist. Verification includes,  
but is not limited to, showing proof of any disciplinary action taken or pending against  
the applicant.  
(5) For purposes of meeting the requirements of subrule (3) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(6) A limited license granted under subrule (5) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
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:  
Page 9  
(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 MR 9, Eff. May 3, 2021.  
R 338.1229 Delegation of limited assessments, tasks or interventions to an  
occupational therapy assistant; supervision of an occupational therapy assistant;  
requirements.  
Rule 29. (1) An occupational therapist who delegates the performance of selected  
limited assessments, tasks or interventions to an occupational therapy assistant as  
permitted 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) An occupational therapist who delegates limited assessments, tasks, or  
interventions to an occupational therapy assistant shall ensure the qualifications of the  
occupational therapy assistant under the occupational therapist’s supervision, 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 and includes 1 of the following:  
(a) “General supervision” means that the occupational therapist is not required to  
be physically present on site but shall be continuously available at the time the limited  
assessment, task, or intervention is performed. Continuously available includes  
availability by telecommunication or other electronic device.  
(b) “Direct supervision” means that the occupational therapist is physically present  
with the occupational therapy assistant or immediately available for direction and onsite  
supervision at the time the limited assessment, task, or intervention is performed, and that  
Page 10  
the occupational therapist has direct contact in the physical presence of the patient or  
client during each visit.  
(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 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 have been delegated.  
(d) Provide predetermined procedures and protocols for limited assessments, tasks,  
or interventions that have been delegated.  
(e) Monitor an occupational therapy assistant’s practice and provision 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 evaluate the assistant’s performance, review client or patient records,  
and educate the occupational therapy assistant on the limited assessments, tasks, or  
interventions that have been delegated to facilitate professional growth and development.  
The occupational therapist shall maintain documentation of the meeting that has been  
signed by both the occupational therapist and the occupational therapy assistant.  
Compliance with this subdivision shall 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:  
(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 MR 9, Eff. May 3, 2021.  
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 permitted 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 any other 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. As used in this subrule, “direct  
Page 11  
supervision” means that the occupational therapist is physically present with the  
unlicensed individual or immediately available for direction and onsite supervision when  
patients or clients are present at the time the task is performed, and that the occupational  
therapist has direct contact with the patient or client during each visit.  
(3) An occupational therapist who delegates tasks under subrule (2) of this rule shall  
also comply with all of the following:  
(a) Ensure 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) Supervise an unlicensed individual to whom tasks have been delegated.  
(d) Provide predetermined procedures and protocols for tasks that have been  
delegated.  
(e) Under section 16213 of the code, MCL 333.16213, maintain a record of the  
names of the unlicensed individuals to whom tasks have been delegated.  
(f) Monitor an unlicensed individual’s practice and provision 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 the performance of an occupational  
therapy intervention to an unlicensed individual.  
(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 MR 9, Eff. May 3, 2021.  
PART 4. OCCUPATIONAL THERAPY ASSISTANTS  
R 338.1231 License required; occupational therapy assistant; use of words,  
titles, or letters.  
Rule 31. Under section 18303 of the code, a person shall not use the following titles  
or similar words which indicate that the person is a licensed occupational therapy  
assistant unless the person is granted an occupational therapy assistant license under these  
rules:  
(a) "Certified occupational therapy assistant."  
(b) "C.O.T.A."  
(c) "Certified occupational therapy assistant licensed."  
(d) "C.O.T.A.L."  
(e) “Occupational therapy assistant.”  
(f) “O.T.A.”  
(g) “Occupational therapy assistant licensed.”  
(h) “O.T.A.L.”  
Page 12  
History: 2014 AACS.  
R 338.1232 Educational program standards; occupational therapy assistant;  
adoption by reference.  
Rule 32. (1) The board approves and adopts by reference in these rules 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  
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 W. 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; 2021 MR 9, Eff. May 3, 2021.  
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 and these rules, 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 preceding the application for licensure and not more than 2 years  
after the application for licensure, the applicant shall pass an occupational therapy  
assistant licensure examination that is approved by the board.  
(c) Within 3 years preceding 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.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
R 338.1233a Application for license; occupational therapy assistant with lapsed  
registration; requirements.  
Rule 33a. (1) An applicant for an occupational therapy assistant license whose  
registration as an occupational therapy assistant in this state lapsed on or before January  
13, 2009, shall submit the required fee and a completed application on a form, provided  
Page 13  
by the department, before June 11, 2015. An applicant shall meet all of the following  
requirements:  
(a) Maintain certification as an occupational therapy assistant by the NBCOT after  
the registration lapsed.  
(b) 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.  
(c) Complete a supervised practice experience that meets the requirements of R  
338. 1237. The duration of the experience must be as follows:  
(i) If the applicant’s registration has lapsed for 3 years but less than 7 years, the  
applicant shall complete not less than 200 hours of supervised practice experience.  
(ii) If the applicant’s registration 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.  
(iii) If the applicant’s registration has lapsed for 15 years or more, the applicant  
shall complete not less than 600 hours of supervised practice experience.  
(2) An applicant’s license or registration must be verified, on a form supplied by the  
department, by the licensing agency of any state in which the applicant holds a current  
license or registration or ever held a license or registration as an occupational therapy  
assistant. Verification includes, but is not limited to, showing proof of any disciplinary  
action taken or pending against the applicant.  
(3) An applicant for licensure who was registered in this state as an occupational  
therapy assistant prior to January 13, 2009, whose registration had lapsed, and who did  
not apply for licensure prior to June 11, 2015, shall complete the requirements of R  
338.1233.  
(4) For purposes of meeting the requirements of subrule (1)(c) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(5) A limited license granted under subrule (4) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
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.  
Page 14  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
R 338.1234a  
Graduate of non-accredited postsecondary institution;  
occupational therapy assistant; equivalency of education; NBCOT examination.  
Rule 34a. (1) 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 and these rules, 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 preceding the application for licensure  
and not more than 2 years after the application for licensure.  
(c) Within 3 years preceding 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.  
(2) This rule is effective on January 1, 2021.  
History: 2021 MR 9, Eff. May 3, 2021.  
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. In addition to meeting the requirements of the code and  
these rules, an applicant meets the requirements of section 16186 of the code, MCL  
333.16186, if the applicant satisfies the requirements of this rule, as applicable.  
(2) If an applicant is actively registered or licensed in another state of the United  
States for 5 years or more and is in good standing as an occupational therapy assistant  
within 30 days prior to filing an application for a 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 of the United States for less than 5 years and is in good standing  
Page 15  
within 30 days prior to filing an application for an occupational therapy assistant license  
in this state, then the applicant shall comply with all 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’s license or registration must be verified, on a form supplied  
by the department, by the licensing agency of any state in which the applicant holds a  
current license or registration or ever held a license or registration as an occupational  
therapy assistant. Verification includes, but is not limited to, showing proof of any  
disciplinary action taken or pending against the applicant.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
R 338.1236 Requirements for relicensure; occupational therapy assistant.  
Rule 36. (1) An applicant whose license has lapsed for less than 3 years preceding  
the date of application for relicensure may be relicensed under section 16201(3) of the  
code, MCL 333.16201(3), if the applicant meets all of the following requirements:  
(a) Submits the required fee and a completed application on a form provided by the  
department.  
(b) Establishes that he or she is of good moral character.  
(c) Submits proof of having completed the continuing education required in R  
338.1252 within the 3-year period immediately preceding the date of the application for  
relicensure. However, if the continuing education hours submitted with the application  
are deficient, the applicant has 2 years from the date of the application to complete the  
deficient hours. The application must be held and the license must not be issued until the  
continuing education requirements have been met.  
(2) An applicant for relicensure whose license has lapsed for 3 years or more  
preceding the date of application may be relicensed under section 16201(4) of the code,  
MCL 333.16201, if the applicant meets all of the following requirements:  
(a) Submits the required fee and a completed application on a form provided by the  
department.  
(b) Establishes that he or she is of good moral character.  
(c) Submits fingerprints as set forth in section 16174(3) of the code, MCL  
333.16174.  
(d) Submits proof of having completed the continuing education required in R  
338.1252 within the 3-year period immediately preceding the date of the application for  
relicensure. However, if the continuing education hours submitted with the application  
are deficient, the applicant has 2 years from the date of the application to complete the  
deficient hours. The application must be held and the license must not be issued until the  
continuing education requirements have been met.  
(e) Within 3 years preceding the application for relicensure and not more than 2  
years after the application for licensure, passes the examination on laws and rules related  
Page 16  
to the practice of occupational therapy in this state that is developed and administered by  
the department or an entity approved by the department.  
(f) Either of the following:  
(i) Within 3 years preceding the application for relicensure and not more than 2  
years after the application for licensure, takes and passes the NBCOT certification  
examination for occupational therapy assistants with a score adopted by the board under  
R 338.1234(1) and completes supervised practice experience pursuant to subrule (3) of  
this rule.  
(ii) Presents evidence to the department that he or she was actively registered or  
licensed as an occupational therapy assistant in another state during the 3-year period and  
was in good standing within 30 days prior to filing the application for relicensure.  
(3) An applicant who meets the requirements of subdivision (2)(f)(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 at least 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 15 years or less, 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.  
(4) In addition to meeting the requirements of either subrule (1) or subrules (2) and  
(3) of this rule, pursuant to section 16174 of the code, MCL 333.16174, an applicant’s  
license or registration must be verified, on a form supplied by the department, by the  
licensing agency of any state in which the applicant holds a current license or registration  
or ever held a license or registration as an occupational therapy assistant. Verification  
includes, but is not limited to, showing proof of any disciplinary action taken or pending  
against the applicant.  
(5) For purposes of meeting the requirements of subrule (3) of this rule, the  
department may grant an applicant a limited license to complete the supervised practice  
experience.  
(6) A limited license granted under subrule (5) of this rule is valid for 1 year and  
may be renewed 1 time.  
History: 2014 AACS; 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
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.  
Page 17  
(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 MR 9, Eff. May 3, 2021.  
R 338.1238 Rescinded.  
History: 2014 AACS; 2017 AACS.  
PART 5. CONTINUING EDUCATION  
R 338.1251 License renewal; occupational therapist; occupational therapy  
assistant; requirements.  
Rule 51. (1) This part applies to applications for renewal of licensure that are filed  
for the renewal cycle beginning 1 year or more after the effective date of these rules.  
(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) A licensee shall retain documentation of meeting the requirements of this rule for  
a period of 4 years from 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 before the expiration date of the license.  
(7) The requirements of this part do not apply to an applicant during an initial  
licensure cycle.  
History: 2017 AACS; 2021 MR 9, Eff. May 3, 2021.  
Page 18  
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 on-  
line or electronic media, such as videos, internet web-based seminars, video conferences,  
on-line continuing education programs, and on-line journal articles that are asynchronous  
and not interactive.  
(b) 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.  
(2) One-half of the required continuing education contact hours must be completed  
by live, synchronous, and interactive courses and programs. The remaining continuing  
education contact hours may be completed in any other format.  
(3) The following are acceptable continuing education activities:  
ACCEPTABLE CONTINUING EDUCATION ACTIVITIES  
(a) Completion of an approved continuing  
The number of hours approved by  
education program or activity related to the the sponsor or the approving  
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:  
organization.  
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.  
NBCOT.  
International Association for Continuing  
Education and Training (IACET)  
authorized providers.  
Another state or provincial board of  
occupational therapy.  
Credit in this category may be earned  
without limitation.  
Michigan Occupational Therapy  
Association (MIOTA).  
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.  
Page 19  
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 on which 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  
program approved by the board pursuant to  
R 338.1222.  
credit hour earned.  
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  
Credit in this category may be earned  
without limitation.  
semester or quarter credit hours earned.  
(c) Initial publication of a chapter or an article  
related to the practice of occupational  
therapy in either of the following:  
A peer-reviewed textbook.  
A maximum of 10 hours may be  
earned in each renewal period.  
10 hours of continuing education can  
may be earned for a publishing a  
peer-reviewed textbook, professional  
healthcare textbook or a peer-  
A professional health care textbook.  
A peer-reviewed journal or periodical.  
Practice area related article in lay  
publication (community newspaper and  
newsletter).  
reviewed journal or periodical.  
Non-peer reviewed professional publication 2 hours of continuing education may  
(such as OT Practice, SIS Quarterly and  
Advance).  
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  
5 hours of continuing education may  
applicant as the author of the publication or be earned for publishing a non-peer  
a publication acceptance letter.  
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 component.  
One hour for each 60 minutes of  
participation.  
A maximum of 5 hours 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  
Page 20  
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 may be earned for each  
60 minutes of presentation.  
A maximum of 10 hours may be  
earned in each renewal period.  
If audited, an applicant shall submit a copy  
of the curriculum and a letter from the  
program sponsor verifying the length and  
date of the presentation.  
(f) Fieldwork supervision that is not part of the Level I: One hour for all supervision  
applicant’s primary job description. activities may be earned per student.  
If audited, an applicant shall submit a copy Level II: One hour may be earned  
of a letter of verification or certificate from for each week of supervision per  
school including dates of fieldwork and  
name of fieldwork student.  
student supervised.  
A maximum of 12 hours may be  
earned in each renewal period.  
(g) Participating on a state or national board, or A maximum of 10 hours of  
board of a local chapter or association or  
committee, or volunteering related to the  
field of occupational therapy. A state or  
national board, or board of a local chapter  
or association is considered acceptable by  
the board if it enhances the participant’s  
knowledge and understanding of the field of  
occupational therapy.  
continuing education may be earned  
for this activity in each renewal  
period.  
Attendance at a meeting equals 1  
credit hour of continuing education.  
Attendance at a volunteering activity  
equals 1 credit hour of continuing  
education.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
participation in at least 50% of the regularly  
scheduled meetings of the board.  
(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.  
(i) Completion of competency assessment or  
knowledge skills assessment activities, or  
both, either online or in person by an  
approved provider or employer.  
A maximum of 10 hours may be  
earned in each renewal period.  
If audited, an applicant shall submit  
Page 21  
documentation to include a certificate of  
completion or similar document including  
name, activity, date, sponsoring  
organization, location and time attended.  
History: 2017 AACS;2021 MR 9, Eff. May 3, 2021.  
Page 22