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R 338.1191 Rescinded.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R 338.1192 Rescinded.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R 338.1194 Rescinded.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R 338.1196 Rescinded.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R 338.1197 Rescinded.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R 338.1197a Rescinded.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.  
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R 338.1198 Rescinded.  
History: 1993 AACS; 2014 AACS.  
R 338.1200 Rescinded.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 Michigan 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) “IACET” means International Accreditors for Continuing Education and  
Training.  
(i) “NBCOT” means National Board for Certification in Occupational Therapy.  
(j) “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 AACS; 2026 MR 6, Eff. March 19, 2026.  
PART 2. GENERAL PROVISIONS  
R 338.1212 Rescinded.  
History: 2014 AACS; 2021 AACS; 2026 MR 6, Eff. March 19, 2026.  
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R 338.1213 Rescinded.  
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 who 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  
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journal, or professional or scientific journal, and the date, volume, and issue of  
publication, as applicable.  
History: 2017 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
PART 2. OCCUPATIONAL THERAPISTS  
SUBPART A. EDUCATIONAL STANDARDS AND EXAMINATION  
APPROVAL AND ADOPTION  
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  
"2023 Accreditation Council for Occupational Therapy Education (ACOTE)  
Standards and Interpretive Guide," adopted by ACOTE, effective July 31, 2025.  
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 25 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) 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 and distribution at 25 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.  
(3) An educational program for occupational therapists that is accredited by  
the ACOTE or its predecessor organization is approved by the board. An  
educational program for occupational therapists that is approved by the WFOT or  
its predecessor organization is approved by the board. An occupational therapist  
educational program that is not accredited by the ACOTE and not approved by the  
WFOT, or either of their predecessor organizations, may be approved by the board  
if the board determines that it is substantially equivalent to a program accredited  
by the ACOTE or approved by the WFOT, or either of their predecessor  
organizations.  
(4) 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
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R 338.1221a Examination; adoption and approval; passing scores.  
Rule 21a. 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 adopts the passing score recommended by the NBCOT for the certification  
examination.  
History: 2026 MR 6, Eff. March 19, 2026.  
R 338.1222 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 AACS.  
SUBPART B. LICENSURE  
R 338.1223 Initial occupational therapist license; requirements.  
Rule 23. An applicant for an initial 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 the rules  
promulgated under the code, an applicant shall meet all of the following  
requirements:  
(a) Complete an occupational therapist education program approved by the  
board under R 338.1221.  
(b) Not more than 3 years before and not more than 2 years after applying for  
licensure, an applicant shall pass the occupational therapist licensure examination  
adopted in R 338.1221a.  
(c) 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.  
(d) 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1223a Rescinded.  
History: 2014 AACS; 2017 AACS; 2023 AACS.  
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R 338.1224 Rescinded.  
History: 2014 AACS; 2017 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1225 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
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 the rules  
promulgated under the code, an applicant shall satisfy the following requirements,  
as applicable:  
(a) If an applicant has been actively registered or licensed as an occupational  
therapist in at least 1 state or actively licensed in at least 1 province of Canada for  
5 years or more, the applicant shall comply with both of the following:  
(i) Hold an active registration or license in good standing in another state or  
active license in good standing in a province of Canada within 30 days before  
applying for licensure by endorsement.  
(ii) Have taken and passed the NBCOT certification examination for  
occupational therapists with a score adopted by the board under R 338.1221a or  
the predecessor examination that was administered by the AOTA.  
(b) If an applicant has been actively registered or licensed as an occupational  
therapist in at least 1 or more states or licensed in at least 1 province of Canada  
for less than 5 years, the applicant shall comply with all of the following:  
(i) Hold the active registration or licensee in good standing in another state  
or active license in good standing in a province of Canada within 30 days before  
applying for licensure by endorsement.  
(ii) Have successfully completed an occupational therapist education  
program that meets the standards adopted by the board in R 338.1221.  
(iii) Have taken and passed the NBCOT certification examination for  
occupational therapists with a score adopted by the board under R 338.1221a or  
the predecessor examination that was administered by the AOTA.  
(2) In addition to meeting the requirements of subrule (1) 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.  
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History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1227 Requirements for relicensure; occupational therapist.  
Rule 27. (1) An applicant for relicensure as an occupational therapist whose  
license or registration from this state has lapsed, 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 whose  
Registere  
License  
Licens  
registration or license from this state hasd in this statehas beene has been  
lapsed:  
before  
January  
2009,  
lapsed lesslapsed  
3
or  
1,than  
withyears.  
3years  
more.  
lapsed  
registration,  
and did not  
apply  
for  
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 therapist by NBCOT after the  
registration lapsed and graduated from an  
occupational therapist education program  
√
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that meets the standards adopted by the  
board under R 338.1221.  
(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) Satisfy 1 of the following:  
(i) Not more than 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  
338.1221a, and complete supervised  
practice experience pursuant to subrule (2) of  
this rule.  
√
√
(ii) Provide 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.  
(i) An applicant who 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 who has had a lapsed registration or license for 3 years or  
more and meets the requirements of subrule (1)(h)(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 3 years but less than 7 years, the  
applicant shall complete not less than 200 hours of supervised practice  
experience.  
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(b) If the applicant’s license has lapsed for 7 years 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 15 years or more, 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1228 Supervised practice experience; occupational therapist;  
requirements.  
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 an occupational therapist who is licensed in this state and who has  
3 or more years clinical experience and no past or pending disciplinary actions.  
(b) The supervising occupational therapist shall provide the department 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 or referral for other services, or both.  
(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; 2021 AACS; 2026 MR 6, Eff. March 19, 2026.  
SUBPART C. DELEGATION AND SUPERVISION  
R 338.1229 Delegation of limited assessments, tasks or interventions to  
an occupational therapy assistant; supervision of an occupational therapy  
assistant; requirements; limitation.  
Rule 29. (1) An occupational therapist who delegates the performance of  
limited assessments, tasks, or interventions to an occupational therapy assistant  
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as allowed under section 16215 of the code, MCL 333.16215, shall supervise the  
occupational therapy assistant consistent with subrule (3) 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 in person or 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.  
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(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 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
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) Under section 16171 of the code, MCL 333.16171, the requirements of  
subrule (3)(b) 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
PART 3. OCCUPATIONAL THERAPY ASSISTANTS  
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SUBPART A. EDUCATIONAL STANDARDS AND EXAMINATION  
APPROVAL AND ADOPTION  
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, effective July 31,  
2025. 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 25 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 is approved by the board. An occupational therapist  
assistant educational program that is not accredited by the ACOTE may be  
approved by the board if the board determines that it is substantially equivalent to  
a program accredited by the ACOTE.  
History: 2014 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1231a Examination; occupational therapy assistant; adoption and  
approval; passing scores.  
Rule 31a. 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.  
History: 2026 MR 6, Eff. March 19, 2026.  
R 338.1232 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 AACS.  
SUBPART B. LICENSURE  
R 338.1233 Initial occupational therapy assistant license; requirements.  
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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 the rules  
promulgated under the code, an applicant shall meet all of the following  
requirements:  
(a) Complete an occupational therapy assistant educational program that  
meets the standards adopted by the board under R 338.1231.  
(b) Not more than 3 years before and not more than 2 years after applying for  
licensure, the applicant shall pass the occupational therapy assistant licensure  
examination adopted in R 338.1231a.  
(c) 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.  
(d) 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1233a Rescinded.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2023 AACS.  
R 338.1234 Rescinded.  
History: 2014 AACS; 2017 AACS; 2021 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1234a Rescinded.  
History: 2021 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
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 the rules promulgated under the code, an applicant shall satisfy the following  
requirements, as applicable:  
(a) If an applicant has been actively registered or licensed as an occupational  
therapy assistant in at least 1 state or licensed in at least 1 province of Canada for  
5 years or more, the applicant shall comply with both of the following:  
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(i) Hold an active registration or license in good standing in another state or  
active license in good standing in a province of Cananda within 30 days before  
applying for licensure by endorsement.  
(ii) Have taken and passed the NBCOT certification examination for  
occupational therapy assistants with a score adopted by the board under R  
338.1231a.  
(b) If an applicant has been actively registered or licensed as an occupational  
therapist assistant in at least 1 state or licensed in at least 1 province of Canada  
for less than 5 years, then the applicant shall comply with all of the following:  
(i) Hold an active registration or license in good standing in another state or  
active license in good standing in a province of Canada within 30 days before  
applying for licensure by endorsement.  
(ii) Have successfully completed an occupational therapy assistant education  
program that meets the standards adopted by the board in R 338.1231.  
(iii) Have taken and passed the NBCOT certification examination for  
occupational therapy assistants with a score adopted by the board under R  
338.1231a.  
(2) In addition to meeting the requirements of subrule (1) 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1236  
assistant.  
Requirements for relicensure; occupational therapy  
Rule 36. (1) An applicant for relicensure as an occupational therapy assistant,  
whose license or registration from this state has lapsed, 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  
Registere  
License  
License  
whose registration or license from thisd in this statehas  
beenhas been  
state has lapsed:  
before  
January  
2009,  
lapsed lesslapsed  
3
or  
1,than  
3years  
more.  
withyears.  
lapsed  
registration,  
and did not  
apply  
for  
licensure  
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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  
occupational  
from  
an  
accredited  
assistant  
therapy  
educational program that meets the  
standards adopted by the board under R  
338.1231.  
(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) Satisfy 1 of the following:  
(i) Not more than 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 338.1231a, and after  
passing the examination complete  
supervised practice experience pursuant  
to subrule (2) of this rule.  
(ii) Provide 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.  
(i) An applicant who 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 who has a lapsed registration or license for 3 years or more  
and meets the requirements of subrule (1)(h)(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 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 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 15 years or more, 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
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 an occupational therapist who is licensed in this state and who has  
3 or more years clinical experience and no past or pending disciplinary actions.  
(b) The supervising occupational therapist shall provide the department 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 or referral for other services, or both.  
(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; 2026 MR 6, Eff. March 19, 2026.  
R 338.1238 Rescinded.  
History: 2014 AACS; 2017 AACS.  
PART 4. TELEHEALTH  
R 338.1241 Telehealth; consent; requirements.  
Rule 41.  
(1) A licensee shall obtain consent for treatment before providing a telehealth  
service under section 16284 of the code, MCL 333.16284. Consent requires all of  
the following:  
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(a) A licensee shall ensure that the patient understands that treatment is  
provided remotely using telehealth.  
(b) At the inception of care, a licensee shall identify themself to the patient as  
an occupational therapist or occupational therapy assistant.  
(c) A licensee shall ensure that the patient is mentally capable of giving  
consent for diagnosis, care, or treatment.  
(d) A licensee shall explain the alternatives, capabilities, and limitations of  
telemedicine and advise the patient that they 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 consent for the telehealth  
service.  
(3) A licensee shall keep proof of consent for a telehealth treatment in the  
patient’s up-to-date medical record in compliance with 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 the licensee’s 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 the patient’s unique presentation.  
(5) A licensee shall be able to examine the patient via a health insurance  
portability and accountability act 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 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1243 Rescinded.  
History: 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
PART 5. LICENSE RENEWAL AND CONTINUING EDUCATION  
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.  
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(2) An applicant for license renewal shall accumulate not less than 20  
continuing education hours that are approved by the board under 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 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/ot.  
History: 2017 AACS; 2021 AACS; 2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
R 338.1252 Acceptable continuing education; occupational therapist;  
occupational  
therapy assistant; requirements.  
Rule 52. (1) Under 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) A licensee may not earn continuing education credit for completing a  
continuing education program or activity that is identical or substantially identical  
to a program or activity the licensee has already earned continuing education credit  
for during that renewal period.  
(3) If a licensee completes a continuing education program approved by the  
board that satisfies the 1-time training in human trafficking requirement, that  
program may be used to satisfy the human trafficking training requirement and  
continuing education credit for license renewal during that renewal period.  
(4) If a licensee completes a continuing education program approved by the  
board that satisfies the implicit bias training required under R 338.7004, that  
program may be used to satisfy the requirements of R 338.7004 and continuing  
education credit for license renewal during that renewal period.  
(5) The following are acceptable continuing education activities:  
ACCEPTABLE CONTINUING EDUCATION ACTIVITIES  
(a)  
Completion  
of  
an  
approved  
The number of hours  
continuing education program or activity approved by the sponsor or the  
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related to the practice of occupational approving organization may be  
therapy. A continuing education earned in each renewal period.  
program or activity is approved if it is  
approved or offered for continuing  
If the activity was not  
education credit by any of the following: approved for a set number of  
AOTA.  
hours, then 1 hour of continuing  
education for each 60 minutes of  
IACET authorized providers.  
Michigan Occupational Therapy participation may be earned.  
Association.  
NBCOT.  
Credit in this category may be  
Another state or provincial board of earned without limitation.  
occupational therapy.  
An occupational therapy education  
program approved by the board in R  
338.1221.  
If the subject matter of the training  
addresses an occupational therapy  
service  
as  
defined  
in  
section  
18301(1)(c) of the code, MCL  
333.18301, and the occupational  
therapy service is identified on the  
certificate of completion, an employer-  
provided work-place training.  
If the subject matter of the training  
addresses an occupational therapy  
service  
as  
defined  
in  
section  
18301(1)(c) of the code, MCL  
333.18301, and the occupational  
therapy service is identified on the  
certificate of completion, a third-party  
presentation.  
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  
Five hours of continuing  
related to the practice of occupational education may be earned for  
therapy offered in an occupational each semester credit hour  
therapy education program approved by earned.  
the board pursuant to R 338.1221.  
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If audited, an applicant shall submit  
Three hours of continuing  
an official transcript that reflects education may be earned for  
completion of the academic course and each quarter credit hour earned.  
number of semester or quarter credit  
hours earned.  
Credit in this category may be  
earned without limitation.  
(c)  
Initial publication of a chapter or an  
A maximum of 10 hours of  
article related to the practice of continuing education may be  
occupational therapy written by the earned in each renewal period.  
applicant in any of the following:  
A peer-reviewed textbook.  
Ten hours of continuing  
A professional healthcare textbook. education may be earned for  
A
peer-reviewed  
journal  
or publishing  
textbook,  
a
peer-reviewed  
professional  
periodical.  
A practice area related article in a lay healthcare textbook, or a peer-  
publication (community newspaper or reviewed journal or periodical.  
newsletter).  
A non-peer-reviewed professional  
Two hours of continuing  
publication (such as OT Practice, SIS education may be earned for  
Quarterly and Advance).  
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  
Five hours of continuing  
publication or a publication acceptance education may be earned for  
letter.  
publishing a non peer-reviewed  
professional publication.  
(d)  
Independent reading or listening to  
One hour of continuing  
the audio format of peer-reviewed education may be earned for  
articles related to the practice of each 60 minutes of participation.  
occupational therapy that does not  
include a self-assessment part.  
A maximum of 5 hours of  
continuing education may be  
If audited, an applicant shall submit earned in each renewal period.  
an affidavit attesting to the date  
completed and the number of hours the  
applicant spent participating in these  
activities and a bibliography listing the  
journal, article, the author or authors,  
and publication date.  
(e)  
Initial presentation of an academic  
Three hours of continuing  
or continuing education program by the education may be earned for  
applicant that is not a part of the each 60 minutes of presentation.  
applicant’s regular job description.  
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If audited, an applicant shall submit  
A maximum of 10 hours of  
a copy of the curriculum and a letter continuing education may be  
from the program sponsor verifying the earned in each renewal period.  
length and date of the presentation.  
(f)  
Fieldwork supervision that is not part  
Level I: One hour of  
of the applicant’s primary job continuing education, for all  
description.  
supervision activities, may be  
earned per student.  
If audited, an applicant shall submit  
a copy of a letter of verification or  
Level II:  
One hour of  
certificate from school including dates of continuing education may be  
fieldwork and name of fieldwork earned for each week of  
student.  
supervision  
supervised.  
per  
student  
A maximum of 12 hours of  
continuing education may be  
earned in each renewal period.  
Participating on a state or national A maximum of 10 hours of  
(g)  
board, board of a local chapter, continuing education may be  
association, or committee, or earned for this activity in each  
volunteering if the activity enhances the renewal period.  
participant’s  
understanding  
knowledge  
of the  
and  
of  
field  
Attendance at a meeting  
equals 1 credit hour of continuing  
education.  
occupational therapy.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
Attendance at a volunteering  
participation in not less than 50% of the activity equals 1 credit hour of  
regularly scheduled meetings of the continuing education.  
board.  
(h)  
Primary or co-primary investigator in  
A maximum of 10 hours of  
research activities or outcome studies, continuing education may be  
or externally funded service training earned in each renewal period.  
projects associated with grants or post-  
graduation studies related to the field of  
occupational therapy.  
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.  
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History: 2017 AACS;2021 AACS;2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
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;