DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
OCCUPATIONAL THERAPISTS – GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16141, 16145, 16148, 16174, 16175, 16178, 16186, 16186a, 16204,  
16205, 16215, 16287, 18307, 18309, and 18313 of the public health code, 1978 PA 368,  
MCL 333.16141, 333.16145, 333.16148, 333.16174, 333.16175, 333.16178, 333.16186,  
333.16186a, 333.16204, 333.16205, 333.16215, 333.16287, 333.18307, 333.18309, and  
333.18313, and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-  
4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)  
R 338.1191 Rescinded.  
History: 1993 AACS; 2014 AACS.  
R 338.1192 Rescinded.  
History: 1993 AACS; 2014 AACS.  
R 338.1194 Rescinded.  
History: 1993 AACS; 1997 AACS; 2014 AACS.  
R 338.1196 Rescinded.  
History: 1993 AACS; 1997 AACS; 2014 AACS.  
R 338.1197 Rescinded.  
History: 1997 AACS; 2014 AACS.  
R 338.1197a Rescinded.  
History: 1997 AACS; 2014 AACS.  
R 338.1198 Rescinded.  
Page 1  
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R 338.1200 Rescinded.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.  
R 338.1213 Rescinded.  
Page 2  
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 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  
Page 3  
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.  
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.  
Page 4  
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.  
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.  
Page 5  
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.  
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 registration Registered in License has License has  
or license from this state has lapsed:  
this state  
been lapsed been lapsed  
before Januaryless than 3 3 years or  
1, 2009, with years.  
lapsed  
more.  
registration,  
and did not  
apply for  
Page 6  
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 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  
Page 7  
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.  
(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  
requirements.  
Supervised practice experience; occupational therapist;  
Rule 28. (1) The supervised practice experience required for relicensure under R  
338.1227 must comply with both of the following:  
(a) The supervised practice experience must be obtained under the supervision of 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.  
Page 8  
(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 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.  
Page 9  
(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.  
(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.  
Page 10  
(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  
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.  
Page 11  
R 338.1232 Rescinded.  
History: 2014 AACS; 2021 AACS; 2023 AACS.  
SUBPART B. LICENSURE  
R 338.1233 Initial occupational therapy assistant license; requirements.  
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  
Page 12  
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:  
(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 Requirements for relicensure; occupational therapy assistant.  
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 whose Registered in License has License has  
registration or license from this state has  
lapsed:  
this state beforebeen lapsed been lapsed  
January 1,  
2009, with  
lapsed  
less than 3 3 years or  
years. more.  
registration,  
and did not  
apply for  
licensure  
Page 13  
before June 11,  
2015.  
(a) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(b) Establish that the applicant is of good  
moral character as defined in, and determined  
under, 1974 PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
(c) Submit fingerprints as required under  
section 16174(3) of the code, MCL  
333.16174.  
√
√
√
√
(d) Submit proof of having completed the  
continuing education required under R  
338.1252, which was earned within the 3-year  
period immediately before the application for  
relicensure. If the continuing education hours  
submitted with the application are deficient,  
the applicant has 2 years after the date of the  
application to complete the deficient hours.  
The application must be held, and the license  
may not be issued until the continuing  
education requirements are met.  
√
(e) Maintain certification as an occupational  
therapy assistant by the NBCOT after the  
registration lapsed and graduated from an  
accredited occupational therapy assistant  
educational program that meets the standards  
adopted by the board under R 338.1231.  
(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.  
(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  
√
√
Page 14  
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.  
(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.  
Page 15  
(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:  
(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.  
Page 16  
(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.  
(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  
Page 17  
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 continuing  
education program or activity related to the by the sponsor or the approving  
practice of occupational therapy. A organization may be earned in each  
The number of hours approved  
continuing education program or activity is renewal period.  
approved if it is approved or offered for  
continuing education credit by any of the  
following:  
If the activity was not approved  
for a set number of hours, then 1  
hour of continuing education for  
each 60 minutes of participation  
AOTA.  
IACET authorized providers.  
Michigan  
Association.  
NBCOT.  
Occupational  
Therapy may be earned.  
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  
Page 18  
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 related  
Five hours of continuing  
to the practice of occupational therapy education may be earned for each  
offered in an occupational therapy semester credit hour earned.  
education program approved by the board  
pursuant to R 338.1221.  
Three hours of continuing  
education may be earned for each  
If audited, an applicant shall submit an quarter credit hour earned.  
official transcript that reflects completion of  
the academic course and number of  
semester or quarter credit hours earned.  
Initial publication of a chapter or an  
Credit in this category may be  
earned without limitation.  
(c)  
A maximum of 10 hours of  
article related to the practice of occupational continuing education may be earned  
therapy written by the applicant in any of in each renewal period.  
the following:  
A peer-reviewed textbook.  
A professional healthcare textbook.  
A peer-reviewed journal or periodical.  
Ten hours of continuing  
education may be earned for  
publishing peer-reviewed  
a
A practice area related article in a lay textbook, professional healthcare  
publication (community newspaper or textbook, or a peer-reviewed journal  
newsletter).  
or periodical.  
A
non-peer-reviewed professional  
publication (such as OT Practice, SIS  
Quarterly and Advance).  
Two hours of continuing  
education may be earned for  
publishing a practice related article  
If audited, an applicant shall submit a in a lay publication.  
copy of the publication that identifies the  
applicant as the author of the publication or  
a publication acceptance letter.  
Five hours of continuing  
education may be earned for  
publishing a non peer-reviewed  
professional publication.  
(d)  
Independent reading or listening to the  
One hour of continuing  
audio format of peer-reviewed articles education may be earned for each 60  
related to the practice of occupational minutes of participation.  
Page 19  
therapy that does not include a self-  
assessment part.  
A maximum of 5 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit an  
affidavit attesting to the 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.  
Initial presentation of an academic or  
(e)  
Three hours of continuing  
continuing education program by the education may be earned for each 60  
applicant that is not a part of the applicant’s minutes of presentation.  
regular job description.  
A maximum of 10 hours of  
If audited, an applicant shall submit a continuing education may be earned  
copy of the curriculum and a letter from the in each renewal period.  
program sponsor verifying the length and  
date of the presentation.  
(f)  
Fieldwork supervision that is not part of  
the applicant’s primary job description.  
Level I: One hour of continuing  
education, for all supervision  
activities, may be earned per  
If audited, an applicant shall submit a student.  
copy of a letter of verification or certificate  
from school including dates of fieldwork  
and name of fieldwork student.  
Level II:  
One hour of  
continuing education may be earned  
for each week of supervision per  
student supervised.  
A maximum of 12 hours of  
continuing education may be earned  
in each renewal period.  
(g)  
Participating on a state or national  
A maximum of 10 hours of  
board, board of a local chapter, association, continuing education may be earned  
or committee, or volunteering if the activity for this activity in each renewal  
enhances the participant’s knowledge and period.  
understanding of the field of occupational  
therapy.  
Attendance at a meeting equals  
credit hour of continuing  
1
If audited, an applicant shall submit education.  
documentation verifying the licensee’s  
participation in not less than 50% of the  
Attendance at a volunteering  
regularly scheduled meetings of the board. activity equals 1 credit hour of  
continuing education.  
Page 20  
(h)  
Primary or co-primary investigator in  
A maximum of 10 hours of  
research activities or outcome studies, or continuing education may be earned  
externally funded service training projects in each renewal period.  
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.  
History: 2017 AACS;2021 AACS;2023 AACS; 2026 MR 6, Eff. March 19, 2026.  
Page 21  
;