DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
OCCUPATIONAL THERAPISTS – GENERAL RULES  
Filed with the secretary of state on April 26, 2023  
These rules become effective immediately after filing with the secretary of state  
unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of  
1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these  
sections become effective 7 days after filing with the secretary of state.  
(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 338.1211, R 338.1215, R 338.1221, R 338.1223, R 338.1224, R 338.1225, R 338.1226,  
R 338.1227, R 338.1229, R 338.1229a, R 338.1231, R 338.1233, R 338.1234a, R  
338.1235, R 338.1236, R 338.1251, and R 338.1252 of the Michigan Administrative  
Code are amended, R 338.1241 and R 338.1243 are added, and R 338.1222, R  
338.1223a, R 338.1232, and R 338.1233a are rescinded, as follows:  
PART 1. GENERAL PROVISIONS  
R 338.1211 Definitions.  
Rule 11. (1) As used in these rules:  
(a) “ACOTE” means Accreditation Council for Occupational Therapy Education.  
(b) “AOTA” means American Occupational Therapy Association.  
(c) "Board" means the board of occupational therapists.  
(d) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(e) "Department" means the department of licensing and regulatory affairs.  
(f) “Direct supervision” means that the occupational therapist is physically present or  
present via telemedicine with the individual being supervised or immediately available  
for direction and onsite supervision when the limited assessment, task, intervention, or  
interaction with the client is performed.  
(g) “General supervision” means that the occupational therapist is not required to be  
physically present on site or present during a telemedicine visit but is continuously  
available when the limited assessment, task, intervention, or interaction with the client is  
performed. Continuously available includes availability by telecommunication or another  
electronic device.  
December 13, 2022  
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(h) “NBCOT” means National Board for Certification in Occupational Therapy.  
(i) “WFOT” means World Federation of Occupational Therapists.  
(2) Unless otherwise defined in these rules, the terms defined in the code have the same  
meaning when used in these rules.  
R 338.1215 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 15. (1) Under section 16148 of the code, MCL 333.16148, an individual seeking  
licensure or that is licensed shall have completed training in identifying victims of human  
trafficking that satisfies the following standards:  
(a) Training content must cover all of the following:  
(i) Understanding the types and venues of human trafficking in the United States.  
(ii) Identifying victims of human trafficking in healthcare settings.  
(iii) Identifying the warning signs of human trafficking in healthcare settings for adults  
and minors.  
(iv) Identifying resources for reporting suspected victims of human trafficking.  
(b) Acceptable providers or methods of training including any of the following:  
(i) Training offered by a nationally recognized or state-recognized, health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training in an educational program that has been approved by the advisory  
committee for initial license or registration, or by a college or university.  
(iv) Reading an article related to the identification of human trafficking that meets the  
requirements of subdivision (a) of this subrule and is published in a peer-review journal,  
healthcare journal, or professional or scientific article.  
(c) Acceptable modalities of training including any of the following:  
(i) Teleconference or webinar.  
(ii) Online presentation.  
(iii) Live presentation.  
(iv) Printed or electronic media.  
(2) The department may select and audit an individual and request documentation of  
proof of completion of training. If audited by the department, the individual shall provide  
an acceptable proof of completion of training, including either of the following:  
(a) Proof of completion certificate issued by the training provider that includes the date,  
provider name, name of training, and the individual’s name.  
(b) A self-certification statement by the individual. The certification statement must  
include the individual’s name and 1 of the following:  
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,  
training provider name, and name of training.  
(ii) For training completed pursuant to subrule (1)(b)(iv) of this rule, the title of the  
article, author, publication name of the peer-review journal, healthcare journal, or  
professional or scientific journal, and the date, volume, and issue of publication, as  
applicable.  
PART 2. OCCUPATIONAL THERAPISTS  
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R 338.1221 Educational program standards; occupational therapist; adoption by  
reference.  
Rule 21. (1) The board approves and adopts by reference the standards for accrediting  
occupational therapist educational programs in the documents entitled "2018  
Accreditation Council for Occupational Therapy Education (ACOTE) Standards and  
Interpretive Guide," adopted by ACOTE, which were effective July 31, 2020. Copies of  
these standards are available at no cost from the ACOTE website at  
https://acoteonline.org/accreditation-explained/standards/. Copies of the standards are  
also available for inspection and distribution at 10 cents per page from the Michigan  
Board of Occupational Therapists, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan  
48909.  
(2) Any educational program for occupational therapists that is accredited by the  
ACOTE qualifies as an occupational therapist educational program approved by the  
board.  
(3) The board approves and adopts by reference the standards in the document entitled  
"Minimum Standards for the Education of Occupational Therapists, Revised 2016”  
published by the WFOT. Copies of these standards are available at no cost on the WFOT  
website at http://www.wfot.org. The standards are also available for inspection at 10  
cents per page from the Michigan Board of Occupational Therapists, Bureau of  
Professional Licensing, Department of Licensing and Regulatory Affairs, 611 West  
Ottawa, P.O. Box 30670, Lansing, Michigan 48909.  
(4) Any educational program for occupational therapists that is approved by the WFOT  
qualifies as an occupational therapist educational program approved by the board.  
(5) Any bachelor’s level educational program for occupational therapists that was  
operating before December 31, 2006, and accredited by the ACOTE or approved by the  
WFOT qualifies as an occupational therapist educational program approved by the board.  
R 338.1222 Rescinded.  
R 338.1223 Application for occupational therapist license; requirements.  
Rule 23. An applicant for an occupational therapist license shall submit the required fee  
and a completed application on a form provided by the department. In addition to  
meeting the requirements of the code, R 338.7001 to R 338.7005, any other rules  
promulgated under the code, and section 16174 of the code, MCL 333.16174, an  
applicant shall meet all of the following requirements:  
(a) Graduate from an occupational therapist education program that is accredited by the  
ACOTE or approved by the WFOT, or their predecessor organizations that meets the  
standards adopted by the board under R 338.1222 or meets the requirements of R  
338.1225.  
(b) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the occupational therapist licensure  
examination adopted in R 338.1224.  
(c) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the examination on laws and rules  
4
related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a health  
profession or specialty issued by another state, the United States military, the federal  
government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
R 338.1223a Rescinded.  
R 338.1224 Examinations; occupational therapist; adoption and approval; passing  
scores.  
Rule 24. (1) The board approves and adopts the certification examination for  
occupational therapists that was developed, administered, and scored by the NBCOT as  
the licensure examination for occupational therapists in this state. The board shall adopt  
the passing score recommended by the NBCOT for the certification examination.  
(2) The board approves the examination on laws and rules related to the practice of  
occupational therapy in this state that is developed and administered by the department,  
or an entity approved by the department. The passing score on the laws and rules  
examination is a converted score of not less than 75.  
(3) An applicant that fails to achieve a passing score on the examination required in  
subrule (2) of this rule may retake the examination without limitation.  
R 338.1225 Graduate of non-accredited postsecondary institution; occupational therapist;  
equivalency of education; NBCOT examination.  
Rule 25. An applicant for an occupational therapist license who graduated from a non-  
accredited postsecondary institution shall submit the required fee and a completed  
application on a form provided by the department. In addition to meeting the  
requirements of the code, R 338.7001 to R 338.7005, any other rules promulgated under  
the code, and section 16174 of the code, MCL 333.16174, an applicant shall meet all of  
the following requirements:  
(a) Establish to the board that the applicant completed an occupational therapist  
educational program that is substantially equivalent to an occupational therapist program  
that is accredited by the ACOTE or approved by the WFOT as provided in R 338.1222.  
(b) Have documentation sent directly to the department from the NBCOT verifying the  
applicant passed the NBCOT certification examination for occupational therapists  
adopted in R 338.1224 within 3 years before the application for licensure and not more  
than 2 years after the application for licensure.  
(c) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the examination on laws and rules  
related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a health  
profession or specialty issued by another state, the United States military, the federal  
government, or another country.  
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(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
R 338.1226 Licensure by endorsement; occupational therapist; requirements.  
Rule 26. (1) An applicant for an occupational therapist license by endorsement shall  
submit the required fee and a completed application on a form provided by the  
department. An applicant meets the requirements of section 16186 of the code, MCL  
333.16186, if the applicant meets the requirements of the code, R 338.7001 to R  
338.7005, any other rules promulgated under the code, and section 16174 of the code,  
MCL 333.16174, and satisfies the following requirements, as applicable.  
(2) If an applicant is actively registered or licensed as an occupational therapist in  
another state for 5 years or more and is in good standing within 30 days before filing an  
application for an occupational therapist license in this state, then the applicant shall  
comply with both of the following:  
(a) Have previously taken and passed the NBCOT certification examination for  
occupational therapists with a score adopted by the board under R 338.1224(1) or the  
predecessor examination that was administered by the AOTA.  
(b) Within 3 years preceding the application for endorsement and not more than 2 years  
after the application for endorsement, the applicant must pass the examination on state  
laws and rules related to the practice of occupational therapy that is developed and  
administered by the department or an entity approved by the department with a minimum  
converted score of 75.  
(3) If an applicant is actively registered or licensed as an occupational therapist in  
another state for less than 5 years and is in good standing within 30 days before filing an  
application for an occupational therapist license in this state, then the applicant shall  
comply with both of the following:  
(a) Graduate from an occupational therapist education program that is accredited by the  
ACOTE, or approved by the WFOT, or their predecessor organizations that meets the  
standards adopted by the board in R 338.1222.  
(b) Meet the requirements of subrule (2) of this rule.  
(4) In addition to meeting the requirements of subrule (1) and either subrule (2) or (3) of  
this rule, an applicant shall meet both of the following requirements:  
(a) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
(b) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
R 338.1227 Requirements for relicensure; occupational therapist.  
Rule 27. (1) An applicant for relicensure as an occupational therapist, who has let his or  
her license or registration from this state lapse, under section 16201(3) or (4) of the code,  
MCL 333.16201, as applicable, may be relicensed by complying with the following  
requirements as noted by (√):  
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For an occupational therapist who has let his or her Registered in this  
Licensed  
Licensed  
registration or license from this state lapse:  
state before January lapsed less lapsed 3  
1, 2009, with lapsed than 3 years. years or  
registration, and did  
not apply for  
more.  
licensure before June  
11, 2015.  
(a) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(b) Establish that the applicant is of good moral  
character as defined in, and determined under, 1974  
PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
√
√
√
√
(d) Submit proof of having completed the continuing  
education required under R 338.1252, which was  
earned within the 3-year period immediately before  
the application for relicensure. If the continuing  
education hours submitted with the application are  
deficient, the applicant has 2 years after the date of  
the application to complete the deficient hours. The  
application must be held, and the license may not be  
issued until the continuing education requirements are  
met.  
√
(e) Maintain certification as an occupational therapist  
by NBCOT after the registration lapsed and graduated  
from an occupational therapist education program  
that is accredited by ACOTE or approved by WFOT,  
or their predecessor organizations that meets the  
standards adopted by the board under R 338.1222 or  
meets the requirements of R 338.1225.  
√
(f) Complete a 1-time training in identifying victims  
of human trafficking that meets the standards in R  
338.1215.  
(g) Meet the English language requirement under R  
338.7002b and the implicit bias training required in R  
338.7004.  
√
√
√
√
√
√
(h) Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, pass the examination on  
laws and rules related to the practice of occupational  
therapy in this state that is developed and  
administered by the department, or an entity approved  
by the department.  
√
√
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(i) Satisfy 1 of the following:  
(i)Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, take and pass the NBCOT  
certification examination for occupational therapists,  
with a score adopted by the board under R  
√
√
338.1224(1), and complete supervised practice  
experience pursuant to subrule (2) of this rule.  
(ii) Present evidence to the department that the  
applicant was actively registered or licensed as an  
occupational therapist in another state during the 3-  
year period and in good standing within 30 days,  
before filing the application for relicensure.  
(j) An applicant that is or has been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States military,  
the federal government, or another country, shall do  
both of the following:  
√
√
√
(i) Disclose on the application form each license,  
registration, or certification.  
(ii) Satisfy the requirements of section 16174(2) of  
the code, MCL 333.16174, including verification  
from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and  
sanctions are not in force at the time of application.  
(2) An applicant that has had a lapsed registration or license for 3 years or more and  
meets the requirements of subrule (1)(i)(i) of this rule shall complete a supervised  
practice experience that meets the requirements of R 338.1228. The applicant shall have a  
limited license from the department while participating in the supervised practice  
experience. The duration of the experience must be as follows:  
(a) If the applicant’s license has lapsed for not less than 3 years but less than 7 years,  
the applicant shall complete not less than 200 hours of supervised practice experience.  
(b) If the applicant’s license has lapsed for 7 years or more but less than 15 years, the  
applicant shall complete not less than 400 hours of supervised practice experience.  
(c) If the applicant’s license has lapsed for more than 15 years, the applicant shall  
complete not less than 600 hours of supervised practice experience.  
(3) For purposes of meeting the requirements of subrule (2) of this rule, the department  
may grant an applicant a limited license to complete the supervised practice experience.  
(4) A limited license granted under subrule (3) of this rule is valid for 1 year and may be  
renewed 1 time.  
R 338.1229 Delegation of limited assessments, tasks or interventions to an occupational  
therapy assistant; supervision of an occupational therapy assistant; requirements.  
Rule 29. (1) An occupational therapist who delegates the performance of 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  
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assistant consistent with section 16109(2) of the code, MCL 333.16109, and satisfy the  
requirements of this rule. As used in this rule, “limited assessment” means those parts of  
an evaluation that an occupational therapy assistant is qualified by education and training  
to perform while under the supervision of an occupational therapist.  
(2) Before an occupational therapist delegates limited assessments, tasks, or  
interventions to an occupational therapy assistant, the occupational therapist shall  
evaluate the qualifications of the occupational therapy assistant, including verification of  
the occupational therapy assistant’s training, education, and licensure.  
(3) An occupational therapist who delegates limited assessments, tasks, or interventions  
to an occupational therapy assistant shall determine and provide the appropriate level of  
supervision required for the occupational therapy assistant’s performance of the delegated  
limited assessment, task, or intervention. The appropriate level of supervision must be  
determined based on the occupational therapy assistant’s education, training, and  
experience. The level of supervision must be either general supervision or direct  
supervision.  
(4) An occupational therapist who delegates limited assessments, tasks, or interventions  
under this rule shall also comply with all of the following:  
(a) Initiate and direct the evaluation of the patient or client before delegating limited  
assessments.  
(b) Complete the evaluation of the patient or client before delegating tasks or  
interventions to be performed by an occupational therapy assistant.  
(c) Supervise an occupational therapy assistant to whom limited assessments, tasks, or  
interventions are delegated.  
(d) Provide predetermined procedures and protocols for limited assessments, tasks, or  
interventions that are delegated.  
(e) Monitor an occupational therapy assistant’s practice of assigned limited  
assessments, tasks, or interventions.  
(f) Maintain a record of the names of the occupational therapy assistants to whom  
limited assessments, tasks, or interventions have been delegated pursuant to section  
16215 of the code, MCL 333.16215.  
(g) Meet using live, synchronous contact at least once per month with the occupational  
therapy assistant to whom limited assessments, tasks, or interventions have been  
delegated to accomplish all of the following:  
(i) Evaluate the occupational therapy assistant’s performance.  
(ii) Review the patient or client.  
(iii) Educate the occupational therapy assistant on the limited assessments, tasks, or  
interventions that have been delegated to facilitate professional growth and development.  
(h) The occupational therapist shall maintain documentation of the meeting, which  
must be signed by both the occupational therapist and occupational therapist assistant.  
Compliance with this subdivision must not be used as a substitute for the ongoing  
supervision required under this subrule and subrule (3) of this rule.  
(5) An occupational therapist shall not delegate the performance of either of the  
following to an occupational therapy assistant:  
(a) The sole development of a treatment plan.  
(b) The sole evaluation and interpretation of evaluation results.  
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(6) An occupational therapist shall not supervise more than 4 occupational therapy  
assistants who are providing services to patients at the same time.  
R 338.1229a Delegation of tasks to an unlicensed individual; direct supervision of an  
unlicensed individual; requirements.  
Rule 29a. (1) An occupational therapist who delegates the performance of selected tasks  
to an unlicensed individual as allowed under section 16215 of the code, MCL 333.16215,  
shall supervise the unlicensed individual consistent with section 16109(2) of the code,  
MCL 333.16109, and satisfy the requirements of this rule. As used in this rule,  
“unlicensed individual” means an individual who does not hold an occupational therapist  
license, an occupational therapy assistant license, or another health professional license  
and who may be able to perform the tasks identified in this rule.  
(2) An occupational therapist who delegates tasks to an unlicensed individual shall  
provide direct supervision of the unlicensed individual.  
(3) An occupational therapist who delegates tasks under subrule (2) of this rule shall  
also comply with all of the following:  
(a) Before delegating a task, the occupational therapist shall evaluate the qualifications  
of the unlicensed individual under the occupational therapist’s direct supervision,  
including verification of the unlicensed individual’s training and education.  
(b) Examine and evaluate the patient or client before delegating tasks to be performed  
by an unlicensed individual.  
(c) Provide predetermined procedures and protocols for tasks that are delegated.  
(d) Maintain a record of the unlicensed individuals to whom tasks have been delegated,  
under section 16213 of the code, MCL 333.16213.  
(e) Monitor an unlicensed individual’s practice of assigned tasks.  
(4) An occupational therapist shall not supervise more than 3 unlicensed individuals  
who are providing services to patients or clients at the same time.  
(5) An occupational therapist shall not delegate any of the to an unlicensed individual:  
(a) An occupational therapy intervention.  
(b) An assessment.  
(c) An evaluation.  
(6) Under section 16171 of the code, MCL 333.16171, the requirements of subrules (2),  
(3)(b), and (5) of this rule do not apply to a student enrolled in an ACOTE accredited or  
WFOT approved occupational therapist educational program or an ACOTE accredited  
occupational therapy assistant educational program approved by the board.  
PART 4. OCCUPATIONAL THERAPY ASSISTANTS  
R 338.1231 Educational program standards; occupational therapy assistant;  
adoption by reference.  
Rule 31. (1) The board approves and adopts by reference the standards for accrediting  
occupational therapy assistant educational programs in the document entitled “2018  
Accreditation Council for Occupational Therapy Education (ACOTE) Standards and  
Interpretive Guide," adopted by the ACOTE, which were effective July 31, 2020. Copies  
of these standards are available at no cost from the ACOTE website at  
10  
https://acoteonline.org/accreditation-explained/standards/. Copies of the standards are  
also available for inspection and distribution at 10 cents per page from the Michigan  
Board of Occupational Therapists, Bureau of Professional Licensing, Department of  
Licensing and Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan  
48909.  
(2) Any educational program for occupational therapy assistants that is accredited by the  
ACOTE qualifies as an occupational therapy assistant educational program approved by  
the board.  
R 338.1232 Rescinded.  
R 338.1233 Application for 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, R 338.7001 to R 338.7005, any other  
rules promulgated under the code, and section 16174 of the code, MCL 333.16174, an  
applicant shall meet all of the following requirements:  
(a) Graduate from an accredited occupational therapy assistant educational program that  
meets the standards adopted by the board under R 338.1232.  
(b) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the occupational therapy assistant  
licensure examination in R 338.1234.  
(c) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the examination on laws and rules  
related to the practice of occupational therapy in this state that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a health  
profession or specialty issued by another state, the United States military, the federal  
government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
R 338.1233a Rescinded.  
R 338.1234a Graduate of non-accredited postsecondary institution; occupational therapy  
assistant; equivalency of education; NBCOT examination.  
Rule 34a. An applicant for an occupational therapy assistant license who graduated from  
a non-accredited postsecondary institution shall submit the required fee and a completed  
application on a form provided by the department. In addition to meeting the  
requirements of the code, R 338.7001 to R 338.7005, any other rules promulgated under  
the code, and section 16174 of the code, MCL 333.16174, an applicant shall meet all of  
the following requirements:  
(a) Establish to the board that the applicant completed an occupational therapy assistant  
educational program that is substantially equivalent to an occupational therapist assistant  
program that is accredited by the ACOTE, as provided in R 338.1232.  
11  
(b) Have documentation sent directly to the department from the NBCOT verifying the  
applicant passed the NBCOT certification examination for occupational therapy  
assistants adopted in R 338.1234 within 3 years before the application for licensure and  
not more than 2 years after the application for licensure.  
(c) Within 3 years before the application for licensure and not more than 2 years after  
the application for licensure, the applicant shall pass the examination on laws and rules  
related to the practice of occupational therapy in this state, that is developed and  
administered by the department, or an entity approved by the department.  
(d) Disclose on the application form each license, registration, or certification in a health  
profession or specialty issued by another state, the United States military, the federal  
government, or another country.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
R 338.1235 Licensure by endorsement of occupational therapy assistant; requirements.  
Rule 35. (1) An applicant for an occupational therapy assistant license by endorsement  
shall submit the required fee and a completed application on a form provided by the  
department. An applicant meets the requirements of section 16186 of the code, MCL  
333.16186, if the applicant satisfies all the requirements of the code, R 338.7001 to R  
338.7005, any other rules promulgated under the code, and satisfies the following  
requirements, as applicable.  
(2) If an applicant is actively registered or licensed in another state for 5 years or more  
and is in good standing as an occupational therapy assistant within 30 days before filing  
an application for an occupational therapy assistant license in this state, then the applicant  
shall comply with both of the following:  
(a) Have previously taken and passed the NBCOT certification examination for  
occupational therapy assistants with a score adopted by the board under R 338.1234(1).  
(b) Within 3 years preceding the application for endorsement and not more than 2 years  
after the application for endorsement, the applicant shall pass the examination on state  
laws and rules related to the practice of occupational therapy that is developed and  
administered by the department or an entity approved by the department. The passing  
score on the laws and rules examination is a converted score of not less than 75.  
(3) If an applicant is actively registered or licensed as an occupational therapist assistant  
in another state for less than 5 years and is in good standing within 30 days before filing  
an application for an occupational therapy assistant license in this state, then the applicant  
shall comply with both of the following:  
(a) Graduate from an occupational therapy assistant education program that is  
accredited by the ACOTE, or its predecessor organization that meets the standards  
adopted by the board in R 338.1232.  
(b) Meet the requirements of subrule (2) of this rule.  
(4) In addition to meeting the requirements of subrule (1) and either subrule (2) or (3) of  
this rule, an applicant shall meet both of the following requirements:  
(a) Disclose on the application form each license, registration, or certification in a  
health profession or specialty issued by another state, the United States military, the  
federal government, or another country.  
12  
(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.  
R 338.1236 Requirements for relicensure; occupational therapy assistant.  
Rule 36. (1) An applicant for relicensure as an occupational therapy assistant, who has  
let his or her license or registration from this state lapse, under section 16201(3) or (4) of  
the code, MCL 333.16201, as applicable, may be relicensed by complying with the  
following requirements as noted by (√):  
For an occupational therapy assistant who has let his Registered in this  
Licensed  
Licensed  
or her registration or license from this state lapse:  
state before January lapsed less lapsed 3  
1, 2009, with lapsed than 3 years. years or  
registration, and did  
not apply for  
more.  
licensure before June  
11, 2015.  
(a) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(b) Establish that the applicant is of good moral  
character as defined in, and determined under, 1974  
PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
√
√
√
√
(d) Submit proof of having completed the continuing  
education required under R 338.1252, which was  
earned within the 3-year period immediately before  
the application for relicensure. If the continuing  
education hours submitted with the application are  
deficient, the applicant has 2 years after the date of  
the application to complete the deficient hours. The  
application must be held, and the license may not be  
issued until the continuing education requirements are  
met.  
√
(e) Maintain certification as an occupational therapy  
assistant by the NBCOT after the registration lapsed  
and graduated from an accredited occupational  
therapy assistant educational program that meets the  
standards adopted by the board under R 338.1232 or  
meets the requirements of R 338.1234a.  
(f) Complete a 1-time training in identifying victims  
of human trafficking that meets the standards in R  
338.1215.  
√
√
√
√
13  
(g) Meet the English language requirement under R  
338.7002b and the implicit bias training required in R  
338.7004.  
√
√
√
√
√
(h) Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, pass the examination on  
laws and rules related to the practice of occupational  
therapy in this state that is developed and  
administered by the department, or an entity approved  
by the department.  
(i) Satisfy 1 of the following:  
(i)Within 3 years preceding the application for  
relicensure and not more than 2 years after the  
application for relicensure, the applicant shall  
take and pass the NBCOT certification examination  
for occupational therapy assistants with a score  
adopted by the board under R 338.1234(1), and after  
passing the examination complete supervised practice  
experience pursuant to subrule (2) of this rule.  
(ii) Present evidence to the department that the  
applicant was actively registered or licensed as an  
occupational therapy assistant in another state during  
the 3-year period and in good standing within 30 days  
before filing the application for relicensure.  
(j) An applicant that is or has been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States military,  
the federal government, or another country, shall do  
both of the following:  
√
√
√
√
√
(i) Disclose on the application form each license,  
registration, or certification.  
(ii) Satisfy the requirements of section 16174(2) of  
the code, MCL 333.16174, including verification  
from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and  
sanctions are not in force at the time of application.  
(2) An applicant that has a lapsed registration or license for 3 years or more and meets  
the requirements of subrule (1)(i)(i) of this rule shall complete a supervised practice  
experience that meets the requirements of R 338.1237. The duration of the experience  
must be as follows:  
(a) If the applicant’s license has lapsed for 3 years or more but less than 7 years, the  
applicant shall complete not less than 200 hours of supervised practice experience.  
(b) If the applicant’s license has lapsed for 7 years or more but less than 15 years, the  
applicant shall complete not less than 400 hours of supervised practice experience.  
(c) If the applicant’s license has lapsed for more than 15 years, the applicant shall  
complete not less than 600 hours of supervised practice experience.  
14  
(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.  
PART 4. TELEHEALTH  
R 338.1241 Definitions.  
Rule 41. As used in this part:  
(a) “Telehealth” means the use of electronic information and telecommunication  
technologies to support or promote long-distance clinical healthcare, patient and  
professional health-related education, public health, or health administration. Telehealth  
may include, but is not limited to, telemedicine.  
(b) “Telehealth service” means a healthcare service that is provided through telehealth.  
(c) “Telemedicine” means the use of electronic media to link patients with healthcare  
professionals in different locations. To be considered telemedicine, the telemedicine  
services must be provided by a healthcare professional who is licensed, registered, or  
otherwise authorized to engage in his or her healthcare profession in the state where the  
patient is located.  
R 338.1243 Consent; scope of practice; standard of care.  
Rule 43. (1) The licensee shall obtain informed consent for treatment before providing a  
telehealth service under section 16284 of the code, MCL 333.16284. Informed consent  
requires all of the following:  
(a) The licensee shall ensure that the patient understands that treatment is provided  
remotely using telehealth.  
(b) At the inception of care, any licensee who has contact with the patient shall identify  
himself or herself to the patient as an occupational therapist, occupational therapy  
assistant, or unlicensed individual.  
(c) The licensee shall ensure that the patient is mentally capable of giving informed  
consent for diagnosis, care, or treatment.  
(d) The licensee shall explain the alternatives, capabilities, and limitations of  
telemedicine and that the patient may decline to receive telehealth services.  
(2) If the patient is less than 18 years of age, or under the care of a legal guardian, a  
parent or legal guardian shall provide informed consent for the patient.  
(3) The licensee shall keep proof of consent for a telehealth service in the patient’s up-  
to-date medical record and satisfy section 16213 of the code, MCL 333.16213.  
(4) A licensee who provides telehealth services shall comply with all of the following:  
(a) Act within the scope of his or her practice.  
(b) Exercise the same standard of care applicable to a traditional, in-person healthcare  
service.  
(c) Verify that telemedicine is appropriate to evaluate, diagnose, and treat the patient  
based on his or her unique presentation.  
(5) The licensee shall be able to examine the patient via a health insurance portability  
and accountability act (HIPAA) of 1996, Public Law 104-191, compliant, secure  
15  
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.  
PART 5. 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 who has been licensed for the 2-year licensing  
period immediately preceding the expiration date of the license shall accumulate not less  
than 20 continuing education contact hours that are approved by the board pursuant to R  
338.1252, during the 2-year licensing period immediately preceding an application for  
renewal.  
(3) Submission of an application for renewal constitutes the applicant’s certification of  
compliance with the requirements of this rule.  
(4) The licensee shall retain documentation of meeting the requirements of this rule for a  
period of 4 years after the date of applying for license renewal. Failure to comply with  
this rule is a violation of section 16221(h) of the code, MCL 333.16221.  
(5) The board may require an applicant or licensee to submit evidence to demonstrate  
compliance with this rule.  
(6) A request for a waiver under section 16205 of the code, MCL 333.16205, must be  
received by the department for the board’s consideration not less than 30 days before the  
last regularly scheduled board meeting before the expiration date of the license. The  
public notice for the board meetings can be found at: https://www.michigan.gov/lara/bureau-  
list/bpl/health/hp-lic-health-prof/dental.  
R 338.1252 Acceptable continuing education; occupational therapist; occupational  
therapy assistant; requirements.  
Rule 52. (1) The 20 hours of continuing education required pursuant to R 338.1251 for  
the renewal of a license must comply with the following:  
(a) Not more than 10 credit hours may be earned during a 24-hour period for online or  
electronic media, such as videos, internet web-based seminars, video conferences, online  
continuing education programs, and online journal articles that are asynchronous and not  
interactive.  
(b) Except for the 1-time training in human trafficking, which may be used to comply  
with the requirement for the 1-time training and continuing education requirements, an  
applicant may not earn credit for a continuing education program or activity that is  
identical or substantially similar to a program or activity the applicant has already earned  
credit for during that renewal period.  
(c) Pursuant to section 16204 of the code, MCL 333.16204, at least 1 hour of  
continuing education must be earned in the area of pain and symptom management.  
16  
Continuing education hours in pain and symptom management may include, but are not  
limited to, courses in behavior management, psychology of pain, pharmacology, behavior  
modification, stress management, clinical applications, and drug interventions as they  
relate to the practice of occupational therapy.  
(2) One-half of the required continuing education contact hours must be completed by  
live, synchronous, and interactive courses and programs, either in-person or virtual, that  
provide for the opportunity for direct interaction during the course or program, between  
faculty and participants, including, but not limited to, lectures, symposia, live  
teleconferences, and workshops. The remaining continuing education contact hours may  
be completed in another format.  
(3) The following are acceptable continuing education activities:  
ACCEPTABLE CONTINUING EDUCATION ACTIVITIES  
(a) Completion of an approved continuing  
education program or activity related to the  
practice of occupational therapy. A  
continuing education program or activity is  
approved if it is approved or offered for  
continuing education credit by any of the  
following:  
The number of hours approved by  
the sponsor or the approving  
organization may be earned in each  
renewal period.  
If the activity was not approved for a  
set number of hours, then 1 hour of  
continuing education for each 60  
minutes of participation may be  
earned.  
AOTA.  
International Association for  
Continuing Education and Training  
authorized providers.  
Credit in this category may be  
earned without limitation.  
Michigan Occupational Therapy  
Association.  
NBCOT.  
Another state or provincial board of  
occupational therapy.  
An occupational therapy education  
program approved by the board in R  
338.1222.  
Employer-provided work-place  
training.  
Third-party presentation that  
contributes to professional growth,  
development, and competency of  
occupational therapy practitioners.  
If audited, an applicant shall submit a copy  
of a letter or certificate of completion  
showing the applicant’s name, number of  
credits earned, sponsor name or the name of  
the organization that approved the program  
or activity for continuing education credit,  
and the date the program was held or  
17  
activity completed.  
(b) Completion of academic courses related to  
the practice of occupational therapy offered may be earned for each semester  
Five hours of continuing education  
in an occupational therapy education  
program approved by the board pursuant to  
R 338.1222.  
credit hour earned.  
Three hours of continuing education  
may be earned for each quarter  
credit hour earned.  
If audited, an applicant shall submit an  
official transcript that reflects completion of  
the academic course and number of semester Credit in this category may be  
or quarter credit hours earned.  
(c) Initial publication of a chapter or an article  
related to the practice of occupational  
therapy in any of the following:  
A peer-reviewed textbook.  
A professional healthcare textbook.  
A peer-reviewed journal or  
periodical.  
earned without limitation.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
Ten hours of continuing education  
may be earned for publishing a peer-  
reviewed textbook, professional  
healthcare textbook, or a peer-  
reviewed journal or periodical.  
A practice area related article in a lay  
publication (community newspaper  
or newsletter).  
A non-peer-reviewed professional  
publication (such as OT Practice, SIS  
Quarterly and Advance).  
Two hours of continuing education  
may be earned for publishing a  
practice related article in a lay  
publication.  
If audited, an applicant shall submit a copy  
of the publication that identifies the  
applicant as the author of the publication or  
a publication acceptance letter.  
Five hours of continuing education  
may be earned for publishing a non  
peer-reviewed professional  
publication.  
(d) Independent reading of peer-reviewed  
articles or viewing or listening to media  
related to the practice of occupational  
therapy that does not include a self-  
assessment part.  
One hour of continuing education  
may be earned for each 60 minutes  
of participation.  
A maximum of 5 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit an  
affidavit attesting to the number of hours the  
applicant spent participating in these  
activities that includes a description of the  
activity.  
(e) Initial presentation of an academic or  
continuing education program that is not a  
part of the applicant’s regular job  
Three hours of continuing education  
may be earned for each 60 minutes  
of presentation.  
18  
description.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit a copy  
of the curriculum and a letter from the  
program sponsor verifying the length and  
date of the presentation.  
(f) Fieldwork supervision that is not part of the Level I: One hour of continuing  
applicant’s primary job description.  
education, for all supervision  
activities, may be earned per  
student.  
If audited, an applicant shall submit a copy  
of a letter of verification or certificate from  
school including dates of fieldwork and  
name of fieldwork student.  
Level II: One hour of continuing  
education may be earned for each  
week of supervision per student  
supervised.  
A maximum of 12 hours of  
continuing education may be earned  
in each renewal period.  
(g) Participating on a state or national board,  
board of a local chapter, association, or  
committee, or volunteering if the activity  
enhances the participant’s knowledge and  
understanding of the field of occupational  
therapy.  
A maximum of 10 hours of  
continuing education may be earned  
for this activity in each renewal  
period.  
Attendance at a meeting equals 1  
credit hour of continuing education.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
participation in not less than 50% of the  
regularly scheduled meetings of the board.  
Attendance at a volunteering activity  
equals 1 credit hour of continuing  
education.  
(h) Primary or co-primary investigator in  
research activities or outcome studies, or  
externally funded service training projects  
associated with grants or post-graduation  
studies related to the field of occupational  
therapy.  
A maximum of 10 hours of  
continuing education may be earned  
in each renewal period.  
If audited, an applicant shall submit  
documentation verifying the licensee’s  
participation as a primary or co-primary  
investigator or in externally funded service  
training projects associated with grants or  
post-graduation studies related to the field of  
occupational therapy.  
;