DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

DIRECTOR’S OFFICE

OCCUPATIONAL THERAPISTS – GENERAL RULES

Filed with the secretary of state on March 19, 2026

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 338.1226, R 338.1227, R 338.1228,

R 338.1229, R 338.1229a, R 338.1231, R 338.1233, R 338.1235, R 338.1236, R 338.1237,

R 338.1241, R 338.1251, and R 338.1252 of the Michigan Administrative Code are

amended, R 338.1221a and R 338.1231a are added, and R 338.1212, R 338.1224, R

338.1225, R 338.1234, R 338.1234a, and R 338.1243 are rescinded, as follows: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 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.

December 12, 2025

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(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.

R 338.1212 Rescinded.

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.

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PART 2. OCCUPATIONAL THERAPISTS

SUBPART A. EDUCATIONAL STANDARDS AND EXAMINATION

APPROVAL AND ADOPTION

R 338.1221 Educational program standards; occupational therapist; adoption by

reference.

Rule 21. (1) The board approves and adopts by reference the standards for accrediting

occupational therapist educational programs in the documents entitled "2023 Accreditation

Council for Occupational Therapy Education (ACOTE) Standards and Interpretive Guide,"

adopted by ACOTE, effective July 31, 2025. Copies of these standards are available at no

cost from the ACOTE website at

https://acoteonline.org/accreditation-

explained/standards/. Copies of the standards are also available for inspection and

distribution at 25 cents per page from the Michigan Board of Occupational Therapists,

Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs, 611

West Ottawa, P.O. Box 30670, Lansing, Michigan 48909.

(2) The board approves and adopts by reference the standards in the document entitled

"Minimum Standards for the Education of Occupational Therapists, Revised 2016”

published by the WFOT. Copies of these standards are available at no cost on the WFOT

website at http://www.wfot.org . The standards are also available for inspection and

distribution at 25 cents per page from the Michigan Board of Occupational Therapists,

Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs, 611

West Ottawa, P.O. Box 30670, Lansing, Michigan 48909.

(3) An educational program for occupational therapists that is accredited by the ACOTE

or its predecessor organization is approved by the board. An educational program for

occupational therapists that is approved by the WFOT or its predecessor organization is

approved by the board. An occupational therapist educational program that is not

accredited by the ACOTE and not approved by the WFOT, or either of their predecessor

organizations, may be approved by the board if the board determines that it is substantially

equivalent to a program accredited by the ACOTE or approved by the WFOT, or either of

their predecessor organizations.

(4) Any bachelor’s level educational program for occupational therapists that was

operating before December 31, 2006, and accredited by the ACOTE or approved by the

WFOT qualifies as an occupational therapist educational program approved by the board.

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.

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

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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.

R 338.1224 Rescinded.

R 338.1225 Rescinded.

R 338.1226 Licensure by endorsement; occupational therapist; requirements.

Rule 26. (1) An applicant for an occupational therapist license by endorsement shall

submit the required fee and a completed application on a form provided by the department.

In addition to meeting the requirements of the code, and the rules promulgated under the

code, an applicant shall satisfy the following requirements, as applicable:

(a) If an applicant has been actively registered or licensed as an occupational therapist in

at least 1 state or actively licensed in at least 1 province of Canada for 5 years or more, the

applicant shall comply with both of the following:

(i) Hold an active registration or license in good standing in another state or active

license in good standing in a province of Canada within 30 days before applying for

licensure by endorsement.

(ii) Have taken and passed the NBCOT certification examination for occupational

therapists with a score adopted by the board under R 338.1221a or the predecessor

examination that was administered by the AOTA.

(b) If an applicant has been actively registered or licensed as an occupational therapist in

at least 1 or more states or licensed in at least 1 province of Canada for less than 5 years,

the applicant shall comply with all of the following:

(i) Hold the active registration or licensee in good standing in another state or active

license in good standing in a province of Canada within 30 days before applying for

licensure by endorsement.

(ii) Have successfully completed an occupational therapist education program that meets

the standards adopted by the board in R 338.1221.

(iii) Have taken and passed the NBCOT certification examination for occupational

therapists with a score adopted by the board under R 338.1221a or the predecessor

examination that was administered by the AOTA.

(2) In addition to meeting the requirements of subrule (1) of this rule, an applicant shall

meet both of the following requirements:

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(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 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 January less than 3 3 years or

1, 2009, with

lapsed

years.

more.

registration,

and did not

apply for

licensure

before June

11, 2015.

(a) Submit a completed application on a form

provided by the department, together with the

requisite fee.

(b) Establish that the applicant is of good moral

character as defined in, and determined under,

1974 PA 381, MCL 338.41 to 338.47.

√

(c) Submit fingerprints as required under section

16174(3) of the code, MCL 333.16174.

√

(d) Submit proof of having completed the

continuing education required under R 338.1252,

which was earned within the 3-year period

immediately before the application for

√

relicensure. If the continuing education hours

submitted with the application are deficient, the

applicant has 2 years after the date of the

application to complete the deficient hours. The

application must be held, and the license may not

be issued until the continuing education

requirements are met.

(e) Maintain certification as an occupational

therapist by NBCOT after the registration lapsed

and graduated from an occupational therapist

√

6

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

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.

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(3) For purposes of meeting the requirements of subrule (2) of this rule, the department

may grant an applicant a limited license to complete the supervised practice experience.

(4) A limited license granted under subrule (3) of this rule is valid for 1 year and may be

renewed 1 time.

R 338.1228 Supervised practice experience; occupational therapist; requirements.

Rule 28. (1) The supervised practice experience required for relicensure under R 338.1227

must comply with both of the following:

(a) The supervised practice experience must be obtained under the supervision of an

occupational therapist who is licensed in this state and who has 3 or more years clinical

experience and no past or pending disciplinary actions.

(b) The supervising occupational therapist shall provide the department with verification

of the applicant's completion of the supervised practice experience on a form provided by

the department.

(2) The supervised practice experience must consist of, at a minimum, professional and

clinical instruction in all of the following areas:

(a) Referral process.

(b) Screening process.

(c) Evaluations.

(d) Intervention plans.

(e) Intervention strategies.

(f) Discontinuation or referral for other services, or both.

(3) Only experience obtained in an approved supervised practice situation by an

individual who holds a limited license counts toward the experience requirement.

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.

8

(4) An occupational therapist who delegates limited assessments, tasks, or interventions

under this rule shall also comply with all of the following:

(a) Initiate and direct the evaluation of the patient or client before delegating limited

assessments.

(b) Complete the evaluation of the patient or client before delegating tasks or

interventions to be performed by an occupational therapy assistant.

(c) Supervise an occupational therapy assistant to whom limited assessments, tasks, or

interventions are delegated.

(d) Provide predetermined procedures and protocols for limited assessments, tasks, or

interventions that are delegated.

(e) Monitor an occupational therapy assistant’s practice of assigned limited assessments,

tasks, or interventions.

(f) Maintain a record of the names of the occupational therapy assistants to whom limited

assessments, tasks, or interventions have been delegated pursuant to section 16215 of the

code, MCL 333.16215.

(g) Meet in person or using live, synchronous contact at least once per month with the

occupational therapy assistant to whom limited assessments, tasks, or interventions have

been delegated to accomplish all of the following:

(i) Evaluate the occupational therapy assistant’s performance.

(ii) Review the patient or client.

(iii) Educate the occupational therapy assistant on the limited assessments, tasks, or

interventions that have been delegated to facilitate professional growth and development.

(h) The occupational therapist shall maintain documentation of the meeting, which must

be signed by both the occupational therapist and occupational therapist assistant.

Compliance with this subdivision must not be used as a substitute for the ongoing

supervision required under this subrule and subrule (3) of this rule.

(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.

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:

9

(a) Before delegating a task, the occupational therapist shall evaluate the qualifications

of the unlicensed individual under the occupational therapist’s direct supervision, including

verification of the unlicensed individual’s training and education.

(b) Examine and evaluate the patient or client before delegating tasks to be performed by

an unlicensed individual.

(c) Provide predetermined procedures and protocols for tasks that are delegated.

(d) Maintain a record of the unlicensed individuals to whom tasks have been delegated,

under section 16213 of the code, MCL 333.16213.

(e) Monitor an unlicensed individual’s practice of assigned tasks.

(4) An occupational therapist shall not supervise more than 3 unlicensed individuals who

are providing services to patients or clients at the same time.

(5) Under section 16171 of the code, MCL 333.16171, the requirements of subrule (3)(b)

of this rule do not apply to a student enrolled in an ACOTE accredited or WFOT approved

occupational therapist educational program or an ACOTE accredited occupational therapy

assistant educational program approved by the board.

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.

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.

10

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.

R 338.1234 Rescinded.

R 338.1234a Rescinded.

R 338.1235 Licensure by endorsement of occupational therapy assistant; requirements.

Rule 35. (1) An applicant for an occupational therapy assistant license by endorsement

shall submit the required fee and a completed application on a form provided by the

department. In addition to meeting the requirements of the code, and the rules promulgated

under the code, an applicant shall satisfy the following requirements, as applicable:

(a) If an applicant has been actively registered or licensed as an occupational therapy

assistant in at least 1 state or licensed in at least 1 province of Canada for 5 years or more,

the applicant shall comply with both of the following:

(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.

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(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.

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 before been lapsed been lapsed

January 1,

2009, with

lapsed

less than 3 3 years or

years.

more.

registration,

and did not

apply for

licensure

before June 11,

2015.

(a) Submit a completed application on a form

provided by the department, together with the

requisite fee.

(b) Establish that the applicant is of good

moral character as defined in, and determined

under, 1974 PA 381, MCL 338.41 to 338.47.

√

(c) Submit fingerprints as required under

section 16174(3) of the code, MCL

333.16174.

√

(d) Submit proof of having completed the

continuing education required under R

338.1252, which was earned within the 3-year

period immediately before the application for

relicensure. If the continuing education hours

submitted with the application are deficient,

the applicant has 2 years after the date of the

application to complete the deficient hours.

The application must be held, and the license

may not be issued until the continuing

education requirements are met.

√

12

(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

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:

13

(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.

R 338.1237 Supervised practice experience; occupational therapy assistant; requirements.

Rule 37. (1) The supervised practice experience required for relicensure under R 338.1236

shall comply with all of the following:

(a) The supervised practice experience must be obtained under the supervision of an

occupational therapist who is licensed in this state and who has 3 or more years clinical

experience and no past or pending disciplinary actions.

(b) The supervising occupational therapist shall provide the department with verification

of the applicant's completion of the supervised practice experience on a form provided by

the department.

(2) The supervised practice experience must consist of, at a minimum, professional and

clinical instruction in all of the following areas:

(a) Referral process.

(b) Screening process.

(c) Evaluations.

(d) Intervention plans.

(e) Intervention strategies.

(f) Discontinuation or referral for other services, or both.

(3) Only experience obtained in an approved supervised practice situation by an

individual who holds a limited license counts toward the experience requirement.

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.

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(2) If the patient is less than 18 years of age, or under the care of a legal guardian, a parent

or legal guardian shall provide consent for the telehealth service.

(3) A licensee shall keep proof of consent for a telehealth treatment in the patient’s up-to-

date medical record in compliance with section 16213 of the code, MCL 333.16213.

(4) A licensee who provides telehealth services shall comply with all of the following:

(a) Act within the scope of the licensee’s practice.

(b) Exercise the same standard of care applicable to a traditional, in-person healthcare

service.

(c) Verify that telemedicine is appropriate to evaluate, diagnose, and treat the patient

based on the patient’s unique presentation.

(5) A licensee shall be able to examine the patient via a health insurance portability and

accountability act of 1996, Public Law 104-191, compliant, secure interactive audio or

video, or both, telecommunications system, or through the use of store and forward online

messaging.

(6) Telehealth must be secure and comply with federal and state security and privacy

regulations.

R 338.1243 Rescinded.

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.

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

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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 the sponsor or the approving

practice of occupational therapy. A organization may be earned in each

The number of hours approved by

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 may be

earned.

 AOTA.

 IACET authorized providers.

 Michigan Occupational Therapy

Association.

Credit in this category may be

earned without limitation.

 NBCOT.

 Another state or provincial board of

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

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18301(1)(c) of the code, MCL

333.18301, and the occupational

therapy service is identified on the

certificate of completion, a third-

party presentation.

If audited, an applicant shall submit a copy

of a letter or certificate of completion

showing the applicant’s name, number of

credits earned, sponsor name or the name

of the organization that approved the

program or activity for continuing

education credit, and the date the program

was held or activity completed.

(b) Completion of academic courses related to Five hours of continuing education

the practice of occupational therapy offered may be earned for each semester

in an occupational therapy education

program approved by the board pursuant to

R 338.1221.

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 or quarter credit hours earned.

Credit in this category may be

earned without limitation.

(c) Initial publication of a chapter or an article A maximum of 10 hours of

related to the practice of occupational

therapy written by the applicant in any of

the following:

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 peer-reviewed textbook.

 A professional healthcare textbook.

 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.

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(d) Independent reading or listening to the

audio format of peer-reviewed articles

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 date completed

and the number of hours the applicant spent

participating in these activities and a

bibliography listing the journal, article, the

author or authors, and publication date.

(e) Initial presentation of an academic or

continuing education program by the

applicant that is not a part of the

Three hours of continuing

education may be earned for each

60 minutes of presentation.

applicant’s regular job description.

A maximum of 10 hours of

If audited, an applicant shall submit a copy continuing education may be

of the curriculum and a letter from the

program sponsor verifying the length and

date of the presentation.

earned in each renewal period.

(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

If audited, an applicant shall submit a copy student.

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.

A maximum of 10 hours of

continuing education may be

earned for this activity 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.

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

Attendance at a volunteering

regularly scheduled meetings of the board. activity equals 1 credit hour of

continuing education.

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(h) Primary or co-primary investigator in

A maximum of 10 hours of

continuing education may be

earned in each renewal period.

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.

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.