Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 19 - Bureau of Professional Licensure › Subpart 60 - Professional Licensure › Chapter 8 - REGULATIONS GOVERNING LICENSURE OF OCCUPATIONAL THERAPISTS AND OCCUPATIONAL THERAPY ASSISTANTS › Subchapter 10 - Occupational Therapy Assistant › Rule 15-19-60-8.10.2 - Supervision or Consultation

Current through June 25, 2024
1. An occupational
					 therapy assistant issued a limited permit (see Rule
					 8.4.5 ).
2. An occupational therapy assistant issued a
					 regular license.
a. A supervisory visit must
					 be performed by the occupational therapist at least once every seventh
					 treatment day or 21 calendar days, after the introduction of the occupational
					 therapy assistant into the treatment process. The occupational therapist will
					 personally render treatment, review and evaluate the treatment progress of the
					 occupational therapy assistant, and perform a functional assessment of the
					 patient's progress. The presence of the occupational therapy assistant is not
					 required during the supervisory visit; however, nothing prevents the
					 occupational therapist from requiring the occupational therapy assistant's
					 presence at the supervisory visit based on a case-by-case assessment of each
					 unique encounter. A supervisory meeting between the occupational therapist and
					 the occupational therapy assistant must be completed and documented prior to
					 the next treatment visit following the supervisory visit in order to review or
					 change the plan of care and/or assess the occupational therapy assistant's
					 performance. The supervisory meeting between the occupational therapist and
					 occupational therapy assistant may be in person or via telecommunications,
					 including audio-only communication, at the discretion of the supervising
					 occupational therapist.
b. The
					 supervising occupational therapist must be accessible by telecommunications to
					 the occupational therapy assistant on a daily basis while the occupational
					 therapy assistant is treating patients.
c. Regardless of the practice setting, the
					 following requirements must be observed when the occupational therapist is
					 supervising or consulting with the occupational therapy assistant:
i. The initial visit for evaluation of the
					 patient and establishment of a plan of care must be made by the supervising or
					 consulting occupational therapist.
ii. A joint supervisory visit must be made by
					 the supervising occupational therapist with the patient present at the
					 patient's residence or treatment setting once every 7 treatment days or every
					 21 calendar days, whichever comes first.
iii. A supervisory meeting between the
					 occupational therapist and the occupational therapy assistant(s) must occur and
					 be documented prior to the next treatment session following the supervisory
					 visit performed by the occupational therapist.
iv. A supervisory visit should include:
1. A review of activities with appropriate
					 revision or termination of the plan of care;
2. An assessment of utilization of outside
					 resources (whenever applicable);
3.
					 Documentary evidence of such visit, including documentation of the specific
					 content in the communication between the occupational therapist and the
					 assistant;
4. Discharge planning as
					 indicated.
v. An
					 occupational therapist may not supervise/consult with more than two (2)
					 occupational therapy assistants and/or fieldwork students that are treating
					 patients at any point in time during the occupational therapist's work day
					 except in school settings, or settings where maintenance or tertiary type
					 services are provided, such as the regional treatment centers under the
					 direction of the Department of Mental Health. The number of supervisees is
					 inclusive of all geographic locations or employing
					 agencies.
d. Regular
					 interim communication should occur between the occupational therapist and
					 occupational therapy assistant(s) during the treatment process over the
					 7-visit/21-day time period. Regular interim communication that occurs with the
					 visits should be documented by either the occupational therapist or the
					 occupational therapy assistant; however, the occupational therapist and
					 occupational therapy assistant may both document the communication. The
					 following are examples of ethical regular interim communication that should be
					 documented between and in addition to the supervisory visit documentation:
i. Example #1: An occupational therapy
					 assistant in a position of regular employment is off work due to illness,
					 vacation, maternity leave, cannot work on the weekends, etc., and an alternate
					 occupational therapy assistant is employed to cover the patient caseload
					 vacated by the regular occupational therapy assistant's absence. The regular
					 occupational therapy assistant is not actively engaged in patient treatment at
					 the time that the alternate occupational therapy assistant is engaging in
					 patient treatment; therefore, the regular occupational therapy assistant's
					 supervising occupational therapist may assume supervision of the alternate
					 occupational therapy assistant while he/she is treating the regular
					 occupational therapy assistant's patient caseload only until the point in time
					 that the regular occupational therapy assistant returns to actively engage in
					 patient treatment. Documentation of these transitions must be recorded in the
					 client's record.
ii. Example #2:
					 The occupational therapist and/or the alternate occupational therapy assistant
					 shall document in the medical record or official client record when an
					 alternate occupational therapy assistant enters the treatment process if the
					 supervising occupational therapist has had any regular interim communication
					 with the alternate occupational therapy assistant. This communication will
					 include information that the alternate occupational therapy assistant would
					 need in order to treat the patient safely and effectively. A supervisory visit
					 would only be required if it were the patient's 7th
					 visit or 21st calendar day since the last
					 supervisory visit.
iii. Example #3:
					 In the event that the supervising occupational therapist is unable to perform
					 the supervisory visit on or before the patient's 7th
					 treatment day or 21st calendar day, the occupational
					 therapy assistant shall document this in the medical record or official client
					 record specifying that he/she (or any other occupational therapy assistant)
					 cannot treat the patient on the patient's 7th visit
					 or 21st calendar day until the supervisory visit is
					 completed. It is the responsibility of the occupational therapy assistant to
					 ensure treatment has not exceeded the patient's 7th
					 treatment day or 21st calendar
					 day.
e. Switching
					 occupational therapy assistants during the 7/21 treatment cycle does not
					 absolve the occupational therapist of their responsibility nor does it alter
					 the 7 visit/21-day rule as the 7th visit is
					 determined by the number of times the patient is treated by any licensed
					 occupational therapy practitioner after the introduction of the occupational
					 therapy assistant role into the treatment plan. A PRN occupational therapist
					 may assume responsibility and supervision duties of a regular occupational
					 therapist until the regular occupational therapist actively returns to the
					 workplace as long as the added occupational therapy assistant does not result
					 in the PRN occupational therapist exceeding the maximum of two (2) occupational
					 therapy assistants/fieldwork students actively providing treatment under
					 his/her supervision. If the PRN occupational therapist has performed a
					 supervisory visit, the PRN occupational therapist is legally bound to that
					 patient and occupational therapy assistant role until such time that the
					 regular occupational therapist performs another supervisory visit to release
					 the PRN occupational therapist of responsibility of that patient
					 client.