Sunset review of the board of occupational therapy examiners

              ARIZONA STATE SENATE
RESEARCH STAFF
TO: JOINT LEGISLATIVE AUDIT COMMITTEE HEATHER OWENS
Senator Robert Blendu, Chairman
Representative John Nelson, Cochair
LEGISLATIVE RESEARCH ANALYST
HEALTH COMMITTEE
Tele~ hone: 1 602) 926- 3 171
DATE: December 3,2007
SUBJECT: Sunset Review of the Board of Occupational Therapy Examiners
Attached is the final report of the sunset review of the Board of Occupational Therapy
Examiners, which was conducted by the Senate Health and House of Representatives Health Committee
of Reference.
This report has been distributed to the following individuals and agencies:
Governor of the State of Arizona
The Honorable Janet Napolitano
President of the Senate
Senator Tim Bee
Senate Members
Senator Tom O'Halleran, Cochairman
Senator Barbara Leff
Senator Paula Aboud
Senator Thayer Verschoor
Senator Amanda Aguirre
Board of Occupational Therapy Examiners
Arizona State Library, Archives & Public Records
Office of the Auditor General
Senate Majority Staff
Senate Research Staff
Senate Minority Staff
Senate Resource Center
Speaker of the House of Representatives
Representative James Weiers
House Members
Representative Bob Stump, Cochairman
Representative Nancy Barto
Representative Rick Murphy
Representative David Bradley
Representative Linda Lopez
House Majority Staff
House Research Staff
House Minority Staff
Chief Clerk
HOIjas
Attachment
Senate Health and House of Representatives Health
Committee of Reference Report
BOARD OF OCCUPATIONAL THERAPYEXAMINERS
Background
Pursuant to Arizona Revised Statutes ( A. R. S.) § 41- 2953, the Joint Legislative Audit Committee
( JLAC) assigned the sunset review of the Board of Occupational Therapy Examiners ( Board) to the
Senate Health and House of Representatives Health Committee of Reference.
The Board was established in 1990 to license and regulate Occupational Therapists and
Occupational Therapy Assistants in order to standardize occupational therapy practices. The mission of
the Board is to ensure the public's health, safety and welfare by licensing and regulating individuals
who provide occupational therapy services. The Board's duties include: setting standards for licensure
examinations, evaluating applicants' qualifications, collecting fees, collecting applicant fingerprints for
the purpose of criminal background checks, adopting rules, and conducting investigations and hearings
in disciplinary matters.
Pursuant to A. R. S. tj 32- 3405, the State Treasurer collects all monies received by the Board and
deposits ten percent of the monies and all civil penalties imposed on licensees into the state General
Fund. The remaining 90 percent of monies received are deposited in the Occupational Therapy Fund
and are used by the Board for all necessary Board expenses.
Committee of Reference Sunset Review Procedures
The Committee of Reference held one public meeting on November 6, ,2007, to review the
Board's responses to the sunset factors as required by A. R. S. $ 41- 2954, subsections D and F, and to
hear public testimony. The Board's responses to the 12 sunset factors and four additional questions are
attached.
Committee of Reference Recommendations
The Committee of Reference recommends continuing the Board for ten years.
Attachments
1. Staff memo.
2. Sunset report requirements pursuant to A. R. S. § 41- 2954, subsections D and F.
3. Meeting notice.
4. An excerpt of the minutes of the Committee of Reference meeting relating to the Board.
ARIZONA STATE SENATE
RESEARCH STAFF
TO: MEMBERS OF THE HOUSE AND SENATE
HEALTH COMMITTEE OF REFERENCE
DATE: October 10, 2007
HEATHER OWENS
ASSISTANT ANALYST
HEALTH COMMITTEE
Telephone: ( 602) 926- 3 17 1
Facsimile: ( 602) 926- 3833
SUBJECT: Sunset Review of the Arizona State Board of Occupational Therapy Examiners
The Arizona State Board of Occupational Therapy Examiners ( Board) is scheduled to sunset on
July 1,2008 ( A. R. S. § 41- 3008.09). The following is a brief description of the history and duties of the
Board, as well as the Board's response to the sunset questionnaire. As part of the sunset submittal, the
Board has also provided a binder containing copies of its enabling statutes, administrative rules,
licensing time frame compliance reports for FY 2004- 2005 to FY 2006- 2007, the initial application for
licensure, the biannual license renewal form, the Board's 2007 2" d quarter performance measures, the
Board's Appropriations Report, pages from the Board's website, a five- year review progress report, a
Board action sheet, a memo from the Office of the Attorney General and the Board's FY 2006- 2007
meeting minutes. These docun~ entas re on file with Senate Research staff should you wish to see them.
A public meeting is scheduled for November 6, 2007, to allow you to ask questions of the
Board, take public testimony and make a final recommendation on the Board's continuation. If you
have any questions or need further assistance, please feel free to contact me.
BOAIID HISTORY AND MISSION
The Board was established in 1990 to license and regulate occupational therapists and
occupational therapy assistants, in order to standardize occupational therapy practices. The mission of
the Board is to ensure the public's health, safety and welfare by licensing and regulating individuals
who provide occupational therapy services. Pursuant to A. R. S. $ 32- 3401, occupational therapy
services include the following: 1) training in activities of daily living and social skills, including play,
self- help skills, work and related activities; 2) evaluating and facilitating developmental, perceptual-motor,
neuromuscular and sensory- integrative function; 3) enhancing functional achievement,
prevocational skills and work capabilities through therapeutic, kinetic, functional, manual and creative
activities or exercises; 4) training an individual in the use of orthotic, prosthetic and adaptive devices
when necessary; 5) administering manual muscle, sensory and range of motion tests as an aid to
treatment; and 6) assessing and adapting environments for individuals with handicaps and those at risk
for dysfunction.
ORGANIZATION AND DUTIES
The Board consists of five members appointed by the Governor. Two members must be public
members who are not directly or indirectly engaged in the provision of health care services. The other
three members must be licensed occupational therapists and have a minimum of three years of
experience in occupational therapy or teaching in an accredited occupational therapy education program
immediately prior to appointment. The Board members serve three- year terms and may not serve more
MEMORANDUM
October 10,2007
Page 2
than two consecutive terms ( A. R. S. 32- 3402). The Board may employ an executive director and other
employees as it deems necessary.
The Board's duties include: setting standards for licensure examinations, evaluating applicants'
qualifications, collecting fees, collecting applicant fingerprints for the purpose of criminal background
checks, adopting rules, and conducting investigations and hearings in disciplinary matters. The Board
aims to issue, renew or deny a license, permit or registration within 30 days. In addition, the Board
investigates and adjudicates complaints with an average turnaround time of 120 days of receiving a
complaint. In FY 2006- 2007, the Board reports that it received 245 initial applications for a license, and
the average time frame for issuing the license was 30 days. The Board also received 564 license
renewal applications and again the average turnaround time was 30 days. In FY 2006- 2007, the Board
received 25 con~ plaintsa nd licensure incidents and issued 1 1 disciplinary actions.
FISCAL ISSUES
The Board's total operating budget in FY 2007- 2008 is $ 239,900. The Board currently has three
Cull- time equivalent ( FTE) positions. Pursuant to A. R. S. 5 32- 3405, the State Treasurer collects all
monies received by the Board and deposits ten percent of the monies and all civil penalties imposed on
licensees into the state General Fund. The remaining 90 percent of monies received are deposited in the
Occupational Therapy Fund and are used by the Board for all necessary Board expenses.
LEGISLATIVE ISSUES
The Board indicates a desire for legislative action to amend the statute governing applications
tbr licensure. The current statute requires an applicant to show that he or she has not been convicted of
a crime of moral turpitude. The Board recommends changing this to require the applicant to show that
he or she has not been convicted of a felony within five years, because the current language limits the
Board's discretion to consider each case on its own merits.
AIIDITIONAL BACKGROUND
Several other organizations familiar with the Board offered input on the Board's performance
and impact on the public. ( Please see letters attached with the sunset response).
Nina Castillo, President of the Arizona Occupational Therapy Association ( ArizOTA), indicates
that ArizOTA supports the continued state regulation of the occupational therapy profession and writes
that " Arizona's occupational therapy practitioners and their clients greatly benefit from [ the Board's]
responsibilities to respond to concerns, complaints, and licensure requests."
According to Charles Willmarth, the Director of the American Occupational Therapy
Association, Inc. ( AOTA), the occupational therapy profession is regulated in all 50 states, and the
AOTA suppoi- ts the continued regulation of occupational therapy in Arizona. AOTA believes that the
Board's conduct has resulted in the highest degree of professional conduct by occupational therapy
practitioners and protects the public from incompetent and unauthorized personnel.
State Board of Occupational Therapy Examiners
Sunset Factors
September 200 7
1 THE OBJECTIVE AND PURPOSE IN ESTABLISHING THE BOARD
In 1990, the Arizona State Board of Occupational Therapy Examiners was established to
license and regulate Occupational Therapists ( OTs) and Occupational Therapy Assistants
( OTAs). The practice of Occupational Therapy is written under A. R. S. 32- 3401 et. seq.
and A. A. C. Rules R4- 43- 101 et. seq.
The intent in establishing the Board was to provide consumer protection and to
standardize Occupational Therapy practices by setting minimum standards of operations
and principals of good practice.
Occupational Therapists and Occupational Therapy Assistants are employed in a variety
of settings. The field of Occupational Therapy is expanding, therefore employment
opportunities include public or private: educational facilities, hospitals, clinics, mental
health centers, community health organizations, physician practices, and home health
care agencies. Clients are served throughout the lifespan and with a variety of disabling
conditions, with the primary focus on engagement in activities. Documentation is used in
each of these environments to reflect a client's participation and performance in
Occupational Therapy and a client's change in functional performance.
Evaluation - a comprehensive overview of a client's functioning to determine if
a client qualifies for intervention. Areas addressed during the evaluation include:
motor control, cognitive ability, mental status, response to sensory stimulation,
self- care skills, cornmunication/ interaction skills, and occupational performance.
Evaluation tools frequently used could include both standardized and non-standardized
assessments. Specific evaluative measures might entail client
observation, interview with client and/ or family members, review of previous
medical and educational history, assessment of muscle strength and range of
motion, developmental assessment, and samples of work- related materials.
Treatment - Intervention activities specific to the disability, age, culture, and
environment of the client to promote function and development. A treatment plan
is completed with the client and other health team members to outline strategies to
achieve mutually agreed upon goals and objectives. Treatment techniques focus
on development of skills, and may involve environmental modifications,
modalities, assistive technology, or training in the use of adaptive devices or
modified techniques to foster independence and success.
Assessment - The review of a client's status throughout the course of
occupational therapy is conducted to verify progression toward identified goals.
The treatment plan is periodically revised to reflect changes as well as determine
when to terminate services.
The mission of the Board is to ensure the public's health, safety and welfare by licensing
and regulating individuals who provide Occupational Therapy services.
The Goals of the Board are to ensure the legal operations, ethical practices and quality
practice in the OT and OTA profession by:
1. Ensure qualified applicants are issued a license or permit
2. Ensure license renewal applicants are issued a renewal license
3. Investigate and adjudicate complaints.
The Board has two primary programs: Licensing and Regulation of OTs and OTAs.
1. Licensing and Regulation - The Board strives to issue, renew or deny a license,
permit, or registration within 30 days.
2. The Board receives, investigates, and adjudicates complaints consistent with an
average turnaround of 120 days, and the Board takes disciplinary action when
evidence of violations occur.
2. THE EFFECTIVENESS WITH WHICH THE BOARD HAS MET ITS
OBJECTIVES AND PURPOSE AND THE EFFICIENCY WITH WHICH IT
HAS OPERATED.
The Board carries out its statutory mandate and meets its objectives. The Board also
efficiently operates as demonstrated below:
1. Licensure - As required by A. R. S. 32- 3421,32- 3426, and 32- 3428, the
Board has been in compliance with its licensing time frames. Please refer to:
Tab 3 - Licensing Time Frame Compliance Reports for FY 2005- 2007
Each new license application contains 6 items that must be reviewed and approved by
st& and then the Board. In addition, each applicant for original licensure, license
renewal, license reinstatement, or a limited permit that has not previously done so must
submit a full set of fingerprints to the Board for the purpose of obtaining a state and
federal criminal records background check pursuant to A. R. S. 41- 1 750 and public law
92- 544. Staff will review the results of each applicant's records background check and
compare it with the applicant's disclosures on the application form. On average it takes
no longer than 30 days to process a new application, however extra time is required for
the fingerprint report to anive. In FY 2007, the Board received 245 initial applications.
The average time frame for issuing an initial license was 30 days. Once licensed, the
licensee must renew their license bi- annually.
- 2-
During license renewal, each licensee must submit 3 items for staff review and approval.
This process takes no longer than 30 days to complete. In FY 2007, the Board received
564 license renewal applications. The average time frame for issuing a renewal was 30
days
Tab 4 - Initial Application for Licensure
Tab 5 - Bi- annual License Renewal Form
2. Complaint Process - The anticipated time frame ffom receipt of a complaint to its
resolution is 120 days.
a. A. R. S. 32- 3442 and 32- 3443 allows the Board to investigate complaints and
hold hearings. The Board strives to resolve complaints that allege less serious
violations within a 120 day time frame. An example of a complaint alleging a
less serious violation is: failing to document or maintain client treatment
records; or failing to prepare client reports within 30 days.
In FY 2007, the Board reviewed 25 complaints andlor licensure incidents. The
Board issued 1 1 disciplinary actions ( 2 of the complaint matters were
carried- over fiom FY 06); issued 3 letters of concern; and dismissed 9
complaints. 21 complaints were resolved within 120 days, and there are
2 pending complaint matters.
b. Complaints with more serious allegations such as billing for services not
rendered; falsifying documents including applications; occupational therapy
assistants practicing outside their training; or practicing occupational therapy
without a license may take significantly longer to investigate. Investigations
may include having to issue subpoenas for client records, interview
the complainant, licensee and any witnesses. At the conclusion of the
investigation, the information is reported to the Board, and they evaluate and
determine if there may be evidence of a possible violation. If the Board
determines that a violation may have occurred, they will hold an Informal
Interview with the licensee to determine possible disciplinary action.
0 Tab 6 - 2007 2" d Quarter Performance Measures Table ( calendar year)
3. Budget - The Board operates within its Legislative Appropriation. In fact, the Board
has never over- spent its appropriation. Please refer to:
0 Tab 7 - FY 2008 - 2009 Appropriations Report.
4. The Board has a very positive relationship with the regulated community. Please refer
to:
Tab 8 - Letter from the American Occupational Therapy Association, Inc.
Letter fiom the Arizona Occupational Therapy Association
3. THE EXTENT TO WHICH THE BOARD HAS OPERATED WITHIN THE
PUBLIC INTEREST.
The Board has operated, and will continue to operate within the public interest as
demonstrated by:
1. Members of the Board possess the Occupational Therapy knowledge and expertise
in areas such as:
Client Evaluation and assessment - understanding of the patientjclient
occupational history and experiences including activities of daily living,
development, activity demands, values, and needs including temporal, spiritual
and cultural.
Client Intervention - ability to implement a variety of strategies to improve a
client's functional skills.
Documentation - the ability to report and interpret results, justify treatment
strategies, and modify interventions to facilitate development and determine
cohesiveness of intervention with expected outcomes
2. The licensure process provides public assurances that the OTs and OTAs provide
quality service to clients, meet minimum licensure requirements and have
principals of good practice.
3. The complaint process provides due process for the licensees. The complainants
are also involved in the process and have an opportunity to present their concerns
at a public Board meeting.
4. Open meeting laws are strictly followed and public record requests are provided in
a timely manner.
5. Any member of the public may call the Board office during regular working hours
and receive public information regarding a licensee, to include dates of licensure,
accreditation and if applicable, any disciplinary actions or non- disciplinary letters
of concern. Upon written request, copies of public records are available for a
copying fee or review at the Board office.
6. The Board continues to maintain a website (&.~; e~ ut,'~ ii~ 11ti13ds~~ crfi-~) i~ n.,~- aib oie)
that provides Board information, laws and rules, complaint forms, application
forms, and licensee information. The Board also posts any proposed statutes
or rules on the website.
7. The Board takes very seriously the notification to all licensees of proposed
amendments to rules and statutes. The matter is always placed on the Board
agenda which is mailed upon request. The Board has identified the following
two changes to the website:
- 4-
a. The need to post meeting agendas, meeting minutes, and the complaint and
licensure process on the website.
b. The desire to conform to the Governor's Information Technology Agency
( GITA).
The agency desires to change the website and email addresses to the GITA's networks for
information technology. This will enable the agency to address any technical problems
more efficiently and effectively. The Board anticipates completion of the transition no
later than December, 2007.
Please refer to:
Tab 9 - Board's website
4. THE EXTENT TO WHICH RULES ADOPTED BY THE AGENCY ARE
CONSISTENT WITH THE LEGISLATIVE MANDATE.
The Board's administrative rules, 4 A. A. C. 43, articles 1 through 4, are authorized by the
agency's general rulemaking authority contained in A. R. S. $ 32- 3404( A)( 4).
Article 1, Article 2, Article 3, and Article 4 became effective in 1992.
Although current rules are consistent with its statutes, the Board drafted proposed rule
amendments to update and clarify several of its rules. The Board has targeted three
specific rule amendments that were identified in their 2003,5- Year- Rules Review
Report. They are: R4- 43- 101 Definitions; R4- 43- 102 Fees; and R4- 43- 103 Service by
the Board. The amendments have been drafted and approved by the Board, and will be
reviewed by a rule writer attorney to help ensure the amendments conform to the
agency's statutes. The Board anticipates final rulemaking no later than March, 2008
which will be within the approved time frame for completion by the Governor's
Regulatory Review Council ( GRRC).
Tab 10 - Five Year Review Progress Report
In addition to the three rule changes above, the Board drafted amendments to the
following rules: R4- 43- 201 Initial Application; R4- R4- 43- 202 Renewal of License;
R4- 43- 203 Continuing Education of Renewal of License; R4- 43- 206 Procedures for
Submitting Fingerprints; and R4- 43- 401 Supervision of Occupational Therapy Assistants.
These amendments will be reviewed by a rule writer attorney no later than March, 2008.
The rule writer will review the rules to ensure the amendments conform to the agency's
statutes. All proposed rules will be amended to:
Conform to current rulemaking format and style requirements;
Improve the rules' clarity, conciseness, and understandability;
Ensure consistency with state statutes and rules;
Better protect the public; and
Enhance regulatory oversight of Occupational Therapists and Occupational
Therapy Assistants practicing in Arizona.
5. THE EXTENT TO WHICH THE BOARD HAS ENCOURAGED INPUT
FROM THE PUBLIC BEFORE ADOPTING ITS RULES AND THE
EXTENT TO WHICH IT HAS INFORMED THE PUBLIC AS TO ITS
ACTION AND THEIR EXPECTED IMPACT ON THE PUBLIC.
The Board complies with A. R. S. 41 - 1 023. Public participation; written statements; oral
proceedings in the promulgation of all Board rules. All proposed rule revisions are
discussed at regularly scheduled Board meetings. The Board meetings comply with
Open Meeting Laws and notices are sent to all interested parties and posted in accordance
with state law. In the most recent proposed rulemaking, the Board considered the draft
proposed rules at open meetings held throughout several open meetings in 2004 through
2006.
The Board solicits and considers comments it receives during the rules promulgation
process. Because of the nature of the rule change, the Board often conducted informal
meetings to better understand constituent concerns. The Board makes every effort to
include stakeholders in the process and receive public comment prior to opening a docket
and submitting a proposed rule package to GRRC.
In addition:
The Board publishes its statutes and rules, including proposed rule packages on
the Board's website.
Proposed rules, including a notice of dates and locations of hearings being held to
obtain public comment, are published in the Arizona Administrative Register.
All new license applicants receive a copy of the statutes and rules with the
application packet.
6. THE EXTENT TO WHICH THE BOARD HAS BEEN ABLE TO
INVESTIGATE AND RESOLVE COMPLAINTS THAT ARE WITHIN ITS
JURISDICTION.
The Board's authority is sufficient to give it the ability to investigate and resolve
complaints.
The Board maintains accurate and complete complaint information. Below is a list of
established complaint- handling procedures that have been implemented since the last
sunset audit in 1996.
I. The Board establishes a complaint file only when the information indicates a violation
of its statutes or rules.
2. The Board ensures each closed complaint file contains complete documentation.
The complaint file includes:
a. a summary of the complaint
b. a complaint number
c. a statement of the nature of the violation
d. background information regarding how and when the complaint was received
e. an outline of investigative actions
f. a notice of hearing if one is warranted
g. a final disposition or order including the date of the final decision
h. notification letter of the action is sent to the complainant, and licensee.
3. The Board ensures that a copy of any disciplinary action is placed in the licensing
file of the licensee.
4. The Board has refined its investigative report writing process by providing
an overview of the allegations made by complainants against licensees. A
chronological framework is provided as well as a listing of the alleged violations
of professional conduct codes contained in A. R. S. 532- 3401. Please refer to:
Tab 1 1 - Board action sheet
7. THE EXTENT TO WHICH THE ATTORNEY GENERAL OR ANY OTHER
APPLICABLE AGENCY OF STATE GOVERNMENT HAS THE
AUTHORITY TO PROSECUTE ACTIONS UNDER THE ENABLING
LEGISLATION.
Judicial review of suspension or revocation of a license is available as provided in Title
12, Chapter 7, Article 6. The Board may seek injunctive relief through the attorney
general or the county attorney may apply to the superior court of Maricopa County for an
injunction restraining individuals fiom violating the statutes governing the Board.
In addition, an assistant attorney general currently, and in the past advise the Board on
legal matters at each of the Board meetings held monthly.
8. THE EXTENT TO WHICH THE BOARD HAS ADDRESSED DEFICIENCIES
1N ITS ENABLING STATUTES THAT PREVENT IT FROM FULFILLING
ITS STATUTORY MANDATE.
In the past five years, the Board has experienced a trend in receipt of complaints andlor
applications involving convictions of a crime. The Board sought the help and guidance
of their assistant attorney general to help develop examples of facts that define crimes
involving moral turpitude and crimes tha~ D O NOT involve moral turpitude. The Board
uses discretion in extraordinary circumstances only when determining whether the crime
is one of moral turpitude.
Please refer to:
Tab 12- Memorandum from the Ofice of the Attorney General
Licensing & Enforcement Section
9. THE EXTENT TO WHICH CHANGES ARE NECESSARY IN THE LAWS OF
THE AGENCY TO ADEQUATELY COMPLY WITH THESE FACTORS.
The Board has identified the following statute for amendment:
A. R. S. $ 32- 3423( 1) Application for licensure; qualifications; examinations
The current statute states: An applicant for licensure as an occupational therapist or as an
occupational therapy assistant shall file a written application, provided by the Board,
showing to the satisfaction of the Board that the applicant: 1. Is of good moral
character and has not been convicted of a crime of moral turpitude.
The Board will propose an amendment to read: 1. Is of good moral character and has
not been convicted of A FELONY WITHIN 5 YEARS.
The Board believes an amendment is necessary because current law limits the Board's
discretion and ability to consider each case on its own merits.
10. THE EXTENT TO WHICH THE TERMINATION OF THE BOARD WOULD
SIGNIFICANTLY HARM THE PUBLIC HEALTH, SAFETY OR
WELFARE.
The Arizona Board of Occupational Therapy Examiners believes that the elimination of
this Board would negatively impact the quality of the Occupational Therapy profession in
the state of Arizona. The deregulation of Occupational Therapists and Occupational
Therapy Assistants could lead to abuse in the health care sector and significantly reduce
consumer ( client) protection. The educational demands of the profession dictate a fm
foundation in areas of anatomy, physiology, psychology, growth and development,
disabilities, technology, and analysis of human performance. Rigorous training is
essential in both the assessment and treatment process as demonstrated by successful
completion in internships. During the internship process, an occupation therapy
professional must demonstrate understanding and impact of physical disabilities and
mental health on a client's function. Persons claiming to provide occupational therapy
without such education and training could lead to serious consequences in client care.
Occupational Therapists frequently interact on an intimate basis with clients who may be
vulnerable to improprieties or are unable to protect themselves due to the nature of their
illness or disability. Without licensure there would be no vehicle for reporting and
investigating such improprieties.
Practitioners in private practice are not subject to controls other than those provided by
licensure. The internal and external control over a therapist's accountability is provided
by larger facilities such as hospitals, educational facilities, and clinics. Such oversight
does not occur with therapists within the private practice sector. As areas of practice
continue to emerge in the occupational therapy profession, more practitioners may not
have controls other than licensure.
11. THE EXTENT TO WHICH THE LEVEL OF REGULATION EXERCISED
BY THE BOARD IS APPROPRIATE AND WHETHER LESS OR MORE
STRINGENT LEVELS OF REGULATION WOULD BE APPROPRIATE.
At this time, the Board believes the level of regulation is appropriate, however the Board
is cognizant that as changes in the occupational therapy profession occur, revisions to
regulation may be needed.
12. THE EXTENT TO WHICH THE BOARD HAS USED PRIVATE
CONTRACTORS IN THE PERFORMANCE OF ITS DUTIES AND
HOW EFFECTIVE USE OF PRIVATE CONTRACTORS COULD BE
ACCOMPLISHED.
The Board has not utilized private contractors to a large extent. Currently, the Board
utilizes an outside contractor to update and install program enhancements to its website.
On occasion, the Board utilized contracts for professional rule writers. The Board could
utilize the professional rule writer more frequently to accomplish its rule writing outcome
more efficiently and effectively.
ADDITIONAL QUESTIONS:
1. AN IDENTIFICATION OF THE PROBLEMS OR THE NEEDS THAT
THE BOARD INTENDS TO ADDRESS.
A. The following are legislative considerations for the Board:
Amend all of the articles in statute to:
Conform to current statute format and style requirements;
Improve the statutes clarity, conciseness, and understandability;
Ensure consistency with statutes and rules;
Enhance regulatory oversight of occupational therapists and
occupational therapy assistants
2. A STATEMENT, TO THE EXTENT PRACTICABLE, IN QUANTITATIVE
AND QUALITATIVE TERMS, OF THE OaJECTIVES OF THE BOARD
AND ITS ANTICIPATED ACCOMPLISHMENTS.
Licensing:
The Board's legislative intent to issue licenses to Occupational Therapists and
Occupational Therapy Assistants that meet the minimum requirements for
licensure will continue.
The Board will continue to meet the statutory time frames for issuing initial
licenses, renewals, and permits.
Complaints:
The Board will ensure the grounds for disciplinary action and the disciplinary
processes are enforced, and in a timely manner.
The Board will continue to work with licensees to correct deficiencies or
violations through the disciplinary process to ensure patient protection.
3. AN IDENTIFICATION OF ANY OTHER BOARDS OR AGENCIES HAVING
SIMILAR, CONFLICTING OR DUPLICATIVE OBJECTIVES, AND AN
EXPLANATION OF THE MANNER IN WHICH THE BOARD AVOIDS
DUPLICATION OR CONFLICT WITH OTHER SUCH AGENCIES.
The Arizona Board of Physical Therapy licenses Physical Therapists. They provide
similar services to patients such as functional training in self- care and in home,
community or work reintegration. However the extent of their services include
performing specific designated tasks related to therapeutic exercise, manual therapy
techniques, therapeutic massage, pulmonary hygiene, debridement and wound care. The
educational criteria for a Physical Therapist differs from the educational criteria required
of an Occupational Therapist.
The Board does not believe that the regulation provided by the Physical Therapy Board is
conflicting or duplicative of the Board's legislative mandate or regulatory
responsibilities.
4. AN ASSESSMENT OF THE CONSEQUENCES OF ELIMINATING THE
BOARD OR OF CONSOLIDATlNG IT WITH ANOTHER BOARD OR
AGENCY.
In addition to the Board's response to Sunset Factor 10, the Board believes the
consolidation of the Board with another agency or agencies would be extremely
detrimental to its licensees and the consumer for the following reasons:
1. The 90110 regulatory boards serve a vast array of constituents. To consolidate the
agencies and their regulatory needs, with such diversity, would require an
infrastructure that would be very costly. The time, effort and costs to such a project,
if done correctly, would take years.
2. The regulated community will lose " its own identity".
3. Bigger does not always mean better service and efficiency.
4. The regulated community will lose its " own" personnellagency, the
personnellagency with the knowledge and experience of their specific profession or
industry.
5. Economies of scale - the number of services that could be shared - accounting
services, attorney general services, records storage, DOA building rent - are already
being paid by the 90110 board either by its 10% to the general fund, or direct
payments.
6. The 9011 0 regulatory boards are not a " drain" on the general h d , in fact, the board
provides funding for the general h dan d many of the other general fund agencies.
7. As a rule, the regulatory boards are well managed and respected by their specific
professionslindustries.
8. Consolidation may very well result in a tax increase of the regulated community, same
amount of fees with less specialized service.
9. Diversity in licensing and reporting requirements of the various professions and
industries would not result in a lot of commonality.
10. The potential loss of the Board members time and energy may be lost if
the Board members are not provided the same amount of experience and
knowledgeable staff support.
1 1. The staff of the Occupational Therapy Board of Examiners carries out the
administrative responsibilities of the Board of Athletic Training.
August 17,2007
Linda Wells
Chairperson
Arizona Board of Occupational Therapy Examiners
5060 North 19th Avenue, Suite 209
Phoenix, AZ 850 1 5
RE: Legislative Sunset Audit Review
The Arizona Occupational Therapy Association ( ArizOTA) strongly supports the
Arizona Board of Occupational Therapy Examiners ( ABOTE). ABOTE serves
occupational therapy practitioners in the state by dealing with issues regarding service
delivery, supervision of occupational therapy assistants, billing, renewing licenses and
granting initial licenses following criminal history checks by fingerprinting. This ensures
the safety and high standards of care for occupational therapy clients. ABOTE has also
taken the time to meet with the ArizOTA board and its members to discuss possible
changes in the ABOTE's statutes and rules.
Arizona's occupational therapy practitioners and their clients greatly benefit from
ABOTE's responsibilities to respond to concerns, complaints, and licensure requests.
We support the continued state regulation of the occupational therapy profession here in
Arizona.
Sincerely,
Nit& cdllo, us, ~ I L
Nina Castillo, MS, OTRL
ArizOTA President
@ The American
-- Occupational Therapy I - Association, Inc.
Occupational Therapy:
Skills for the Job of Living
August 3,2007
Kathryn Babits, MS OTRIL
Chairperson
Arizona Board of Occupational Therapy Examiners
5060 North 1 gth venue, Suite 209
Phoenix, Anzona 850 15
RE: Legislative Sunset Audit Review
On behalf of the American Occupational Therapy Association, Inc. ( AOTA), which
represents the professional interests of more than 36,000 occupational therapists and
occ. upationa1 therapy assistants throughout the country, including nearly 500 members in
the state of Arizona, thank you for the opportunity to comment on the Legislative Sunset
Audit Review of Arizona Board of Occupational Therapy Examiners. AOTA strongly
supports the continued state regulation of occupational practice in Arizona.
For more than 25 years, AOTA has worked with state occupational therapy associations
to enact practice acts. The occupational therapy profession is regulated in all 50 states,
the District of Columbia, Guam and Puerto Rico. AOTA supports licensure for
occupational therapists and occupational therapy assistants because it provides guidelines
and standards that protect consumers and improve the profession as a whole. We believe
that it is important to assure consumers that occupational therapy practitioners meet strict
education, training and examination requirements. Arizona's licensure requirements are
consistent with AOTA's professional standards. I have attached a copy of AOTA's
Standards of Practice for the Board's reference.
AOTA commends the Arizona Board of Occupational Therapy Examiners for the work it
has done to implement and enforce the state's Occupational Therapy Practice Act since it
+ tv-- Gooh p aasied ic 1989. 1. Vs k: sw fiat thz EGXG h x csed its authsrity tc asswe the
highest degree of professional conduct on the part of occupational therapy practitioners
and to protect the public fi- om incompetent and unauthorized personnel.
Again, we support the continued state regulation of the occupational therapy profession
in Anzona. Please contact me if you have questions or need additional information.
Sincerely.
Charles Willmarth
Director, State Affairs
cc: Nina Castillo, MS, OTR/ L, President, Arizona Occupational Therapy Association
The American 4720 Montgomery Lane 301 - 652- 2682
Occupational Therapy Bethesda, MD 20814- 3425 301 - 652- 771 1 Fax
Association. Inc
800- 377- 8555 TDD
www. aota. org
Standards of Practice
The American Occupational Therapy Association
STANDARDS OF PRACTICE FOR OCCUPATIONAL THERAPY
Preface
This document defines minimum standards for the practice of occupational therapy. The Standards of
Practice for Occupational Therapy are requirements for occupational therapists and occupational
therapy assistants for the delivery of occupational therapy services. The Reference Manual of Oficial
Documents contains documents that clarify and support occupational therapy practice ( American
Occupational Therapy Association [ AOTA, 20041). These documents are reviewed and updated on an
ongoing basis for their applicability.
Education, Examination, and Licensure Requirements
All occupational therapists and occupational therapy assistants must practice under federal and state
law.
To practice as an occupational therapist, the individual trained in the United States
has graduated from an occupational therapy program accredited by the Accreditation Council
for Occupational Therapy Education ( ACOTE? or predecessor organizations;
has successfully completed a period of supervised fieldwork experience required by the
recognized educational institution where the applicant met the academic requirements of an
educational program for occupational therapists that is accredited by ACOTE@ or
predecessor organizations;
has passed a nationally recognized entry- level examination for occupational therapists; and
fulfills state requirements for licensure, certification, or registration.
To practice as an occupational therapy assistant, the individual trained in the United States
has graduated from an associate- or certificate- level occupational therapy assistant program
accredited by ACOTE@ or predecessor organizations;
has successfully completed a period of supervised fieldwork experience required by the
recognized educational institution where the applicant met the academic requirements of an
educational program for occupational therapy assistants that is accredited by ACOTE@ or
predecessor organizations;
has passed a nationally recognized entry- level examination for occupational therapy
assistants; and
fulfills state requirement's for licensure, certification, or registration.
Definitions
Assessment. Specific tools or instruments that are used during the evaluation process.
Client. A person, group, program, organization, or community for whom the occupational therapy
practitioner is providing services.
Evaluation. The process of obtaining and interpreting data necessary for intervention. This includes
planning for and documenting the evaluation process and results.
Screening. Obtaining and reviewing data relevant to a potential client to determine the need for further
Standards of Practice
The American Occupational Therapy Association
evaluation and intervention.
Standard I: Professional Standing and Responsibility
1. An occupational therapy practitioner ( occupational therapist or occupational therapy assistant)
delivers occupational therapy services that reflect the philosophical base of occupational therapy and
are consistent with the established principles and concepts of theory and practice.
2. An occupational therapy practitioner is knowledgeable about and delivers occupational therapy
services in accordance with AOTA standards, policies, and guidelines, and state and federal
requirements relevant to practice and service delivery.
3. An occupational therapy practitioner maintains current licensure, registration, or certification as
required by law or regulation.
4. An occupational therapy practitioner abides by the AOTA Occupational Therapy Code ofEthics
( AOTA, 2000).
5. An occupational therapy practitioner abides by the AOTA Standards for Continuing Competence
( AOTA, 1999) by establishing, maintaining, and updating professional performance, knowledge, and
skills.
6. An occupational therapist is responsible for all aspects of occupational therapy service delivery and
is accountable for the safety and effectiveness of the occupational therapy service delivery process.
7. An occupational therapy assistant is responsible for providing safe and effective occupational
therapy services under the supervision of and in partnership with the occupational therapist and in
accordance with laws or regulations and AOTA documents.
8. An occupational therapy practitioner maintains current knowledge of legislative, political, social,
cultural, and reimbursement issues that affect clients and the practice of occupational therapy.
9. An occupational therapy practitioner is howledgeable about evidence- based research and applies it
ethically and appropriately to the occupational therapy process.
Standard 11: Screening, Evaluation, and Re- evaluation
1. An occupational therapist accepts and responds to referrals in compliance with state laws or other
regulatory requirements.
2. An occupational therapist, in collaboration with the client, evaluates the client's ability to participate
in daily life activities by considering the client's capacities, the activities, and the environments in
which these activities occur.
3. An occupational therapist initiates and directs the screening, evaluation, and re- evaluation process
and analyzes and interprets the data in accordance with law, regulatory requirements, and AOTA
documents.
Standards of Practice
The American Occupational Therapy Association
4. An occupational therapy assistant contributes to the screening, evaluation, and re- evaluation process
by implementing delegated assessments and by providing verbal and written reports of observations
and client capacities to the occupational therapist in accordance with law, regulatory requirements,
and AOTA documents.
5. An occupational therapy practitioner follows defined protocols when standardized assessments are
used.
6. An occupational therapist completes and documents occupational therapy evaluation results. An
occupational therapy assistant contributes to the documentation of evaluation results. An
occupational therapy practitioner abides by the time frames, formats, and standards established by
practice settings, government agencies, external accreditation programs, payers, and AOTA
documents.
7. An occupational therapy practitioner communicates screening, evaluation, and re- evaluation results
within the boundaries of client confidentiality to the appropriate person, group, or organization.
8. An occupational therapist recommends additional consultations or refers clients to appropriate
resources when the needs of the client can best be served by the expertise of other professionals or
services.
9. An occupational therapy practitioner educates current and potential referral sources about the scope
of occupational therapy services and the process of initiating occupational therapy services.
Standard IIC: Intervention
1. An occupational therapist has overall responsibility for the development, documentation, and
implementation of the occupational therapy intervention based on the evaluation, client goals,
current best evidence, and clinical reasoning.
2. An occupational therapist ensures that the intervention plan is documented within the time frames,
formats, and standards estab1, ished by the. practice settings, agencies, external accreditation
programs, and payers.
3. An occupational therapy assistant selects, implements, and makes modifications to therapeutic
activities and interventions that are consistent with the occupational therapy assistant's demonstrated
competency and delegated responsibilities, the intervention plan, and requirements of the practice
setting.
4. An occupational therapy practitioner reviews the intervention plan with the client and appropriate
others regarding the rationale, safety issues, and relative benefits and risks of the planned
interventions.
5. An occupational therapist modifies the intervention plan throughout the intervention process and
documents changes in the client's needs, goals, and performance.
Standards of Practice
The American Occupational Therapy Association
6. An occupational therapy assistant contributes to the modification of the intervention plan by
exchanging information with and providing documentation to the occupational therapist- about the
client's responses to and communications throughout the intervention.
7. An occupational therapy practitioner documents the occupational therapy services provided within
the time frames, formats, and standards established by the practice settings, agencies, external
accreditation programs, payers, and AOTA documents.
Standard IV: Outcomes
1. An occupational therapist is responsible for selecting, measuring, documenting, and interpreting
expected or achieved outcomes that are related to the client's ability to engage in occupations.
2. An occupational therapist is responsible for documenting changes in the client's performance and
capacities and for discontinuing services when the client has achieved identified goals, reached
maximum benefit, or does not desire to continue services.
3. An occupational therapist prepares and implements a discontinuation plan or transition plan based
on the client's needs, goals, performance, and appropriate follow- up resources.
4. An occupational therapy assistant contributes to the discontinuation or transition plan by providing
information and documentation to the supervising occupational therapist related to the client's
needs, goals, perfonnance, and appropriate follow- up resources.
5. An occupational therapy practitioner facilitates the transition process in collaboration with the client,
family members, significant others, team, and community resources and individuals, when
appropriate.
6. An occupational therapist is responsible for evaluating the safety and effectiveness of the
occupational therapy processes and interventions within the practice setting.
7. An occupational therapy assistant contributes to evaluating the safety and effectiveness of the
occupational therapy processes and interventions within the practice setting.
References
American Occupational Therapy Association. ( 1 999). Standards for continuing competence. American
Journal of Occupational Therapy, 53, 599- 600.
American Occupational Therapy Association. ( 2000). Occupational therapy code of ethics ( 2000).
American Journal of Occupational Therapy, 54,6 14- 6 16.
American Occupational Therapy Association. ( 2004). The reference manual of the oficial documents of
the American Occupational Therapy Association ( 10th ed.). Bethesda, MD: Author.
Standards of Practice
The American Occupational Therapy Association
Authors
The Commission on Practice:
Sara Jane Brayman, PhD, OTRIL, FAOTA, Chairperson
Susanne Smith Roley, MS, OTR/ L, FAOTA, Chairperson- Elect
Gloria Frolek Clark, MS, OTR/ L, FAOTA
Janet V. DeLany, DEd, MSA, OTR/ L, FAOTA
Eileen R. Garza, PhD, OTR, ATP
Mary V. Radomski, MA, O m , FAOTA
Ruth Ramsey, MS, OTR/ L
Carol Siebert, MS, OTR/ L
Kristi Voelkerding, BS, COTAIL
Lenna Aird, COTIVL, ASD Liaison
Patricia D. LaVesser, PhD, OTR/ L, SIS Liaison
Deborah Lieberman, MHSA, OTRIL, FAOTA, AOTA Headquarters Liaison
for
The Commission on Practice
Sara Jane Brayman, PhD, O m , FAOTA, Chairperson
Adopted by the Representative Assembly 2005C218
NOTE: This document replaces the 1994 Standards of Practice for Occupational Therapy. These standards. are intended as
recommended guidelines to assist occupational therapy practitioners in the provision of occupational therapy services. These
standards serve as a minimum standard for occupational therapy practice and are applicable to all individual populations and
the programs in which these individuals are served.
Previously published and copyrighted in 1998 by the American Occupational Therapy Association in the American Journal
of Occupational Therapy, 52,866- 869.
Interim agendas can be obtained via the Internet at http: llwww. azleg. state. az. usllnterimCommittees. asp
ARIZONA STATE SENATE
INTERIM MEETING NOTICE
OPEN TO THE PUBLIC
SENATE HEALTH AND HOUSE HEALTH COMMITTEE OF REFERENCE
Date: Tuesday, November 6,2007
Time: 9: 30 A. M.
Place: SHR I
AGENDA
1. Call to Order
2. Opening Remarks
3. Sunset Review of the Board of Homeopathic Medical Examiners
Presentation by Auditor General
Response by Board of Homeopathic Medical Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
4. Sunset Review of the Regulatory Board of Physician Assistants
Presentation by Regulatory Board of Physician Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
5. Sunset Review of the Board of Behavioral Health Examiners
Presentation by Board of Behavioral Health Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
6. Sunset Review of the Acupuncture Board of Examiners
Presentation by Acupuncture Board of Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
7. Sunset Review of the Board of Occupational Therapy Examiners
Presentation by Board of Occupational Therapy Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
Page 1 of 2
8. Sunrise application of the Arizona Alliance of Non- Physician Surgical Assistants
Presentation by Arizona Alliance of Non- Physician Surgical Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
9. Sunrise application of the Southern Arizona Behavioral Health Coalition
Presentation by Southern Arizona Behavioral Health Coalition
Public Testimony
Discussion
Recommendations by the Committee of Reference
10. Sunrise application of the Arizona Dental Association
Presentation by Arizona Dental Association
Public Testimony
Discussion
Recommendations by the Committee of Reference
1 1. Sunrise application of Radiology Practitioner Assistants
Presentation by Radiology Practitioner Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
12. Adjourn
Members:
Senator Tom O'Halleran, Co- Chair
Senator Paula Aboud
Senator Amanda Aguirre
Senator Barbara Leff
Senator Thayer Verschoor
Representative Bob Stump, Co- Chair
Representative Nancy Barto
Representative David Bradley
Representative Linda Lopez
Representative Rick Murphy
Persons with a disability may request a reasonable accommodation such as a sign language interpreter, by contacting the
Senate Secretary's Office: ( 602) 926- 4231 ( voice). Requests should be made as early as possible to allow time to arrange the accommodation.
Page 2 of 2
ARIZONA STATE LEGISLATURE
Forty- eighth Legislature - First Regular Session
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
Minutes of Interim Meeting
Tuesday, November 6,2007
Senate Hearing Room 1 - 9: 30 a. m.
Chairman OYHalleran called the meeting to order at 9: 32 a. m. and attendance was noted by the
secretary.
Members Present
Senator Tom O'Halleran, Co- Chair Representative Bob Stump, Co- Chair
Senator Amanda Aguirre Representative Nancy Barto
Senator Barbara Leff Representative David Bradley
Senator Thayer Verschoor Representative Linda Lopez
Representative Rick Murphy
Members Absent
Senator Paula Aboud
Speakers Present
Kim Hildebrand, Performance Audit Manager, Office of the Auditor General
Todd Rowe, Board of Homeopathic Medical Examiners
Christine Springer, Board of Homeopathic Medical Examiners
Jerry Weinsheink, representing himself
Marianne Cherney, representing herself
Neil Garfield, Association for Public Access to Medicine
Barney Nugent, representing himself
Linda Heming, CHOICE
Iris Bell, Doctor, Arizona Homeopathic and Integrative Medical Association
Cliff Heinrich, Doctor, representing himself
Kathleen Fry, Doctor, representing herself
Denise Nugent, representing herself
Lee Bakunin, Attorney, representing herself
Bruce Shelton, Doctor, Arizona Homeopathic and Integrative Medical Association
Amanya Jacobs, Director of Evolution of Self School of Homeopathy
Cindy Zukerman, representing herself
Shelly Malone, representing herself
Stan Klusky, representing himself
Gladys Conroy, representing herself
SENATE HEALTH AND HOUSE HEALTH
COMMlTTEE OF REFERENCE
November 6,2007
Joan Reynolds, Regulatory Board of Physician Assistants
Debra Rinaudo, Board of Behavioral Health Examiners
Stuart Goodman, Board of Behavioral Health Examiners
Bev Hermon, BH Consulting
Richard Poppy, Therapeutic Practitioners Alliance of Arizona ( The Alliance)
Rachael Hopkins, representing herself
Ronald Anton, representing himself
Josephine Sbrocca, representing herself
Cedric Davis, Board of Behavioral Health Examiners
Della Estrada, Arizona Acupuncture Board of Examiners
Kathryn Babits, Arizona State Board of Occupational Therapy Examiners
Eugene Smith, Arizona Alliance of Non- Physician Surgical Assistants
Susie Cannata, Arizona Alliance of Non- Physician Surgical Assistants
Rory Hays, Arizona Nurses' Association
Scott Leckie, Radiology Practitioner Assistants
Jane Van Valkenburg, Certification Board for Radiology Practitioner Assistants ( CBRPA)
Mary Connell, M. D., representing herself
Christine Lung, American Society of Radiologic Technologists ( ASRT)
John Gray, Grand Canyon University
Joyce Geyser, Arizona Radiological Society
James Abraham, National Society of Radiology Practitioner Assistants
Heather Owens, Senate Health Analyst
Aubrey Godwin, Medical Radiologic Technology Board of Examiners ( MRTBE)
Teresa Rodgers, Behavioral Health Coalition of Southern Arizona
David Giles, Behavioral Health Coalition of Southern Arizona
Holly Baumann, Southwest Autism Research and Resource Center
John MacDonald, Arizona Dental Association ( ADA)
Rick Murray, Arizona Dental Association
Anita Elliott, Arizona Dental Association
Nicole Laslavic, Arizona State Dental Hygienists' Association
Janet Midkiff, Arizona State Dental Hygienists' Association
Nicole Albo, Arizona Dental Assistants' Association
Alisa Feugate, Arizona Dental Hygienists' Association
OPENING REMARKS
Chairman 07Halleran welcomed everyone and requested that the speakers keep their comments
as brief as possible, as the committee members are well- versed in the issues to be discussed
today.
SUNSET REVIEW OF THE BOARD OF HOMEOPA
Presentation by Auditor General
Kim ~ i l d e b r m r m a n c eA udit Manager, Office of the Auditor General, gave a
p r e d o n th eir findings issued in August, 2007 ( Attachment 1). She described the history
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
2 November 6,2007
about the length of the continuation.
/'
Recommendations by the Committee of Reference / Cochairman Stump moved that the Senate and House
Reference recommend the continuation of the Board
Examiners for five years and that the Joint Legislative
scheduling a performance audit in due haste.
Senator Leff asked if the committee could reconvene after the audit is corydeted.
Cochairman Stump withdrew his motion. / Cochairman Stump moved that ouse Health Committee of
Reference recommend
Examiners for five years and Committee consider
scheduling a performance committee
review at the end of such
Chairman O'Halleran recessed the com7mi e' at 1: 31 p. m.
Chairman 07Halleran at 2: 11 p. m.; all members were present except
Senator Aboud and
Presentation by ~ c u d n c t u rBeo ard of Examiners
explained that the Board provides
in Arizona and has
the general public
ndations by the Committee of Reference
/ Cochairman Stump moved that the Senate and House Health Committee of
Reference recommend the continuation of the Acupuncture Board of Examiners for
ten years. The motion carried by a voice vote.
SUNSET REVIEW OF THE BOARD OF OCCUPATIONAL THERAPY EXAMINERS
Presentation by Board of Occupational Therapy Examiners
Kathryn Babits, Arizona State Board of Occupational Therapy Examiners, addressed the board to
stress that the Board continues to meet its statutory mandate to ensure the public health by
licensing and regulating individuals who provide occupational therapy services.
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
November 6,2007
Recommendations by the Committee of Reference
Cochairman Stump moved that the Senate and House Health Committee of
Reference recommend the continuation of the Board of Occupational Therapy
Examiners for ten years. The motion carried by a voice vote.
SUNRISE APPLICATION OF THE ARIZONA ALLIANCE OF NON- PHYSICIAN /
SURGICAL ASSISTANTS /
Presentation by Arizona Alliance of Non- Physician Surgical Assistants / Eupene Smith, Arizona Alliance of Non- Physician Surgical the committee
to explain that the application now requires licensure
voluntary.
Senator Leff explained that non- physician in limbo because,
although they work in the operating room a separate license.
She stated they were not getting paid recognize their
service as they recognize a surgical she stated, this
profession must be licensed by the Board is now
saying that these individuals are
supervising surgeon's medical license.
Public Testimony
Susie Cannata, Arizona Alliance of on-~ hdcian Surgical Assistants, addressed the committee
to state that this is an attempt to legitimi at is currently going on.
, stated that she is neutral on this but does have concerns
of services, and regulation. She also spoke about
be taken, but with assurances regarding testing and
educational programs.
Recommendations by the mmittee of Reference
that the Senate and House Health Committee of Reference
approve the sunrise application submitted by the
Surgical Assistants. The motion carried by a
res send ti on by Radiolow Practitioner Assistants
SC& Leckie, Radiologv Practitioner Assistants, explained that while radiology assistants ( RAs)
radiology practitioner assistants ( RPAs) are very similar entities, there is no legislation that
ecognizes RPAs, which is a fairly new sub- specialty of radiology. He described RPAs as
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
11 November 6,2007
Janet Midkiff. Arizona State Dental Hygienists' Association, stated that they support the concept
of training community people to be dental health representatives, and that the definition of the
COHR does make sense to them. She stated concerns about the education, licensing, or
certification of the people who fill the COHR positions. She said that her organization would
like to work with the ADA and to be a part of the access to care issue.
Nicole Albo, Arizona Dental Assistants' Association, stated her support for the COHR program
provided that the positions will be filled by certified dental assistants with additional training
components. She stated that she has been working with the ADA to develop a curriculum for
expanded COHR training.
Representative Murphy asked if the committee could approve the concept but not specify the
details, letting the Legislative process do that. Mr. Murray stated that the supervision issue is the
biggest concern.
Alisa Feugate, Arizona Dental Hygienists' Association, stated that she supports the concept of
the COHR but is neutral on the application at this time due to concerns about supervision and
scope of practice.
Recommendations bv the Committee of Reference
Cochairman Stump moved that the Senate and House Health Committee of
Reference recommend that the Legislature amend the statutes of the Arizona Board
of Dental Examiners to create a new certified professional, the Community Oral
Health Representative, to coordinate community- based oral health promotion and
provide specified dental care under the general supervision of a licensed dentist.
The motion carried by a voice vote.
Without objection, the meeting adjourned at 4: 15 p. m.
Jane Dooley, Committee Secretary
November 6,2007
( Original minutes, attachments and audio on file in the Office of the Chief Clerk; video archives
available at
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
November 6,2007