10/15/01
State Disciplinary Provisions
Meredith Mongello
Every occupational therapist; occupational therapy assistant; and applicant for state licensure, certification, or registration should be aware of the professional conduct and disciplinary provisions of their state practice act and regulations. States often incorporate a code of ethics into their disciplinary provisions and may define violations as unprofessional conduct and grounds for disciplinary actions. Some states have adopted The Occupational Therapy Code of Ethics. Others use the Code as a resource for developing their own code of ethics or standards of professional conduct. Some states do not refer to a code of ethics or professional standards and instead focus on unprofessional conduct that is subject to disciplinary action.
As members of the occupational therapy profession, we should all be aware of and comply with the Occupational Therapy Code of Ethics, but the Code most likely is not the only professional conduct standard that you are required to follow. Many states have similar provisions, but many differences also exist--some that may surprise you.
In Arizona's regulations, "failing to document or maintain patient treatment records, or failing to prepare patient or client reports within 30 days of service or treatment" can be grounds for license revocation. Similarly, Florida has standards for "failing to keep written records justifying the course of treatment for the patient, including but not limited to, patient histories, examination results, and test results."
Most state regulatory boards use unprofessional conduct as grounds to deny licensure, and some have the power to impose a fine or penalties. In Minnesota, failure "to refer a client for medical evaluation when appropriate or when a client indicated symptoms associated with diseases that could be medically or surgically treated" is grounds for disciplinary action. In Pennsylvania, some violations of unprofessional conduct can result in a fine of $100 to $500, 30 to 90 days in jail, or both along with license suspension or revocation.
Each regulation is issued primarily to protect the consumer, but regulations also can protect the licensee and the profession. Alabama's regulations state that "an occupational therapist or an occupational therapy assistant shall not continue treatment beyond the point of possible benefit to the patient or treat more frequently than necessary to obtain the maximum therapeutic effect." Several states, including Ohio, have similar language. Iowa goes even further by stating that "It is the responsibility of the occupational therapist to inform the referring practitioner when any requested treatment procedure is inadvisable or contraindicated. The occupational therapist shall refuse to carry out orders that are inadvisable or contraindicated and advise the referring practitioner as such." In Wyoming, "the licensee shall report illegal, incompetent or unethical practice to the appropriate authority." In Ohio, "practicing in an area of occupational therapy for which the individual is clearly untrained or incompetent" also is subject to disciplinary actions. These standards of professional conduct not only are important to keep in mind for oneself, but also should be shared with administrators to guide ethical and legal practice in your facility.
Most states include provisions for sexual misconduct, including conduct of a sexual nature with a patient, but in Nevada "the board will presume that there is a violation of the subsection if the sexual relationship and activity begins during the course of treatment of the patient or within 6 months after termination of the professional relationship with the patient."
In Tennessee, "giving testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, or other articles or materials which are offered to the public, claiming radical cure or prevention of diseases by their use" is grounds for disciplinary action.
Occupational therapy practitioners should follow their professional code of ethics not because they want to avoid disciplinary action, but because they are motivated to maintain high standards of behavior. The Occupational Therapy Code of Ethics is a public statement of the values and principles that promote high standards of behavior in occupational therapy. AOTA welcomes the use of the Code by state regulatory boards as part of its disciplinary provisions. A chart that includes the statutes and regulations on disciplinary provisions for every state is available on AOTA's Web site under State Policy.
Meredith Mongello, an occupational therapy student at Lenoir-Rhyne College, completed Level II fieldwork on July 19, 2001, in AOTA's State Affairs Group.
