Licensure Activity

On July 27, 2017, the Board of Allied Health voted on continuing competency regulations, 259 CMR 7.00: Continuing Competence, and they passed unanimously. These were originally drafted in August 2016.

Massachusetts is one of four states that do not require continuing competency! 

24 units per 2-year cycle will be required. 

2 units must be ethics or laws and regulations governing practice in the Commonwealth of Massachusetts.

On August 24, 2017, the Board of Allied Health reviewed the regulations that were passed in May 2014. 

These regulations were stalled and then put on hold by Governor Baker’s Executive Order 562 when he took office. With some edits/revisions, the regulations were again passed unanimously.

Both sets of regulations are proceeding through the regulatory process.  They will then be submitted for public comment and then become effective. 

There are no updates on these regulations as they are not yet effective.

A representative from MAOT attends most of the monthly Board of Allied Health meetings and reports back to MAOT membership.

Licensure Activity

The new legislative cycle will begin in January 2019.

Interest has been indicated with respect to telehealth and mental health parity legislation.

MAOT was part of the tMed Coalition supporting two health care bills (HB4639 and SB2573) for telemedicine.  Unfortunately, these bills did not pass and MAOT will be monitoring similar bills with the tMed Coalition in the next Legislative Session.

MAOT was in support of HB4742: An Act for prevention and access to appropriate care and treatment of addiction which passed and was signed into law by the Governor.

MAOT was in support of the comprehensive health care initiative-HB 2219 An Act to enhance access to high quality, affordable, and transparent health care in the Commonwealth. 

Unfortunately, this bill did not pass and MAOT will be monitoring any similar bills in the next Legislative Session.

In the next legislative session, MAOT will be pursing mental health and school based practice issues.

We will continue to monitor any opportunities that present themselves for occupational therapy in the health, mental health and education areas.

Licensure Activity

On July 27, 2017, the Board of Allied Health voted on continuing competency regulations, 259 CMR 7.00: Continuing Competence, and they passed unanimously. These were originally drafted in August 2016.

Massachusetts is one of four states that do not require continuing competency! 

24 units per 2-year cycle will be required. 

2 units must be ethics or laws and regulations governing practice in the Commonwealth of Massachusetts.

On August 24, 2017, the Board of Allied Health reviewed the regulations that were passed in May 2014. 

These regulations were stalled and then put on hold by Governor Baker’s Executive Order 562: To Reduce Unnecessary Regulatory Burden, when he took office. With some edits/revisions, the regulations were again passed unanimously.

Both sets of regulations are proceeding through the regulatory process. They will then be submitted for public comment and then become effective. 

There are no updates on these regulations as they are not yet effective.

A representative from MAOT attends most of the monthly Board of Allied Health meetings and reports back to MAOT membership.

Legislative Activity

The legislative cycle began January 17, 2017.

Interest has been indicated with respect to telehealth and mental health parity legislation.

July 18, 2017 Testimony in support of Senate Bill 549 and House Bill 578:  An Act Advancing and Expanding Access to Telemedicine Services

Advocacy/Health Care Reform/Access to Health Care

Participated and reviewed documents for Health Care for All/Mental Health Parity-MAOT signed on to documents to various government agencies advocating mental health parity.

MAOT Board members participated in Mass Health Provider Association Forum meetings

We will continue to monitor any opportunities that present themselves for occupational therapy in the health, mental health and education areas.

For more information on legislative matters, go to http://www.malegislature.gov

Licensure activity

Since February 2008, members of MAOT have been actively involved in reviewing the statute and regulations for

occupational therapy. These regulations have not been revised since the implementation of licensure in 1984.

They are outdated and no longer reflect current practice or terminology. The occupational therapy profession has

undergone tremendous growth and change as a result of evolving health care systems, research, and advances

within health care education and practice.

As reported last year, with Governor Baker's term starting in January 2015, part of his transition was Executive Order 562: To Reduce Unnecessary Regulatory Burden. He issued a "pause" on all boards, on all regulations. This "pause" concluded in June 2016.

All boards had to review CURRENT regulations (not the new proposed regulations that were approved by the Allied Health Board in May 2014) and eliminate the "confusing, unnecessary, redundant, and inconsistent".

Revisions in the spirit of Executive Order 352: Establishing an inter-agency disability services coordinating council were voted on by the Allied Health Board on October 21, 2015. Administration and Finance then had to review all of the changes submitted by the various professional boards and then the process of the public hearings could begin.

In June 2016, the revised regulations were approved by Administration and Finance. In summary, the proposed

changes to our outdated 1984 regulations as a result of Executive Order 352: Establishing an inter-agency disability services coordinating council included the following:

• Documentation-signature with the provider’s name, professional designation, and license number and

  identification of types of documentation from the occupational therapist, occupational therapy assistant, and

  occupational therapy aide.

• Co-signing of documentation-streamlining criteria for co-signing requirements

• Designations-OT, OTA, OT/s (OT student), OTA/s (OTA student), OT/c or OTA/c (OT or OTA applicants practicing

   under the direction of a licensee)

MAOT requested additional changes:

1) Change all references from AOTCB to NBCOT. AOTCB disbanded in April 1996.

2) Replace the word “patient” with “client”. The term “client” is more inclusive and is more applicable to the variety of practice settings for occupational therapy.

3) Change all references to “occupational therapist assistant” to “occupational therapy assistant”.

4) Replace the words “treatment” or "services" to “intervention”. The term “intervention” is more inclusive and is

more applicable to the variety of practice settings for occupational therapy.

Administration and Finance agreed that changes should be made for “AOTCB” to “NBCOT”, changing “patient" to

“client”, and changing “occupational therapist assistant” to “occupational therapy assistant”.

Changing the term “treatment” to “intervention” was felt to be a more significant change than was in the spirit of Executive Order 562 which stated, "no Agency shall promulgate a new regulation which has not been reviewed pursuant to this Order and does not meet the standards set out in this Order.”

On August 1, 2016, MAOT submitted comments to John Chapman, Undersecretary, Massachusetts Office on

Consumer Affairs and Business Regulations, advocating changes in order to update our professional licensure

regulations.

On August, 2, 2016, a representative from MAOT attended a listening session at Office of Consumer Affairs and provided oral testimony advocating changes in order to update our professional licensure regulations and making corrections on the mass.gov website to change all references from "occupational therapist assistant" to "occupational therapy assistant".

On August 19, 2016, representatives from MAOT and AOTA presented oral testimony and written comments to the Board of Allied Health Professionals in favor of the proposed (limited) changes and advocated additional changes in order to update our professional licensure regulations.

On August 25, 2016, the Board of Registration in Allied Health Professionals held a Subcommittee Meeting regarding Continuing Competency. Draft regulations were developed. Key points include:

• Continuing education for 24 units per licensing cycle (every 2 years) with the same requirements for OT and

   OTA and PT and PTA.

• Activities can come from a variety of avenues with some limits on the number of units in various categories

  (similar to NBCOT).

• Lapsed licenses will be subject to additional requirements.

• The Allied Health Board will conduct audits. Documentation must be kept by the licensee.

• The Allied Health Board will have the ability to suspend, require additional units, pay a fine, etc.

• Requirements will include 2 units of jurisprudence and 2 units of ethics per licensing cycle

Next steps

• Proposed regulations will be edited and reviewed by the whole Allied Health Board.

• The State will need to have the "pause" lifted (per the Executive Order 562) in order to go forward in the process for continuing competency regulations.

In August 2016, MAOT submitted edits to the Board of Registration of Allied Health Professionals website to change all references from :occupational therapist assistant" to "occupational therapy assistant".

And they were done!

Licensure is now online! DPL is in process of reviewing vendor for Allied Health.

The PCS contract is up for renewal.

On September 21, 2016, representatives from OT, AT, and PT met with Charles Borstel, Director of Division of

Professional Licensure, and Robert Fortes, Deputy Director for Policy and Boards, to discuss continued concerns with outdated regulations and plans to move forward with further revisions.

On October 27, 2016, the revised regulations were voted on by the Board of Allied Health. These revised

regulations will be submitted on November 4, 2016 and changes will take effect on November 18, 2016.

The changes were published on the website on December 14, 2016.

PCS will be notified of the changes for licensure candidates.

Legislative Activity

November 2015 - Provided testimony in support of Senate Bill 556, An Act Relative to make habilitative services

available to the children of the Commonwealth.

March 2016 - A bill was submitted regarding telehealth, but it failed.

June 2016 - Conditionally supported Bill H.176: An Act Establishing a board of registration in physical therapy, as long as all three boards can split into separate boards.

The next legislative cycle begins January 17, 2017.

Interest has been indicated with respect to telehealth and mental health parity legislation.

Health Care Reform/Access to Health Care

On April 28, 2016, a MAOT representative attended an initial organizational meeting, Health Care for All-Mental

Health Parity Coalition. This a Massachusetts Behavioral Health Access and Parity Advocacy Project. MAOT has

attended subsequent meetings and has signed on to letters to various government agencies advocating mental

health parity.

We continue to work on having occupational therapy included in new Mental Health initiatives that are available to 24 states from SAMSHA.

We will continue to monitor any opportunities that present themselves for occupational therapy in the health, mental health and education areas.

Licensure activity

• Updated licensure regulations were approved by the Massachusetts Board of Registration in Allied Health 

Professionals in May 2014.

Unfortunately they sat in transit to Governor Patrick's office for approval and public hearing.

• With Governor Baker's term starting in January 2015, part of his transition was Executive Order 562: To Reduce Unnecessary Regulatory Burden.

He issued a "pause" on all boards, on all regulations. This "pause" will conclude in June 2016.

The Executive Order now requires all boards to review CURRENT regulations (not the new proposed regs) and eliminate the "confusing, unnecessary, redundant, and inconsistent".

• At the Allied Health Board meeting in May 2015, it was reported that the new proposed regulations would be considered too lengthy, particularly in contrast to our current, outdated, regulations and would not be looked upon favorably. However, some of the new regulations may in fact satisfy the executive order to eliminate the "confusing, unnecessary, redundant, and inconsistent".

There is a reasonable expectation that the proposed regulations will be changed and it will be about reducing.

The purpose is based on the Office of Consumer Affairs with the questions,

"Are the regulations going to make it more difficult to become licensed?"

"Is there an additional burden to the consumer or licensee?"

The executive order requires ALL agencies to review their current regulations.

• A listening session was held on June 25, 2015. Representatives from OT and PT attended.

AT representatives were not available as they were at their national conference.

Additionally, written comments were submitted by MAOT on behalf of OT practitioners.

• The State has opened a portal for public comments as part of the Executive Order.

In July 2015, MAOT submitted written comments to this portal and it has been acknowledged that our letter was received.

• In August, representatives from OT, AT, and PT have met with Charles Borstel, Director of Division of Professional Licensure, and Robert Fortes, Deputy Director for Policy and Boards, to discuss concerns with outdated regulations and the impact of the Executive Order.

The Allied Health Board, Mr. Borstel, and Mr. Fortes were provided with additional documentation about continuing education requirements in the State of Massachusetts and nationally. For the Division of Professional Licensure, there are 28 boards. Twenty two (22) have continuing education requirements, 3 are under development, and 3 do not have any requirements (Barbers/Cosmetologists, Landscape Architects, and Allied Health Professionals).

For the 50 states, only 6 do not have continuing education requirements for occupational therapy providers, Massachusetts being one of them.

• For the September Board meeting, MAOT submitted additional written comment regarding typographical errors and clarification of the screening process.

• For the October Board meeting, MAOT submitted suggestions for revisions to the current/outdated regulations to clear up "confusing" and "inconsistent" language, such as references to the American Occupational Therapy Certification Board (AOTCB) which disbanded in 1996, use of client versus patient, use of intervention versus treatment or services, referencing occupational therapy assistant versus occupational therapist assistant, and clarifying signature designations to OT/L and OTA/L.

At the October meeting, the Board focused on clarifying language under designations and signatures, supervision, and documentation. Revisions were voted upon and approved.

MAOT will be requesting a copy of this new document.

• The Executive Office for Administration and Finance is holding listening sessions throughout the state to hear feedback on all Executive Branch regulations. Representatives from MAOT attended a meeting on October 28th and presented testimony regarding outdated regulations and the impact of the Executive Order. This was chaired and attended by 9 executive officials and OT was able to "bend their ear" as this session had only one other testimony.

Some of the feedback from this listening session suggests that there is an acknowledgement that a complete overhaul of regulations may be the way to go. This group was also provided with copies of letters sent to the Board since January 2013 and the additional documentation about continuing education requirements in the State of Massachusetts and nationally.

• As part of our national organization, AOTA, the Representative Assembly started meeting on October 28th.

One section of the policies that are being reviewed is that licensure and legislation should include minimum continuing competence requirements for license renewal.

Legislative Activity

MAOT is watching and reviewing a number of bills filed for habilitation services, concussion management, and redefining/separation of the Allied Health Board into separate components.

PT has filed to become a separate board.

We continue the discussion that we would like to be separate board and even consider moving from Division of Professional Licensure to Department of Public Health.

Health Care Reform/Access to Health Care

We will be working over the next year to have occupational therapy included in some possible new Mental Health initiatives that are available to 24 states from the Substance Abuse and Mental Health Services Administration (SAMSHA).

We will continue to monitor any opportunities that present themselves for occupational therapy in the health, mental health and education areas.

For more information on legislative matters, go to www.malegislature.gov