Original Notice.

     Preproposal statement of inquiry was filed as WSR 03-08-029.

     Title of Rule and Other Identifying Information: WAC 246-847-065 Continued competency, these rules set the continuing competency requirements for licensed occupational therapists and occupational therapy assistants. The proposed changes will create additional options for therapists to maintain competence and clarify existing requirements. The legislature has mandated that the Occupational Therapy Practice Board establish and administer requirements for continuing competency as a prerequisite for the renewal of an occupational therapist or occupational therapy assistant license.

     Hearing Location(s): Red Lion Hotel Yakima Center, 607 East Yakima Avenue, Yakima, WA 98901, on October 21, 2005, at 2:30 p.m.

     Date of Intended Adoption: October 21, 2005.

     Submit Written Comments to: Kris Waidely, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, e-mail http://www3.doh.wa.gov/policyreview/, fax (360) 664-9077, by September 30, 2005.

     Assistance for Persons with Disabilities: Contact Kris Waidely, Program Manager, by September 30, 2005, TTY (800) 833-6388 or (360) 236-4847.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed changes are intended to provide greater flexibility for occupational therapy practitioner to complete their continuing education requirements. The proposed changes will create additional options for therapists to maintain competence and clarify existing requirements. The legislature has mandated that the Occupational Therapy Practice Board establish and administer requirements for continuing competency as a prerequisite for the renewal of an occupational therapist or occupational therapy assistant license. The proposed changes assure continued protection of consumers from incompetent occupational therapy, while clarifying existing requirements and improving flexibility for occupational therapy practitioners to maintain competency.

     Reasons Supporting Proposal: Practitioners will benefit by the board creating clearer guidance about acceptable continuing competency requirements. The detail listing of activities provides practitioners with clear understandable guidelines. By including occupational therapy assistants in the rule better ensures all occupational therapy practitioners are receiving ongoing continuing competency to provide safe, skilled, and competent care to the public. The proposed language provides a detailed list of thirteen continued competency activities that will be accepted, and states the required documentation needed.

     Statutory Authority for Adoption: RCW 18.59.130 and 18.59.090.

     Statute Being Implemented: Chapter 18.59 RCW.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of Health, governmental.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Kris Waidely, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4847.

     A small business economic impact statement has been prepared under chapter 19.85 RCW.

•	Clarify language for current requirements.
•	Require occupational therapy assistants to adhere to the same continuing education requirements as occupational therapists.
•	Require a minimum of twenty hours of continuing education to be directly related to the practice of occupational therapy.
•	Allow the remaining ten hours of continuing education to be in professional development activities.
•	Insist the required thirty contact hours to be obtained through two or more of the activities listed in this section.
•	Require documentation for all activities to include the licensee's name, date of activity, and number of hours.
•	Add a detailed list of both practicing and professional continuing education activities that will fulfill continuing education requirements.

     2. Is a small business economic impact statement (SBEIS) required for this rule? Yes, the Department of Health (DOH) has reviewed this proposal and has determined that an SBEIS is required.

     3. Which industries are affected by this rule? In preparing this SBEIS, the DOH used the following SIC codes:

Table 1

			No. of Units		No. of Employees
SIC		Description					Threshold ($)
8049	Offices of health practitioners, nec		913		5,450		66.1
8051	Skilled nursing care facilities		281		26,407		195.6
8052	Intermediate care facilities		29		1,651		66.1
8059	Nursing and personal care, nec		110		4,081		66.1
8062	General medical & surgical hospital		146		78,593		396.6
8069	Specialty hospitals exc. Psychiatrist		23		4,106		237.9
8082	Home health care services		169		7,408		122.9
8093	Specialty outpatient clinics, nec		245		7,530		116.3
8099	Health and allied services, nec		93		1,484		66.1

     4. What are the costs of complying with this rule for small businesses (those with fifty or fewer employees) and for the largest 10% of businesses affected? The associated costs for each practitioner is the costs of requirement to complete at least two continuing education activities. With reference to the list, ten hours of "self study," (number 12 in the list) and ten hours of "fieldwork direct supervision" (number 13) can be completed on practitioners' own time at no costs. The remaining ten hours can be completed through "in-service training" at no costs or at the maximum opportunity costs of ten hours of practitioner's earnings. Assuming $23.71 hourly wage for occupational therapists and $15.56 for occupational therapist assistants, these costs translate into $231 and $160 respectively.

     5. Does the rule impose a disproportionate impact on small businesses?

								Avg.		Avg.
		Avg.		Avg.		Assumed		Costs		Costs
SIC	Description	Employees		Employees		Costs of		Employees		Employees
		< 50		Top 10%		Compliance		< 50		Top 10%
8049	Offices of health practitioners, ne	4.5		102.9		231		51.8		2.2
8051	Skilled nursing care facilities	14.7		116.0		231		15.8		2.0
8052	Intermediate care facilities	22.3		99.8		231		10.4		2.3
8059	Nursing and personal care, nec	18.0		98.8		231		12.8		2.3
8062	General medical & surgical hospital	11.1		758.4		231		20.9		0.3
8069	Specialty hospitals exc. psychiatric	15.4		167.7		231		15.0		1.4
8082	Home health care services	14.2		109.3		231		16.3		2.1
8093	Specialty outpatient clinics, nec	9.3		113.5		231		24.9		2.0
8099	Health and allied services, nec	7.0		64.3		231		33.1		3.6

     The last two columns in Table 2 show the possibility of a disproportionate impact on small businesses. This is based on the assumption that large businesses pay the costs of continued education for their practitioners. However, assuming each licensed practitioner is responsible for the costs of his/her continued education, the proposed rule changes do not impose a disproportionate impact on small businesses.

     6. How are small businesses involved in the development of this rule? The DOH held open public rules workshops in coordination with state associations. All active state licensees were invited by mail.

     A copy of the statement may be obtained by contacting Kris Waidely, P.O. Box 47867, Olympia, WA 98504-7867, phone (360) 236-4847, fax (360) 664-9077, e-mail Kris.waidely@doh.wa.gov.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kris Waidely, P.O. Box 47867, Olympia, WA 98504-7867, phone (360) 236-4847, fax (360) 664-9077, e-mail Kris.waidely@doh.wa.gov.

July 7, 2005

Kris Waidely

Program Manager

OTS-7055.3

AMENDATORY SECTION(Amending WSR 98-05-060, filed 2/13/98, effective 3/16/98)

WAC 246-847-065   Continued competency.   ((Licensed occupational therapists must complete thirty hours of continuing education every two years as required in chapter 246-12 WAC, Part 7.)) As required in chapter 246-12 WAC, Part 7, licensed occupational therapists and licensed occupational therapy assistants must complete thirty hours of continuing education every two years. A minimum of twenty hours must be directly related to the practice of occupational therapy as defined in RCW 18.59.020 and WAC 246-847-010. The remaining ten hours may be in professional development activities that enhance the licensed occupational therapist or licensed occupational therapy assistant. The thirty contact hours must be obtained through two or more of the activities listed below. Documentation for all activities must include licensee's name, date of activity, and number of hours. Additional specific documentation is defined below:

     (1) Continuing education course work. The required documentation for this activity is a certificate or documentation of attendance.

     (2) In-service training. The required documentation for this activity is a certificate or documentation of attendance.

     (3) Professional conference or workshop. The required documentation for this activity is a certificate or documentation of attendance.

     (4) Course work offered by an accredited college or university, provided that the course work is taken after the licensee has obtained a degree in occupational therapy, and the course work provides skills and knowledge beyond entry-level skills or knowledge. The required documentation for this activity is a transcript.

     (5) Publications. The required documentation for this activity is a copy of the publication.

     (6) Presentations. The required documentation for this activity is a copy of the presentation or program listing. Any particular presentation may be reported only once per reporting period.

     (7) Interactive online courses. The required documentation for this activity is a certificate or documentation of completion.

     (8) Development of instructional materials incorporating alternative media such as: Video, audio and/or software programs to advance professional skills of others. The required documentation for this activity is a program description. The media/software materials must be available if requested during audit process.

     (9) Professional manuscript review. The required documentation for this activity is a letter from publishing organization verifying review of manuscript. A maximum of ten hours is allowed per reporting period for this category.

     (10) Guest lecturer for occupational therapy related academic course work (academia not primary role). The required documentation for this activity is a letter or other documentation from instructor.

     (11) Serving on a professional board, committee, disciplinary panel, or association. The required documentation for this activity is a letter or other documentation from the organization. A maximum of ten hours is allowed per reporting period for this category.

     (12) Self study of cassette, tape, video tape, or other multimedia device, or book. The required documentation for this activity is a two page synopsis of each item written by the licensee. A maximum of ten hours is allowed per reporting period for this category.

     (13) Level II fieldwork direct supervision of an occupational therapy student or occupational therapy assistant student by site designated supervisor(s). The required documentation for this activity is a name of student(s), letter of verification from school, and dates of fieldwork. A maximum of ten hours per supervisor is allowed per reporting period for this category.

[Statutory Authority: RCW 43.70.280. 98-05-060, § 246-847-065, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.59.130. 92-18-015 (Order 300B), § 246-847-065, filed 8/24/92, effective 9/24/92; 91-11-064 (Order 171B), § 246-847-065, filed 5/16/91, effective 6/16/91; 91-05-027 (Order 112B), recodified as § 246-847-065, filed 2/12/91, effective 3/15/91; 90-22-011 (Order 094), § 308-171-041, filed 10/26/90, effective 11/26/90.]

© Washington State Code Reviser's Office