PROPOSED RULEMAKING
STATE BOARD OF OCCUPATIONAL THERAPY EDUCATION AND LICENSURE
[49 PA. CODE CH. 42]
Orders
[36 Pa.B. 5981]
[Saturday, September 30, 2006]The State Board of Occupational Therapy Education and Licensure (Board) proposes to amend § 42.25 (relating to oral orders) to read as set forth in Annex A.
Effective Date
The proposed rulemaking will take effect upon final-form publication in the Pennsylvania Bulletin.
Statutory Authority
Section 5(b) of the Occupational Therapy Practice Act (act) (63 P. S. § 1505(b)) authorizes the Board to promulgate and adopt rules and regulations not inconsistent with law as it deems necessary for the performance of its duties and the proper administration of the act.
Background and Purpose
Board members and licensees have noted the lack of clarity to the organization of current § 42.25. The section heading is ''oral orders'' although it discusses both written and oral orders. To clarify the organization of § 42.25, the Board proposes to divide the text into two subsections: (a) written orders; and (b) oral orders.
Section 14 of the act (63 P. S. § 1514) authorizes an occupational therapist to implement direct occupational therapy to an individual for a specific medical condition based on a referral from a licensed physician, podiatrist or optometrist. The act does not require that the referral be written. Current § 42.25 requires that the referral be in the form of a written order unless the urgency of the medical circumstances requires immediate treatment, in which case an oral order may be accepted. While the Board continues to express a preference for written orders over oral orders for the implementation of therapy, the current language has proven needlessly restrictive and difficult to interpret by practitioners in the field. In a typical situation, the occupational therapist in a setting such as a long-term care facility may receive an oral order rather written order. It may be very desirable, although not necessarily urgent, to begin therapy. It may be impractical to receive a written order. The Board proposes to amend § 42.25 by adopting the standard for long-term care facilities that permits oral orders for medication or treatment to be accepted when ''it is impractical for the orders to be given in a written manner by the responsible practitioner'' as set forth in 28 Pa. Code § 211.3 (relating to oral and telephone orders).
Prior to adopting this proposed rulemaking, the Board sent an exposure draft of the rulemaking to various persons and entities identified as having an interest in its rulemaking. The Board received responses from the Department of Occupational Therapy of the School of Health and Rehabilitation Sciences of the University of Pittsburgh and from the Pennsylvania Occupational Therapy Association. Both supported the proposed rulemaking.
Description of Amendments
The proposed rulemaking renames and reorganizes § 42.25. The new heading is ''orders'' because the section includes both written and oral orders. Subsection (a) deals with written orders and subsection (b) deals with oral orders. Second, both subsections would permit an occupational therapist to accept a referral in the form of an order issued by a licensed physician, licensed optometrist or licensed podiatrist. Third, while subsection (b) maintains the preference for written orders over oral orders, receiving an oral order would be acceptable when it is impractical for a written order to be given by the responsible practitioner.
Fiscal Impact and Paperwork Requirements
The proposed rulemaking will not have a fiscal impact on, or create additional paperwork for, the regulated community or the political subdivisions of the Commonwealth.
Sunset Date
The Board continuously monitors the effectiveness of the regulations. Therefore, no sunset date has been assigned.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on September 20, 2006, the Board submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Board, the General Assembly and the Governor of comments, recommendations or objections raised.
Public Comment
Interested persons are invited to submit written comments, recommendations or objections regarding this proposed rulemaking to Herbert Abramson, Board Counsel, State Board of Occupational Therapy Education and Licensure, P. O. Box 2649, Harrisburg, PA 17105-2649 within 30 days following publication of this proposed rulemaking in the Pennsylvania Bulletin.
ELLEN L. KOLODNER,
ChairpersonFiscal Note: 16A-676. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 42. STATE BOARD OF OCCUPATIONAL THERAPY EDUCATION AND LICENSURE
MINIMUM STANDARDS OF PRACTICE § 42.25. [Oral orders] Orders.
(a) [An occupational therapist shall accept a referral in the form of a written order from a licensed physician, licensed optometrist or licensed podiatrist in accordance with section 14 of the act (63 P. S. § 1514) unless the urgency of the medical circumstances requires immediate treatment. In these circumstances, an occupational therapist may accept an oral order for occupational therapy from a licensed physician, licensed optometrist or licensed podiatrist, if the oral order is immediately transcribed, including the date and time, in the patient's medical record and signed by the occupational therapist taking the order.
(b) The countersignature of the licensed physician, licensed optometrist or licensed podiatrist shall be obtained within 5 days of receipt of the oral order in the case of an occupational therapist providing ordered services in a private office setting. In the case of an occupational therapist providing services in a setting that is independent of the prescribing physician's, optometrist's or podiatrist's office, the countersignature on a written copy of the order may be mailed or faxed to the occupational therapist.
(c) In the case of an occupational therapist providing services in a facility licensed by the Department of Health, the countersignature of the licensed physician, licensed optometrist or licensed podiatrist shall be obtained in accordance with applicable regulations of the Department of Health governing the facility, including 28 Pa. Code §§ 211.3 and 601.31 (relating to oral and telephone orders; and acceptance of patients, plan of treatment and medical supervision).]
Written orders. An occupational therapist shall accept a referral in the form of a written order from a licensed physician, licensed optometrist or licensed podiatrist.
(b) Oral orders.
(1) An occupational therapist may accept a referral in the form of an oral order if it is impractical for the order to be given in writing by the responsible licensed physician, licensed optometrist or licensed podiatrist.
(2) An occupational therapist receiving an oral order shall immediately transcribe the order in the patient's medical record, including the date and time the order was received, and shall sign the medical record.
(3) The occupational therapist in a private office setting who has received an oral order shall obtain the countersignature of the practitioner who issued the order within 5 days of receiving the order.
(4) If the occupational therapist who receives an oral order provides services in a setting that is independent of the prescriber's setting, the occupational therapist may accept the countersignature of the ordering practitioner on a written copy of the order that is mailed or faxed to the occupational therapist.
(5) If an occupational therapist provides services in a facility licensed by the Department of Health, the countersignature of the ordering practitioner shall be obtained in accordance with the applicable regulations of the Department of Health governing the facility, including 28 Pa. Code §§ 211.3 and 601.31 (relating to oral and telephone orders; and acceptance of patients, plan of treatment and medical supervision).
[Pa.B. Doc. No. 06-1905. Filed for public inspection September 29, 2006, 9:00 a.m.]
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