HOUSE BILL 72

54th legislature - STATE OF NEW MEXICO - first session, 2019

INTRODUCED BY

Elizabeth "Liz" Thomson

FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE

AN ACT

RELATING TO PROFESSIONAL LICENSURE; AMENDING SECTIONS OF THE OCCUPATIONAL THERAPY ACT TO MAKE SCOPE OF PRACTICE CHANGES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. Section 61-12A-3 NMSA 1978 (being Laws 1996, Chapter 55, Section 3, as amended) is amended to read:

     "61-12A-3. DEFINITIONS.--As used in the Occupational Therapy Act:

          A. "board" means the board of examiners for occupational therapy;

          B. "censure" means a formal expression of disapproval that is publicly announced;

          C. "denial of license" means that a person is barred from becoming licensed to practice in accordance with the provisions of the Occupational Therapy Act either indefinitely or for a certain period;

          D. "licensee" means an occupational therapist or occupational therapy assistant, as appropriate;

          E. "occupational therapist" means a person who holds an active license to practice occupational therapy in New Mexico in accordance with board rules;

          F. "occupational therapy" means the therapeutic use of occupations, including everyday life activities with persons [or] across the life span, including groups, populations or organizations, to [participate] enhance or enable participation, performance or function in roles, [and situations] habits and routines in home, school, workplace, community and other settings [to promote]. Occupational therapy services are provided for habilitation, rehabilitation and the promotion of health and wellness [in] to those clients who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation or participation restriction. "Occupational therapy" includes addressing the physical, cognitive, psychosocial, [sensory] sensory-perceptual and other aspects of performance in a variety of contexts and environments to support [a client's] engagement in [everyday life activities] occupations that affect physical and mental health, well-being and quality of life. [G.] Occupational therapy [aide or technician" means an unlicensed person who assists in occupational therapy, who works under direct supervision of an occupational therapist or occupational therapy assistant] uses everyday life activities to promote mental health and support functioning in people with or at risk of experiencing a range of mental health disorders, including psychiatric, behavioral, emotional and substance abuse disorders;

          [H.] G. "occupational therapy assistant" means a person having no less than an associate degree in occupational therapy and holding an active license to practice occupational therapy in New Mexico who assists [an] in the practice of occupational [therapist] therapy under the supervision of the occupational therapist in accordance with board rules;

          [I.] H. "person" means an individual, association, partnership, unincorporated organization or corporate body;

          [J.] I. "probation" means that continued licensure is subject to fulfillment of specified conditions such as monitoring, education, supervision or counseling;

          [K.] J. "reprimand" means a formal expression of disapproval that is retained in the licensee's file but not publicly announced;

          [L.] K. "revocation" means permanent loss of licensure; and

          [M.] L. "suspension" means the loss of licensure for a certain period, after which the person may be required to apply for reinstatement."

     SECTION 2. Section 61-12A-4 NMSA 1978 (being Laws 1996, Chapter 55, Section 4, as amended) is amended to read:

     "61-12A-4. OCCUPATIONAL THERAPY SERVICES.--The practice of occupational therapy [services include:

          A. selected strategies to direct the process of interventions, such as:

                (1) establishment, remediation or restoration of a skill or ability that has not yet developed or is impaired;

                (2) compensation, modification or adaptation of activity or environment to enhance performance;

                (3) maintenance and enhancement of capabilities without which performance in everyday life activities would decline;

                (4) health promotion and wellness to enable enhanced performance in everyday life activities; and

                (5) prevention of barriers to performance, including disability prevention] includes the following processes and services:

          [B.] A. evaluation of factors affecting all areas of occupation, including activities of daily living, instrumental activities of daily living, rest and sleep, education, work, productivity, play, leisure and social participation; including:

                (1) client factors, including neuromuscular, sensory, visual, [perceptual and] mental, cognitive [functions] and pain factors and body structures, including cardiovascular, digestive, integumentary and genitourinary systems and structures related to movement;

                (2) habits, routines, roles and behavior patterns;

                (3) cultural, physical, environmental, social and spiritual contexts and activity demands that affect performance; and

                (4) performance skills, including motor process and communication and interaction skills; [and]

          B. activity analysis to determine activity demands of occupations performed;

          C. design, implementation and modification of therapeutic interventions, including the following activities related to selection of intervention strategies to direct the process of interventions:

                (1) establishment, remediation or restoration of a skill or ability that has not yet developed, is impaired or is in decline;

                (2) compensation, modification or adaptation of activity or environment to enhance performance or to prevent injuries, disorders or other conditions;

                (3) retention, maintenance and enhancement of skills and capabilities without which performance in everyday life activities would decline;

                (4) promotion of health and wellness, including the use of self-management strategies to enable or enhance performance in everyday life activities;

                (5) prevention of barriers to performance, including injury and disability prevention; and

                [C.] (6) interventions and procedures to promote or enhance safety and performance in [activities of daily living, instrumental activities of daily living, education, work, play, leisure and social participation] areas of occupation, including:

                     [(1)] (a) therapeutic use of occupations, exercises and activities;

                     [(2)] (b) training in self-care, self-management, health management and maintenance, home management, [and] community-work reintegration, school activities and work performance;

                     [(3)] (c) development, remediation or compensation of [physical] neuromusculoskeletal, sensory-perceptual, sensory-integrative and modulation, visual, mental and cognitive [neuromuscular and sensory] functions, pain tolerance and management, developmental skills and behavioral skills;

                     [(4)] (d) therapeutic use of self, including one's personality, insights, perceptions and judgments, as part of the therapeutic process;

                     [(5)] (e) education and training of persons, including family members, caregivers, groups, populations and others;

                     [(6)] (f) care coordination, case management and transition services;

                     [(7)] (g) consultative services to groups, programs, organizations or communities;

                     [(8)] (h) modification of home, work, school and community environments and adaptation [or] of processes, including the application of ergonomic principles;

                     [(9)] (i) assessment, design, fabrication, application, fitting and training in seating and positioning, assistive technology, adaptive devices and orthotic devices and training in the use of prosthetic devices;

                     [(10)] (j) assessment, recommendation and training in techniques to enhance functional mobility, including [wheelchair] management of wheelchairs and other mobility devices;

                     (k) low-vision rehabilitation;

                     [(11)] (l) driver rehabilitation and community mobility;

                     [(12)] (m) management of feeding, eating and swallowing; [to enable eating and feeding performance; and

                     (13)] (n) application of physical agent modalities and use of a range of specific therapeutic procedures such as wound care management; techniques to enhance sensory, perceptual and cognitive processing; and manual therapy techniques to enhance performance skills;

                     (o) facilitating the occupational performance of groups, populations or organizations; and

                     (p) management of a client's mental health, functioning and performance; and

          D. use of means to measure the outcomes and effects of interventions to reflect the attainment of treatment goals, including:

                (1) improved quality of life;

                (2) the degree of participation;

                (3) role competence;

                (4) well-being;

                (5) improved life function;

                (6) enhanced performance; and

                (7) prevention criteria."

     SECTION 3. Section 61-12A-5 NMSA 1978 (being Laws 1996, Chapter 55, Section 5, as amended) is amended to read:

     "61-12A-5. SUPERVISION--REQUIRED--DEFINED.--[A.] Occupational therapy shall not be performed by an occupational therapy assistant [occupational therapy aide or technician] or by any person practicing on a provisional permit unless [such] the occupational therapy is supervised by an occupational therapist. The board shall adopt rules defining supervision. [which definitions may include various categories such as "close supervision", "routine supervision" and "general supervision".

          B. An occupational therapy aide or technician is not a primary service provider of occupational therapy in any practice setting and, therefore, does not provide skilled occupational therapy services. An occupational therapy aide or technician is trained by an occupational therapist or an occupational therapy assistant to perform specifically delegated tasks, and the occupational therapist is responsible for the overall use and actions of the occupational therapy aide or technician. An occupational therapy aide or technician must demonstrate competence to perform the assigned, delegated client and nonclient tasks.]"

     SECTION 4. A new section of the Occupational Therapy Act is enacted to read:

     "[NEW MATERIAL] APPLICABILITY TO OTHER HEALTH PROFESSIONS.--Nothing in the Occupational Therapy Act shall be construed as limiting the practice of other licensed and qualified health professionals in their specific disciplines."

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