North Carolina Occupational Therapy Practice Act
What the Practice Act governs
The North Carolina Occupational Therapy Practice Act, codified in Article 18E of Chapter 90 of the General Statutes, creates the licensure system for occupational therapists and occupational therapy assistants and establishes the North Carolina Board of Occupational Therapy. The exam tests the statute's structure: who must be licensed, what the Board can do, how titles are protected, and which conduct exposes a licensee to discipline.
Core statutory rules
- A person may not practice occupational therapy or hold out as an OT/OTA without a current license. Title protection covers abbreviations such as "OT/L" and "OTA/L" and any misleading variation.
- The Board licenses, renews, investigates complaints, and imposes discipline. Grounds commonly tested include fraud or misrepresentation in obtaining a license, incompetence, unprofessional conduct, impairment, conviction of certain offenses, and violating Board rules.
- The Act defines occupational therapy as skilled services that use occupation to promote health and participation. The OT is responsible for evaluation, interpretation, and the plan of care; the OTA implements delegated interventions under supervision.
- Unlicensed aides or technicians may perform non-skilled tasks but may not provide skilled occupational therapy, evaluate, interpret results, or independently document skilled treatment.
Worked example
A clinic owner tells an unlicensed rehab technician to lead a client's ADL retraining session and write the progress note because the OT is double-booked. The technician is performing skilled occupational therapy and documenting skilled intervention, both outside the aide role. The OT must evaluate, set the plan, and either provide or directly supervise the delegated service; the aide may assist with setup or non-skilled tasks. The note must reflect who provided the service and must not imply the aide practiced independently.
Traps that cost marks
Do not confuse the Board (regulator) with NCOTA (professional association). Do not assume an OTA may practice without an OT's supervision or may perform the initial evaluation. Do not treat a license as permission to delegate any task to an aide.