ND OT Jurisprudence cheat sheet

North Dakota Century Code chapter 43-17 governs occupational therapy practice; the North Dakota Board of Occupational Therapy Practice adopts administrative rules under title 34 of the ND Administrative Code to implement it.

Occupational therapy is defined as the therapeutic use of everyday life activities (occupations) with individuals or groups to develop, recover, or maintain participation in roles, habits, and routines in home, school, workplace, and community settings.

Practice requires a license issued by the Board; an unlicensed person may not use the title "occupational therapist," "occupational therapy assistant," or abbreviations OT/L or OTA/L, nor represent themselves as licensed.

An occupational therapist applies to the Board with proof of graduation from an ACOTE-accredited program and a passing score on the NBCOT certification exam; a limited permit may allow supervised practice before results are final.

An occupational therapy assistant must graduate from an ACOTE-accredited OTA program and pass the NBCOT OTA exam; OTAs practice only under the supervision of a licensed OT.

Scope includes evaluation, intervention planning, ADL and IADL training, sensory and motor skill development, splinting, environmental modification, and assistive technology, but excludes diagnosis of disease and medical treatment outside OT scope.

The Act distinguishes occupational therapy from physical therapy, respiratory therapy, and psychology; overlapping techniques are permitted when performed within OT's own defined scope and competence.

Licensees must report to the Board within a defined period any change of name or address, and must display or produce the license on request of the Board or an employer.

The supervising OT is responsible for the evaluation, the intervention plan, and the ongoing review of services delivered by an OTA; the OTA may contribute to data collection and carry out delegated interventions.

Supervision levels range from direct (on-site, in-person observation) to general (periodic contact, which may be by telephone or electronic means) and must be documented with dates and content of supervision.

Delegation to unlicensed assistive personnel is limited to tasks that do not require the clinical judgment of an OT or OTA; the delegating therapist retains accountability for the outcome.

An OT must not delegate an evaluation, an initial intervention plan, or a reassessment to an OTA or aide; those functions remain with the OT.

Supervision frequency and method must match client acuity, setting requirements, and the OTA's demonstrated competence; the Board rules set minimum contact expectations by practice setting.

A supervising OT must be licensed in North Dakota and available for consultation; supervision by an OT licensed in another state does not satisfy the requirement unless endorsed by the Board.

Competency must be documented for delegated tasks, including training, verification, and periodic reassessment of the person performing the task.

When an OTA identifies a change in client status, the OTA must notify the supervising OT promptly so the plan can be revised; the OTA may not independently alter the plan of care.

Licenses renew on the Board's established cycle (biennially, in the year designated by the Board); renewal requires a completed application, fee, and attestation of continuing education.

Continuing education must include a specified number of contact hours per renewal period, with a portion in ethics and jurisprudence; courses must be relevant to occupational therapy and documented with certificates.

Licensees must retain CE documentation for a set retention period (commonly the current and prior renewal cycle) and produce it on audit by the Board.

Continuing education credit may be earned through approved courses, conference sessions, academic coursework, publications, and certain professional service, subject to Board limits on self-study and non-clinical hours.

Disciplinary grounds include practicing without a license, gross negligence, incompetence, fraud in obtaining a license, impairment, unprofessional conduct, and violation of Board orders.

The Board's process typically proceeds from complaint intake and investigation to a notice of charges, an opportunity for hearing, findings, and sanctions such as reprimand, probation, suspension, or revocation.

Licensees must self-report arrests, convictions, and disciplinary actions taken by another jurisdiction within the timeframe set in Board rules.

Failure to renew by the deadline results in lapsed licensure; practicing on a lapsed license is unlicensed practice and subjects the individual to disciplinary and legal consequences.

Core ethical obligations include beneficence, nonmaleficence, autonomy, justice, veracity, and fidelity; client welfare takes precedence over the therapist's self-interest.

Informed consent for evaluation and intervention requires disclosure of the nature of services, risks, benefits, alternatives, and the right to refuse or withdraw at any time.

Confidentiality covers all protected health information; disclosure requires client authorization or a legal exception such as suspected abuse, court order, or serious threat of harm.

Boundaries of the therapeutic relationship prohibit sexual or exploitative relationships with clients and discourage dual relationships that could impair professional judgment.

Fees, billing, and documentation must be accurate; falsifying records or billing for services not rendered is unethical and a disciplinary violation.

Cultural humility, non-discrimination, and respect for client values and preferences are required; treatment decisions must not be based on race, gender, religion, disability, or sexual orientation.

Clients have the right to access their records, to be informed of fees, and to receive services in a safe environment free from abuse or neglect.

When an ethical dilemma arises, the therapist should consult the AOTA Code of Ethics, the Board, and supervisors, and document the reasoning and actions taken.

Documentation must be timely, accurate, legible, and authenticated; entries include date, time, intervention delivered, client response, and the therapist's signature with credentials.

Initial evaluation documentation includes referral information, history, standardized and non-standardized assessment results, interpretation, deficits, strengths, and the plan with goals.

Progress notes should reflect measurable progress toward goals and justification for continued skilled services; documentation supports medical necessity and reimbursement.

Errors are corrected by a single line-through, initials, date, and an explanatory note; erasures, whiteout, and backdating are prohibited.

Informed consent must be documented in the record, including the form used, the discussion held, and the client's decision or the legally authorized representative's consent.

Protected health information may be released only with a valid authorization that identifies the recipient, purpose, and expiration, or under a recognized legal exception.

Electronic records require secure access, unique user credentials, and audit trails; sharing passwords or leaving records unsecured violates confidentiality obligations.

Retention and destruction of records follow state and facility requirements; records must be available to the Board on request during an investigation.

The Board consists of appointed occupational therapists, an occupational therapy assistant, and public members; it adopts rules, sets fees, approves educational requirements, and adjudicates complaints.

Administrative rules under NDAC title 34 address licensure applications, renewal, continuing education, supervision standards, and the disciplinary hearing process.

The Board has authority to investigate complaints, issue subpoenas, conduct hearings, and impose sanctions including fines, probation, suspension, and revocation.

The Board publishes application forms, renewal deadlines, fee schedules, and CE requirements on its website; licensees are responsible for knowing current rules.

Board meetings and rulemaking follow the open meetings and administrative procedure laws of North Dakota, including public notice and comment periods.

Licensees must cooperate with Board investigations; failure to respond to a Board inquiry can itself be grounds for discipline.

The Board may issue advisory opinions and interpretive guidance on scope and supervision questions; these clarify but do not replace the statute and rules.

Licensure is a legal privilege granted by the state; practicing without a license or beyond the scope of the license exposes the therapist to civil and criminal liability.

Negligence requires a duty of care, a breach of that duty, causation, and damages; documentation and adherence to standards of practice are the primary defenses.

The therapist has a duty to report suspected child abuse, elder abuse, or vulnerable adult abuse to the designated authority under North Dakota law.

Mandatory reporting also extends to impaired or unethical colleagues in many circumstances; retaliation against a good-faith reporter is prohibited.

Federal law (HIPAA) and North Dakota confidentiality law apply together; the stricter requirement controls when they conflict.

Informed consent, refusal of treatment, and advance directives are governed by state law; a competent adult may refuse OT services even when clinically indicated.

Business practices, including supervision of aides, billing, and telehealth delivery, must comply with both the Practice Act and applicable payer and telehealth rules.

A therapist who moves to North Dakota from another state must obtain a North Dakota license; licensure compact participation and endorsement pathways are determined by Board rule.