Practice Act Foundations: Definitions, Scope of Practice, and Licensure
This domain tests the statutory foundation of North Dakota OT practice: who must be licensed, what the Act defines as OT, and where the OT/OTA scope boundary lies.
Statutory anchor
The North Dakota Occupational Therapy Practice Act is codified at N.D.C.C. ch. 43-26.1, with Board rules in N.D. Admin. Code Title 43. The Act creates the Board, defines practice, and makes licensure mandatory. Title protection is strict: only a licensee may use “occupational therapist,” “OT,” “occupational therapy assistant,” or “OTA,” and may not offer OT services unless licensed or exempt.
Licensure path
Initial licensure requires graduation from an accredited OT or OTA program, supervised fieldwork, passage of the NBCOT examination, application, fee, and any criminal-history review the Board requires. Certification is not a license; NBCOT certification alone does not authorize practice in North Dakota.
Scope boundary
OT includes evaluation, intervention, consultation, education, and case management to improve participation in daily occupations. The OT performs evaluation, interprets data, sets goals, designs and modifies intervention, and decides discharge. The OTA implements delegated intervention under OT supervision. Neither license authorizes medical diagnosis, prescribing, surgery, or independent practice outside the Act.
Worked example
An applicant has passed NBCOT and received a wallet card but has not been issued a North Dakota license. A clinic asks her to begin treating patients “under the doctor’s supervision.” She must decline. NBCOT certification and physician supervision do not substitute for state licensure. She may complete non-clinical onboarding but cannot deliver OT or call herself an OTA until the Board issues a license.
Traps
Do not confuse certification with licensure, or assume an out-of-state license automatically authorizes ND practice. Do not let an aide perform evaluation tasks. Do not treat employer job descriptions as scope authority; the statute and Board rules control.