Happy occupational therapy month

The OT Compact and the Future of Multi-State Licensing

Occupational therapy professionals across the country are celebrating Occupational Therapy Month, a recognition in April of the important role they play in helping patients recover from injuries and illnesses. One of the most exciting happenings for occupational therapists (OTs) and occupational therapy assistants (OTAs) is the launch of the Occupational Therapy Licensure Compact (OT Compact).

“The compact is helpful to [OTs and OTAs] because they will be able to move to other states or provide services in other states,” said Chuck Willmarth, vice president of health policy and state affairs at the American Occupational Therapy Association (AOTA).

Celebrating the Occupational Therapy Profession

After researching and crowdsourcing, AOTA arrived at the 2023 theme for Occupational Therapy Month, “Occupational Therapy Brings Possibilities to Life,” according to Amanda Goldman, marketing manager for AOTA.

Occupational therapy jobs are growing much faster than average at about 14 percent, according to the U.S. Bureau of Labor Statistics. About 134,000 occupational therapists (OTs) are working in the United States. Each year, more than 10,000 openings will occur from now through 2031. 

Demand remains strong for traveling occupational therapists, according to the recruiters at AMN Healthcare. Most travel assignments are for 13 weeks, and OTs can choose from hundreds of travel OT positions in a variety of settings, from Alaska to Florida. Certified occupational therapy assistants also have dozens of travel COTA assignments from which to choose.

Occupational Therapy Licensure Compact Underway

The Occupational Therapy Licensure Compact (OT Compact), a joint initiative between AOTA and the National Board for Certification in Occupational Therapy, is becoming a reality. It will allow OTs and COTAs with an unencumbered license in a home compact state to travel to or participate in telehealth in other states within the compact without needing to secure additional licenses.  

“Other professions, starting with the nurses, created licensure compacts,” Willmarth said. “Licensure compacts facilitate interstate mobility and telehealth.”

Willmarth added the decision to pursue an OT compact occurred before COVID, but its creation has proven timely as more therapy is provided via telehealth.

“Before the pandemic, telehealth was limited because payors were not paying for it,” Willmarth said. “But with the lockdowns, overnight in most settings, we were authorized to provide telehealth services.”

Examples of OTs using telehealth include monitoring patients’ wearable devices and using sensor technologies, such as virtual reality and video capture gaming systems, according to the AOTA position paper Telehealth in Occupational Therapy.  

The Timeline for the OT Compact

The OT Compact Advisory Group approved a final draft of legislation that states must pass to join the compact in the spring of 2020. The compact became active when 10 states or territories enacted the compact language into statute.

Virginia was the first state to join the OT Compact in March 2021. Since then, other states, including Ohio, Maryland, Georgia, North Carolina, Missouri, Maine, Colorado, New Hampshire, Wisconsin, West Virginia, Alabama, Wyoming, Utah, Washington, Arizona, Kentucky, Nebraska, Tennessee, South Carolina, Iowa, Delaware have joined the OT Compact. Twenty-four states now participate. Legislation is pending in other states.

The Occupational Therapy Licensure Compact Commission which will implement the compact had its inaugural meeting in August 2022. They will hire a company to staff the commission, which Willmarth indicated should be operational in mid-2024.

Applying for the OT Compact License

OTs and COTAs will need to apply for Compact privileges, which is equivalent to a license. The application will be available via the OT Compact site, and the fee will vary by state. The OT or OTA will need to provide basic identifying information and fingerprints for a background check. The compact will allow investigations across state lines.

“The standard is high,” Willmarth said. “Only those practitioners with a clear record for two years will be able to get a compact privilege.”

The goals of the Occupational Therapy Licensure Compact include increasing access to occupational therapy for consumers, improving continuity of care for patients who relocate, enhancing opportunities and mobility for OTs and OTAs, and supporting spouses of military personnel who are OTs or OTAs.

“The compact will make practicing in another state, easier and quicker,” Willmarth said. “There is something in it for practitioners, for the consumers, and for the regulatory community.”

AMN Healthcare reimburses healthcare travelers accepting an assignment in another state for licensure costs and plans to reimburse the costs for multistate licensure for its OT travelers.

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