H.B. 224
Mar 3, 2021
Short Title: Occupational Therapy Interstate Compact. (Public)
Sponsors: Representatives Potts, K. Baker, Humphrey, and Hurley (Primary Sponsors).
Referred to:
4 The General Assembly of North Carolina enacts:
5 SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article
6 to read:
7 "Article 18I.
8 "Occupational Therapy Licensure Compact.
9 "§ 90-270.180. Purpose.
10 The purpose of this Compact is to facilitate interstate practice of occupational therapy with
11 the goal of improving public access to occupational therapy services. The practice of
12 occupational therapy occurs in the state where the patient or client is located at the time of the
13 patient or client encounter. The Compact preserves the regulatory authority of states to protect
14 public health and safety through the current system of state licensure. This Compact is designed
15 to achieve the following objectives:
16 (1) Increase public access to occupational therapy services by providing for the
17 mutual recognition of other member state licenses.
18 (2) Enhance the states' ability to protect the public's health and safety.
19 (3) Encourage the cooperation of member states in regulating multistate
20 occupational therapy practice.
21 (4) Support spouses of relocating military members.
22 (5) Enhance the exchange of licensure, investigative, and disciplinary information
23 between member states.
24 (6) Allow a remote state to hold a provider of services with a compact privilege
25 in that state accountable to that state's practice standards.
26 (7) Facilitate the use of telehealth technology in order to increase access to
27 occupational therapy services.
28 "§ 90-270.181. Definitions.
29 As used in this Compact, and except as otherwise provided, the following definitions shall
30 apply:
31 (1) Active duty military. – Full-time duty status in the active uniformed service
32 of the United States, including members of the National Guard and Reserve
33 on active duty orders pursuant to 10 U.S.C. Chapter 1209 and 10 U.S.C.
34 Chapter 1211.
35 (2) Adverse action. – Any administrative, civil, equitable, or criminal action
36 permitted by a state's laws which is imposed by a licensing board or other
General Assembly Of North Carolina Session 2021
1 authority against an occupational therapist or occupational therapy assistant,
2 including actions against an individual's license or Compact privilege, such as
3 censure, revocation, suspension, probation, monitoring of the licensee, or
4 restriction on the licensee's practice.
5 (3) Alternative program. – A nondisciplinary monitoring process approved by an
6 occupational therapy licensing board.
7 (4) Compact privilege. – The authorization which is the equivalent to a license,
8 granted by a remote state to allow a licensee from another member state to
9 practice as an occupational therapist or practice as an occupational therapy
10 assistant in the remote state under its laws and rules. The practice of
11 occupational therapy occurs in the member state where the patient or client is
12 located at the time of the patient-client encounter.
13 (5) Continuing competence/education. – A requirement, as a condition of license
14 renewal, to provide evidence of participation in, or completion of, educational
15 and professional activities relevant to practice or area of work.
16 (6) Current significant investigative information. – Investigative information that
17 a licensing board, after an inquiry or investigation that includes notification
18 and an opportunity for the occupational therapist or occupational therapy
19 assistant to respond, if required by state law, has reason to believe is not
20 groundless and, if proved true, would indicate more than a minor infraction.
21 (7) Data system. – A repository of information about licensees, including, but not
22 limited to, license status, investigative information, Compact privileges, and
23 adverse actions.
24 (8) Encumbered license. – A license in which an adverse action restricts the
25 practice of occupational therapy by the licensee or said adverse action has
26 been reported to the National Practitioners Data Bank (NPDB).
27 (9) Executive Committee. – A group of directors elected or appointed to act on
28 behalf of, and within the powers granted to them by, the Commission.
29 (10) Home state. – The member state that is the licensee's primary state of
30 residence.
31 (11) Impaired practitioner. – Individuals whose professional practice is adversely
32 affected by substance abuse, addiction, or other health-related conditions.
33 (12) Investigative information. – Information, records, or documents received or
34 generated by an occupational therapy licensing board pursuant to an
35 investigation.
36 (13) Jurisprudence requirement. – The assessment of an individual's knowledge of
37 the laws and rules governing the practice of occupational therapy in a state.
38 (14) Licensee. – An individual who currently holds an authorization from the state
39 to practice as an occupational therapist or as an occupational therapy assistant.
40 (15) Member state. – A state that has enacted the Compact.
41 (16) Occupational therapist. – An individual who is licensed by a state to practice
42 occupational therapy.
43 (17) Occupational therapy assistant. – An individual who is licensed by a state to
44 assist in the practice of occupational therapy.
45 (18) Occupational therapy; occupational therapy practice; practice of occupational
46 therapy. – The care and services provided by an occupational therapist or an
47 occupational therapy assistant as set forth in the member state's statutes and
48 regulations.
49 (19) Occupational Therapy Compact Commission or Commission. – The national
50 administrative body whose membership consists of all states that have enacted
51 the Compact.
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1 (20) Occupational therapy licensing board or licensing board. – The agency of a
2 state that is authorized to license and regulate occupational therapists and
3 occupational therapy assistants.
4 (21) Primary state of residence. – The state, also known as the home state, in which
5 an occupational therapist or occupational therapy assistant who is not active
6 duty military, declares a primary residence for legal purposes as verified by
7 any of the following:
8 a. Drivers license.
9 b. Federal income tax return.
10 c. Lease.
11 d. Deed.
12 e. Mortgage.
13 f. Voter registration.
14 g. Other verifying documentation as defined by Commission rules.
15 (22) Remote state. – A member state other than the home state where a licensee is
16 exercising or seeking to exercise the Compact privilege.
17 (23) Rule. – A regulation promulgated by the Commission that has the force of
18 law.
19 (24) State. – Any state, commonwealth, district, or territory of the United States of
20 America that regulates the practice of occupational therapy.
21 (25) Single-state license. – An occupational therapist or occupational therapy
22 assistant license issued by a member state that authorizes practice only within
23 the issuing state and does not include a Compact privilege in any other
24 member state.
25 (26) Telehealth. – The application of telecommunication technology to deliver
26 occupational therapy services for assessment, intervention, or consultation.
27 "§ 90-270.182. State participation in the Compact.
28 (a) To participate in the Compact, a member state shall do all of the following:
29 (1) License occupational therapists and occupational therapy assistants.
30 (2) Participate fully in the Commission's data system, including, but not limited
31 to, using the Commission's unique identifier as defined by rules of the
32 Commission.
33 (3) Have a mechanism in place for receiving and investigating complaints about
34 licensees.
35 (4) Notify the Commission, in compliance with the terms of the Compact and
36 rules, of any adverse action or the availability of investigative information
37 regarding a licensee.
38 (5) Implement or utilize procedures for considering the criminal history records
39 of applicants for an initial Compact privilege. These procedures shall include
40 the submission of fingerprints or other biometric-based information by
41 applicants for the purpose of obtaining an applicant's criminal history record
42 information from the Federal Bureau of Investigation and the agency
43 responsible for retaining the state's criminal records. The procedures must
44 comply with the following:
45 a. The member state shall, within a time frame established by the
46 Commission, require a criminal background check for a licensee
47 seeking or applying for a Compact privilege whose primary state of
48 residence is that member state, by receiving the results of the Federal
49 Bureau of Investigation criminal record search, and shall use the
50 results in making licensure decisions.
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1 b. All communication between a member state, the Commission, and
2 among member states regarding the verification of eligibility for
3 licensure through the Compact shall not include any information
4 received from the Federal Bureau of Investigation relating to a federal
5 criminal records check performed by a member state under P.L.
6 92-544.
7 (6) Comply with the rules of the Commission.
8 (7) Utilize only a recognized national examination as a requirement for licensure
9 pursuant to the rules of the Commission.
10 (8) Having continuing competence/education requirements as a condition for
11 license renewal.
12 (b) A member state shall grant the Compact privilege to a licensee holding a valid
13 unencumbered license in another member state in accordance with the terms of the Compact and
14 rules.
15 (c) Member states may charge a fee for granting a Compact privilege.
16 (d) A member state shall provide for the state's delegate to attend all Occupational
17 Therapy Compact Commission meetings.
18 (e) Individuals not residing in a member state shall continue to be able to apply for a
19 member state's single-state license as provided under the laws of each member state. However,
20 the single-state license granted to these individuals shall not be recognized as granting the
21 Compact privilege in any other member state.
22 (f) Nothing in this Compact shall affect the requirements established by a member state
23 for the issuance of a single-state license.
24 "§ 90-270.183. Compact privilege.
25 (a) To exercise the Compact privilege under the terms and provisions of the Compact,
26 the licensee shall meet all of the following requirements:
27 (1) Hold a license in the home state.
28 (2) Have a valid United States social security number or National Practitioner
29 Identification number.
30 (3) Have no encumbrance on any state license.
31 (4) Be eligible for a Compact privilege in any member state in accordance with
32 subsections (d) through (h) of this section.
33 (5) Have paid all fines and completed all requirements resulting from any adverse
34 action against any license or Compact privilege, and two years have elapsed
35 from the date of such completion.
36 (6) Notify the Commission that the licensee is seeking the Compact privilege
37 within a remote state.
38 (7) Pay any applicable, including any state, fee for the Compact privilege.
39 (8) Complete a criminal background check in accordance with
40 G.S. 90-270.182(a)(5), and pay any fee associated with the completion of the
41 criminal background check.
42 (9) Meet any jurisprudence requirements established by the remote state in which
43 the licensee is seeking a Compact privilege.
44 (10) Report to the Commission adverse action taken by any nonmember state
45 within 30 days from the date the adverse action is taken.
46 (b) The Compact privilege is valid until the expiration date of the home state license. The
47 licensee must comply with the requirements of subsection (a) of this section to maintain the
48 Compact privilege in the remote state.
49 (c) A licensee providing occupational therapy in a remote state under the Compact
50 privilege shall function within the laws and regulations of the remote state.
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1 (d) Occupational therapy assistants practicing in a remote state shall be supervised by an
2 occupational therapist licensed or holding a Compact privilege in that remote state.
3 (e) A licensee providing occupational therapy in a remote state is subject to that state's
4 regulatory authority. A remote state may, in accordance with due process and that state's laws,
5 remove a licensee's Compact privilege in the remote state for a specific period of time, impose
6 fines, and take any other necessary actions to protect the health and safety of its citizens. The
7 licensee may be ineligible for a Compact privilege in any state until the specific time for removal
8 has passed and all fines are paid.
9 (f) If a home state license is encumbered, the licensee shall lose the Compact privilege
10 in any remote state until all of the following occur:
11 (1) The home state license is no longer encumbered.
12 (2) Two years have elapsed from the date on which the home state license is no
13 longer encumbered in accordance with subdivision (1) of this subsection.
14 (g) Once an encumbered license in the home state is restored in good standing, the
15 licensee must meet the requirements of subsection (a) of this section to obtain a Compact
16 privilege in any remote state.
17 (h) If a licensee's Compact privilege in any remote state is removed, the individual may
18 lose the Compact privilege in any other remote state until all of the following occur:
19 (1) The specific period of time for which the Compact privilege was removed has
20 ended.
21 (2) All fines have been paid, and all conditions have been met.
22 (3) Two years have elapsed from the date of completing requi