No. 41705 (Amendment): Rule R156-40. Recreational Therapy Practice Act Rule

(Amendment)

DAR File No.: 41705
Filed: 05/30/2017 02:23:33 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The Board of Recreational Therapy reviewed this rule at its meeting on 05/02/2017 and determined these changes need to be made. The purpose of this filing is to: 1) define diversional activity; 2) define initial recreational therapy treatment; 3) include prescribing initial recreational treatment under the qualifications for consultation; 4) update citations to materials incorporated by reference; and 5) make minor formatting changes throughout for clarification and correction.

Summary of the rule or change:

In Section R156-40-102, citations to materials incorporated by reference are updated throughout, as follows: references to the January 2011 NCTRC (National Council for Therapeutic Recreation Certification) National Job Analysis are replaced with the new 2014 NCTRC Job Analysis, and references to the January 2014 NCTRC Certification Standards are replaced with the new January 2017 NCTRC Certification Standards. Subsections R156-40-102(2)(a) and (b) are updated to include the updated January 2017 NCTRC Certification Standards. A new Subsection R156-40-102(5) is added to define "diversional activity". A new Subsection R156-40-102(7) is added to define "initial recreational therapy treatment". Section R156-40-302f is modified to include prescribing initial recreational therapy treatment under the qualifications for consultation. In Section R156-40-302g, a minor formatting change is made. In Section R156-40-304, first, minor formatting changes are made throughout. Second, the six-hour cap on continuing education provided by the Division of Occupational and Professional Licensing is removed, to conform with Subsection R156-40-304(5)(a)(ii). Third, the provisions of Subsection R156-40-304(6) that allowed a licensee to request a waiver of continuing education are deleted, and the subsection now cites to Section R156-1-308d, which contains the Division's detailed continuing education waiver provisions. In Section R156-40-502, a minor formatting change is made.

Statutory or constitutional authorization for this rule:

• Subsection 58-1-202(1)(a)
• Section 58-40-101
• Subsection 58-1-106(1)(a)

This rule or change incorporates by reference the following material:

• Updates 2014 NCTRC Job Analysis, published by National Council for Therapeutic Recreation Certification, 2014
• Updates January 2017 NCTRC Certification Standards Part 1, published by National Council for Therapeutic Recreation Certification, January 2017

Anticipated cost or savings to:

the state budget:

The Division will incur minimal costs of approximately $75 to print and distribute the rule once the proposed amendments are made effective. Any costs incurred will be absorbed in the Division's current budget.

local governments:

The proposed amendments apply only to licensees under Title 58, Chapter 40. As a result, the proposed amendments do not apply to local governments.

small businesses:

No fiscal impact to small business is anticipated related to any of the updated references or formatting changes, because the new language merely updates the rule and clarifies practices that are already taking place in the industry. Regarding Subsection R156-40-102(5), no fiscal impact to small business is anticipated related to defining diversional activity. The new language adds clarification to practices that should already be taking place in the industry. Regarding Subsection R156-40-102(7) and Section R156-40-302f, there may be a minimal cost increase for small businesses who will now be required to provide initial recreation therapy treatment. This cost will be relative to the time required to prescribe what services the therapeutic recreation therapy technician should be implementing until a treatment plan is developed by the master therapeutic recreation specialist consultant and then to document that information in a patient's chart. The division cannot calculate the increased costs due to varying circumstances but anticipates that the small business employees who will prescribe, provide, and chart this initial recreation therapy treatment will do so as part of their regular job duties, and that the time required and cost will be minimal. Further, the board and the Division believe that any cost increase will be offset by the improved quality of care provided by small businesses to their patients, as at this time it can take up to three weeks for a treatment plan to be initiated in some facilities. This change also would allow for consistency in the consultation services provided in small business facilities.

persons other than small businesses, businesses, or local governmental entities:

No fiscal impact to other persons is anticipated related to any of the updated references or formatting changes because the new language merely updates the rule and clarifies practices that are already taking place in the industry. Regarding Subsection R156-40-102(5), no fiscal impact to other persons is anticipated related to defining diversional activity. The new language adds clarification to practices that should already be taking place in the industry. Regarding Subsection R156-40-102(7) and Section R156-40-302f, these amendments may create a minimal cost increase for self-employed individual licensees and for large businesses that will now be required to prescribe and provide initial recreation therapy treatment. Again, this cost will be relative to the time required for them to prescribe treatment and document that information in patient charts. The Division cannot calculate the increased costs due to varying circumstances but anticipates that the time required and cost will be minimal and absorbed within regular job duties and that any cost increase will be offset by the improved quality of care and consistency in the consultation services provided.

Compliance costs for affected persons:

No fiscal impact to affected persons is anticipated related to any of the updated references or formatting changes because the new language merely updates the rule and clarifies practices that are already taking place in the industry. Regarding Subsection R156-40-102(5), no fiscal impact to other persons is anticipated related to defining diversional activity. The new language adds clarification to practices that should already be taking place in the industry. Regarding Subsection R156-40-102(7) and Section R156-40-302f, these proposed amendments may cause some minimal compliance costs for a self-employed individual licensee who will now be required to prescribe and provide initial recreation therapy treatment, relative to the time required to prescribe and to document that information in patient charts. The Division cannot calculate the compliance cost due to varying circumstances but anticipates that the time required and cost will be minimal and absorbed within regular job duties, and that any cost increase will be offset by the improved care and consistency in the consultation services provided.

Comments by the department head on the fiscal impact the rule may have on businesses:

The amendments to Sections R156-40-102, R156-40-302f, R156-40-304, and R156-40-502: 1) define "diversional activity" and "initial recreational therapy treatment"; 2) include prescribing initial recreational treatment as part of the "qualifications for consultation" under Section R156-40-302f; 3) update citations of incorporated materials to the new 2014 NCTRC Job Analysis and the new 2017 NCTRC Certification Standards; 4) eliminate the six-hour cap on continuing education provided by the Division and modify the processes to obtain, and references to, waivers of continuing education; and 5) make minor formatting changes. All of the amendments, except for the matter addressed in subparagraph 2) above, have no fiscal impact to small business. By including prescribing initial recreational treatment as part of the qualifications for consultation, there may be a minimal cost increase for small businesses who will now be required to prescribe initial recreation therapy treatment. It is anticipated that this fiscal impact will be small, as small business employers prescribing and charting this therapy will do so as part of their regular job duties, and the time required and cost will be minimal. (DOPL FILER'S NOTE: it should be noted that this Division rule was reviewed and approved by the Department Executive Director on 05/15/2017 which was prior to the newly identified requirements related to H.B. 272 which were distributed on 05/18/2017.)

Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY, UT 84111-2316

Direct questions regarding this rule to:

• Dane Ishihara at the above address, by phone at 801-530-7632, by FAX at 801-530-6511, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/17/2017

Interested persons may attend a public hearing regarding this rule:

• 06/26/2017 09:00 AM, Heber Wells Bldg, 160 E 300 S, Conference Room 474, Salt Lake City, UT

This rule may become effective on:

07/24/2017

Authorized by:

Mark Steinagel, Director

RULE TEXT

R156. Commerce, Occupational and Professional Licensing.

R156-40. Recreational Therapy Practice Act Rule.

R156-40-102. Definitions.

In addition to the definitions in Title 58, Chapters 1 and 40, as used in Title 58, Chapters 1 and 40 or this rule:

(1) "Approved graduate degree", as used in Subsection 58-40-302(2)(a), means an earned graduate (Masters, Ed.D., or Ph.D.) degree in recreational therapy or a graduate degree with an approved emphasis in recreational therapy, which includes:

(a) a minimum of nine semester hours or 12 quarter hours of upper division or graduate level course[ ]work in therapeutic recreation and/or recreational therapy;

(b) a minimum of 18 semester hours or 24 quarter hours of supportive coursework as outlined by the January [2014]2017 NCTRC Certification Standards, Part I, which are incorporated by reference; and

(c) an approved practicum that:

(i) includes field placement experience in recreational therapy services that:

(A) uses the therapeutic recreation process as defined in the [January 2011]2014 NCTRC [National ]Job Analysis, which is incorporated by reference; and

(B) is under the supervision of an onsite field placement supervisor who:

(I) is licensed in Utah as a TRS or MTRS; and

(II) is nationally certified by NCTRC as a CTRS; and

(ii) if the practicum is conducted outside Utah, is verified on an official university transcript.

(2) "Approved emphasis, option, or concentration in therapeutic recreation or recreational therapy", as used in Subsection 58-40-302(3)(a)(ii), means an emphasis, option or concentration posted on the transcript that meets the January [2014]2017 NCTRC Certification Standards, Part I, which are incorporated by reference, including:

(a) a minimum of 18 semester or 24 quarter hours of therapeutic recreation and general recreation content coursework with no less than a minimum of [12]15 semester or [16]20 quarter hours in therapeutic recreation, consisting of a minimum of [four]five three-credit hour courses;

(b) a total of 18 semester or 24 quarter hours of support coursework with a minimum of:

(i) three semester hours or [three]four quarter hours coursework in the content area of anatomy and physiology;

(ii) three semester hours or [three]four quarter hours coursework in the content area of abnormal psychology; and

(iii) three semester hours or [three]four quarter hours coursework in the content area of human growth and development across the lifespan. The remaining semester hours or quarter hours of coursework must be fulfilled in the content area of "[human service]social sciences and humanities" as defined by the NCTRC; and

(c) field placement experience in therapeutic recreation services that:

(i) uses the therapeutic recreation process as defined in the January [2011]2014 NCTRC [National ]Job Analysis, which is incorporated by reference;

(ii) is under the supervision of an academic supervisor and an onsite field placement supervisor, each of whom:

(A) is state licensed as a TRS or MTRS;

(B) is nationally certified by NCTRC as a CTRS; and

(C) meets the standards for field placement supervision; and

(iii) if the practicum is conducted outside Utah, is verified on an official university transcript.

(3) "Consultation", as used in Subsection 58-40-601(3)(a)(ii), is defined in Subsection R156-40-302f.

(4) "CTRS" means a person certified as a Certified Therapeutic Recreation Specialist by the NCTRC.

(5) "Diversional activity" means an activity that is unrelated to the goals, objectives, and expected outcomes outlined in the "recreational therapy treatment or intervention plan" described in Section 58-40-602.

([5]6) "Full-time[,] and on-site", as used in Subsections 58-40-601(3)(a) and (b), means an individual who is employed on the premises with the hiring agency for a minimum of 30 hours per week.

(7) "Initial recreational therapy treatment", as used in Subsection R156-40-302f(3), means an order that directs the TRT to:

(a) collect data from chart reviews, interviews, and observations as part of an assessment as defined in Subsection 58-40-102(2)(a)(i);

(b) invite the patient to leisure diversionary programs and observe for recreation and leisure patterns;

(c) provide leisure materials to the patient and support the patient's independent leisure choices; and

(d) complete recreation therapy admission notes.

([6]8) "Maintain the ongoing documentation", as used in Subsection 58-40-601(3)(b), means:

(a) documenting the ongoing treatment or intervention provided to clients according to the treatment plan; and

(b) providing review of patient status according to federal, state, and agency regulations.

([7]9) "MTRS" means a person licensed as a master therapeutic recreation specialist.

([8]10) "NCTRC" means the National Council for Therapeutic Recreation Certification.

([9]11) "Supervision", as used in Section 58-40-601, means that a person who is employed full-time and on-site as a TRS or MTRS by a recreational therapy services provider is responsible to ensure that the supervised TRT implements the treatment plan as established by the supervisor.

([10]12) "Supervision of a temporary TRS", as used in Subsection R156-40-302[f]g(1)(d), means that the TRS or MTRS supervisor:

(a) is responsible for the recreational therapy interventions performed by the temporary TRS; and

(b) will be required to review and approve the treatment plans as well as any modifications to the treatment plans as evidenced by the signature of the TRS or MTRS in the treatment plan.

([11]13) "TRS" means a person licensed as a therapeutic recreation specialist.

([12]14) "TRT" means a person licensed as a therapeutic recreation technician.

([13]15) "Written plan of operation", as used in Subsection 58-40-102(6)(b)(viii), means a comprehensive management plan that outlines recreational therapy services that, at a minimum, includes:

(a) vision and mission statement;

(b) policy and procedures;

(c) assessment protocol;

(d) treatment and/or intervention plan;

(e) scope of care; and

(f) personnel management.

([14]16) "Unprofessional conduct" is defined in Title 58, Chapters 1 and 40.

 

R156-40-302f. Qualifications for Consultation.

"In consultation with[Consultation of] a master therapeutic recreation technician", as used in Subsection 58-40-601(3)(a)(ii), means that the MTRS consultant[,] contracted by the agency is responsible for:

(1) providing "general supervision" as defined in Subsection R156-1-102a(4)(c);

(2) performing the assessment as described in Subsection 58-40-102(2)(a)(ii);

(3) prescribing "initial recreational therapy treatment" as defined in Subsection R156-40-102(7), outlining the recreation therapy services to be performed by the TRT upon client admission, and to be superceded by the recreation therapy treatment or intervention plan;

([3]4) prescribing, creating or modifying the treatment or intervention plans to be performed by the TRT as determined by the assessment;

([4]5) observing, evaluating, and documenting that the recreation therapy services are being conducted according to administrative and governing regulations;

([5]6) observing, evaluating, and documenting adherence to the standards of practice of the recreational therapy profession; and

([6]7) demonstrating adherence, as evidenced by the signature of the MTRS in the patient chart, reviews, and evaluation of ongoing regulatory documentation.

 

R156-40-302g. Qualifications for Temporary License as a TRS - Supervision Required.

(1) In accordance with Section 58-1-303, an applicant for temporary licensure as a TRS shall:

(a) submit an application for temporary license in the form prescribed by the [d]Division, which includes a verification that the applicant has registered and been approved to take the next available NCTRC examination;

(b) pay a fee determined by the department under Section 63J-1-504;

(c) meet all the requirements for licensure, except passing the NCTRC examination; and

(d) practice recreational therapy under the supervision of a Utah licensed TRS or MTRS, as defined in Subsection R156-40-102([8]12).

(2) The temporary license shall be issued for a period not to exceed 120 days, to allow the applicant to pass the NCTRC examination.

(3) The temporary license [will]shall not be renewed or extended for any purpose.

 

R156-40-304. Continuing Education.

In accordance with Section 58-40-304, qualified continuing education requirements are established as follows:

(1) All [licensed ]MTRS, TRS, and TRT['s] licensees shall complete 20 hours of qualified continuing education including two hours of suicide prevention training , that meets the requirements of this section.

(2) Qualified continuing education hours for licensees who have not been licensed for the entire two-year period [will]shall be prorated from the date of licensure.

(3) Continuing education under this section shall:

(a) be relevant to the licensee's professional practice;

(b) be prepared and presented by individuals who are qualified by education, training , and experience to provide recreational therapy continuing education; and

(c) have a method of verification of attendance and completion.

(4) The suicide prevention training shall include one or more of the following subject areas:

(a) suicide concepts and facts;

(b) suicide risk assessment, crisis intervention, and first aid;

(c) evidence-based intervention for suicide risk;

(d) continuity of care and follow-up services for suicide risk; or

(e) therapeutic alliances for intervention in suicide risk.

(5) Credit for continuing education shall be recognized in accordance with the following:

(a) unlimited hours [shall be recognized ]for continuing education completed in blocks of time of not less than 50 minutes in formally established classroom courses, seminars, lectures, conferences , or training sessions which meet the criteria listed in Subsection (3) above, and which are approved by, conducted by, or under the sponsorship of:

(i) the Division of Occupational and Professional Licensing;

(ii) recognized universities and colleges; or

(iii) professional associations, societies and organizations representing a licensed profession whose program objectives relate to the practice of recreational therapy;

(b) a maximum of ten hours per two-year period may be recognized for teaching continuing education courses relevant to recreational therapy;

(c) a maximum of 12 hours per two-year period may be recognized for continuing education courses completed [that is provided ]via the internet [and/]or webinar which provide[s] a certificate of completion;

(d) [a maximum of six hours per two-year period may be recognized for continuing education provided by the Division of Occupational and Professional Licensing;

(e) ]a maximum of four hours per two-year period may be recognized for CPR and first aid certification through a live course, not online; and

([f]e) a maximum of six hours per two-year period may be recognized for publications in an article, journal, newsletter , or other professional publication[s].

(6) [If properly documented that a licensee is subject to circumstances which prevent that licensee from meeting the continuing education requirements established under this section, the licensee may be excused from the requirement for a period of up to three years. However it is the responsibility of the licensee to document the reasons and justify why the requirement could not be met.]A licensee subject to circumstances that prevent the licensee from meeting one or more of these continuing education requirements may request a waiver or extension of time for a period of up to three years, in accordance with the provisions of Section R156-1-308d.

(7) A licensee shall [be responsible for ]maintain[ing] competent records of completed qualified continuing education for a period of six years, and if requested by the Division, shall demonstrate that the licensee meets the requirements [under]of this section.

 

R156-40-502. Unprofessional Conduct.

Unprofessional conduct includes:

(1) failing to establish and maintain professional boundaries with a patient or former patient;

(2) exploiting a current patient [and/]or former patient for personal gain;

(3) failing as a TRS/MTRS to ensure the student TRT completes the minimum required education and experience prior to working with patients;

(4) failing as a TRS/MTRS to ensure the student TRT is competent to provide recreational therapy services when signing the education and experience verification; and

(5) failing to abide by the provisions of the American Therapeutic Recreation Association (ATRA) Code of Ethics, November 2009, which is incorporated by reference.

 

KEY: licensing, recreational therapy, recreation therapy

Date of Enactment or Last Substantive Amendment: [December 22, 2015]2017

Notice of Continuation: April 26, 2016

Authorizing, and Implemented or Interpreted Law: 58-40-101; 58-1-106(1)(a); 58-1-202(1)(a)

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