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AOTA delineates the roles of OTs and COTAs
Occupational Therapists (OTs) are responsible for client evaluation, therapeutic interventions, discharging the client, and making clinical decisions (National Board for Certification in Occupational Therapy, 2025). The Certified Occupational Therapy Assistant (COTA) works under the supervision of the OT, however they collaborate as a team to deliver client-centered care. -
The Education for All Handicapped Children Act
Known as The Individual's with Disabilities Education Act today. Identifies occupational therapy as a related service in schools for students with disabilities (U.S. Government Accountability Office, 1980). This allowed OTs to support students in their academic participation and engagement. -
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OT Historical Timeline
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First stand-alone Occupational Therapy Code of Ethics is adopted by AOTA
The Occupational Therapy Code of Ethics set standards for ethical behaviors in OT practice. It remains in use today through its most recent 2020 version (AOTA, 2020). The Code provides a framework including core values and ethical principles which guide OTs in their decision-making. If the OT Code of Ethics is violated by a practitioner, they may face various professional consequences. -
The Omnibus Budget Reconciliation Act of 1980
Classifies OT as a qualified home health benefit, and classifies outpatient rehab facilities as providers under Medicare Part B (H.R. 7765, 1980). -
The Education of the Handicapped Amendments
The Education of the Handicapped Amendment of 1986 was an updated version of the Education for All Handicapped Children Act of 1975. This act comprehensive early intervention system that includes family centered services and individualized service plans for ages birth through 2. This act also required states to have free appropriate public education for ages 3 through 5 as well as funding for special education for aged 3 through 5. -
Title IV: The Omnibus Budget Reconciliation Act
The Omnibus Budget Reconciliation Act established a minimum standard of care in nursing homes that participated in Medicare or Medicaid funding. Patient rights in the nursing home such as being except of unnecessary restraints and being apart of their own care plan. Also included, The Pre-Admission Screening and Resident Review which screened for any mental illness or developmental disabilities before entering the nursing facility. -
ADA Signed
The Americans with Disabilities Act (ADA) was enacted, which expanded opportunities for occupational therapy through increased focus on accessibility and accommodations (U.S. Department of Justice, Civil Rights Division, n.d.). Equipped with a unique lens that allows them to consider/evaluate the interaction between the person, environment, and occupation, OTPs are ideal collaborators to work alongside various community stakeholders to ensure compliance with ADA regulations. -
EHA becomes IDEA
The reauthorization of the Education for All Handicapped Children Act (EHA) elicited several modifications to the law, including a name change to the Individuals with Disabilities Education Act, adding TBI and autism as recognized disability categories, and requiring transition planning for all students nearing graduation (US. Department of Education, 2024). The added disability categories and the inclusion of required transition services expanded the reach of OTPs working within school systems. -
Omnibus Budget Reconciliation Act of 1990
The Omnibus Budget Reconciliation Act was passed, enabling Medicare to cover partial hospitalization program (PHP) services, and furthering the scope of occupational therapy in community mental health settings (Omnibus Budget Reconciliation Act of 1990, 1990). -
Medicaid Reform
The Medicaid Reform boosted quality of care. More people were able to obtain healthcare, and each state Medicare group can determine the expense for medicare. -
IIRIRA: AOTA Requirements For Occupational Therapist
The Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 requires certification for foreign Occupational Therapist workers seeking Visa's in the U.S. Such workers must comply with the the AOTA requirement and standards for Occupational Therapists (The American Occupational Therapy Association, n.d). -
The Balanced Budget Act of 1997 (P.L. 105-33)
The Balanced Budget Act of 1997 an obstacle for OT's face from cuts to Medicare. Changes were a Prospective Payment System based on a fixed amount, impacting the OT's ability to provide the needed services for home health, skilled nursing, and inpatient rehab facilities. Except for Hospital Outpatient Departments, expanding the cap on private practitioners to therapy placing all Part B Payment ($1500) from the Medicare Physician Fee Schedule (The American Occupational Therapy Association, n.d).