Section 1315.162  Modalities in Occupational Therapy

Occupational therapy services include the use of physical agent modalities for occupational therapists and occupational therapy assistants who have the training, skill  and competency to apply these modalities.

a)         Physical agent modalities:

1)         refer to those modalities that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity;

2)         are characterized as adjunctive methods used in conjunction with or in immediate preparation for: patient involvement in purposeful activity; the use of ergonomic principles; the adaptation of environments and processes to enhance functional performance; or the promotion of health and wellness; and

3)         include but are not limited to the following:

A)        electrical stimulation;

B)        iontophoresis;

C)        superficial heating agents;

D)        cryotherapy; and

E)         deep heating agents.

b)         Following is the training required for the use of physical agent modalities used by occupational therapists and occupational therapy assistants.

1)         Modalities

A)        Modalities using electricity would cover: pain control, edema reduction, and muscle reeducation.  Examples include, but are not limited to: biofeedback, NMES/FES, TENS, HVGS, interferential, iontophoresis.  The training shall include:

i)          a minimum of 12 hours of didactic training in a program defined in this Section that includes demonstration and return demonstration and an examination; and

ii)         5 treatments in each modality supervised by a licensed health care professional trained in the use of the modality.

B)        Thermal modalities would include superficial and deep heat and cyrotherapy.  Examples include, but are not limited to, hot and cold packs, ice massage, fluidotherapy, warm whirlpool, cool whirlpool, ultrasound, phonophoresis, paraffin, contrast baths.

i)          a minimum of 3 hours of didactic training in a program defined in this Section that includes demonstration and return demonstration and an examination. The training session should include the mechanics and precautions of using the modality safely as well as case studies and problem solving on when to use. The ethics, economics, liability, and insurance issues related to using modalities should also be addressed in the educational process.

ii)         5 treatments in each modality supervised by a licensed health care professional trained in the use of the modality.

2)         The didactic training shall be obtained through educational programs, workshops, or seminars offered by a college or university, Illinois Occupational Therapy Association, the American Occupational Therapy Association and its affiliates, Illinois Physical Therapy Association, the American Physical Therapy Association or its chapters, National Board of Certification of Occupational Therapy (NBCOT), or the Hand Therapy Certification Commission.

3)         The training shall be documented and made available to the Department or Board upon request.  Training shall be completed prior to the use of these modalities.  Documentation shall include:

A)        a transcript or proof of successful completion of the coursework, including the number of educational hours;

B)        the name and address of the individual or organization sponsoring the activity;

C)        the name and address of the facility at which the activity was presented;

D)        a copy of the course, workshop, or seminar description that includes topics covered, learning objectives, credentials of presenters and standards for meeting the objectives;

E)         documentation of the 5 clinical treatments that includes date of the treatments, the modality and the name and credentials of the supervisor.

c)         Occupational therapists and occupational therapy assistants who, prior to January 1, 2002, have attended training programs and have developed competencies in the use of physical agent modalities may demonstrate competency through proof of one or more of the following:

1)         documentation of previous attendance and completion of the required training as stated in subsection (b);

2)         documentation of professional experience at the work place through policy and procedures indicating the use of modalities, inservice training, proof of prior use.  Such experience shall include at least 20 applications for each modality within the last 3 years;

3)         documentation of attendance at educational programs, including post-professional programs, in-service training and specific certifications in the use of modalities; or

4)         documentation of certification as a hand therapist from the Hand Therapy Certification Commission.

(Source:  Added at 26 Ill. Reg. 18330, effective December 13, 2002)