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Overview of Level II Fieldwork

Fieldwork Coordinator & Staff|Frequently Asked FW Questions|Fieldwork Dates|Fieldwork Objectives & Expectations|Sample Contract|Potential Employment|Legislative Update|

The completion of the equivalent of 24 weeks of full-time Level II fieldwork (FW) is required to become a registered occupational therapist. It is required by both the Accreditation Council for Occupational Therapy Education (ACOTE) and the National Board for Certification of Occupational Therapists (NBCOT). At the University of Wisconsin-Madison, all other course work must be completed before students are allowed to begin Level II fieldwork. Students earn a M.S. in Therapeutic Science and Occupational Therapy after successful completion of required Level II fieldwork. This means that the graduation date for most students is in December following the completion of their second FW placement, or, for students who complete Level II fieldwork later than mid-December, in May or August of the following year depending on when they complete all required Level-II fieldwork. There are only 3 graduation dates per year at UW-Madison, May, August, and December.

Students are eligible to take the national certification exam given by NBCOT only after successfully completing all requirements for graduation including all required Level-II fieldwork.

Fieldwork Coordinator: Debbie Bebeau MS, OTR

dbebeau@education.wisc.edu

 2165 Medical Sciences Center

 1300 University Ave.

 Madison, WI 53706

(608)262-0093

Fieldwork Coordinating Assistant:  Lisa Blochwitz

blochwitz@education.wisc.edu

2130 Medical Sciences Center

1300 University Ave.

Madison, WI 53706

(608)262-8976

Fieldwork Facts:

Students' Frequently Asked Questions About Fieldwork:

Please go to AOTA to view Students' Frequently Asked Questions about Fieldwork (http://www.aota.org/Students/Current/Fieldwork/FAQs.aspx).

Fieldwork Dates:

2008

June 30 – September 19

September 29 -  December 19

2009

June 29 – September 18

September 28 – December 18

2010

June 28 – September 17

September 27 – December 17

2011

June 27 – September 16

September 26 – December 16

2012

July 2 – September 21

September 24 – December 14

Fieldwork Objectives/ Expectations:

LEVEL II FIELDWORK OBJECTIVES & EXPECTATIONS

UW-Madison Occupational Therapy Program

The following general objectives apply to all fieldwork experiences developed to be consistent with the conceptual core and curriculum design of the University of Wisconsin-Madison. Level II Fieldwork experiences will include the application of knowledge of (1) the science of occupation, (2) professional ethics, (3) effective therapeutic relationships, (4) group process, (5) the contexts of service delivery, and (6) principles of management and systems. Students will be expected to provide evidence-based interventions that promote the participation of individuals in meaningful and culturally relevant occupations within lived contexts. In addition, students will have the opportunity to engage in research-related activities and participate in the education of others about the practice of occupational therapy. The term, “client,” may refer to an individual, a group, or a population of individuals. Upon completion of Level II Fieldwork experience, the student will demonstrate the following in accordance with the standards established by the fieldwork center:

  • Competency in evaluation procedures designed to identify problems related to a client’s satisfactory participation in meaningful occupations in lived contexts
    • Appropriately select and utilize observation, interview, and data from other assessments routinely used by the fieldwork center
    • Accurately record evaluation results
  • Ability to accurately interpret evaluation data and use that information in developing appropriate goals and intervention plans that (1) incorporate current knowledge about occupation, (2) are occupation-based, (3) are consistent with evidence of best practice, and (4) respect client priorities
    • Identify and define problems related to participation in occupations in ways that are relevant and meaningful to clients
    • Develop specific therapy objectives that reflect a client’s occupational priorities
    • Collaborate with clients and their caregivers and teachers in developing therapy intervention plans
    • Articulate the clinical reasoning behind the selection of interventions used
  • Proficiency in implementing interventions
    • Establish and maintain a collaborative therapeutic relationship with clients
    • Make program changes in response to changes in client needs
    • Collaborate with other staff, including OTAs, in implementing interventions
    • Set appropriate limits to a client’s undesirable behaviors
    • Accurately evaluate effectiveness of interventions
    • Collaborate on follow-up programs in accordance with a client’s priorities and discharge environment
  • Effective communication with others
    • Interact effectively with clients, colleagues, other professionals, and community members from diverse cultural and ethnic backgrounds on a one-on-one basis and within the context of groups
    • Communicate effectively with varied audiences for varied purposes
  • Acquisition of professional behaviors
    • Demonstrate appropriate professional conduct
    • Adhere strictly to all confidentiality standards and protocols
    • Represent the occupational therapy profession accurately and effectively
    • Seek out and make use of feedback from others
    • Provide effective feedback to others
    • Accept responsibility for own actions and the outcomes of those actions
    • Fulfill commitments
    • Differentiate facts from illusions and assumptions
    • Demonstrate a broad sense of professional responsibility to the community and social and health care issues
    • Contribute to selected management functions
    • Participate in selected research-related activities
    • Contribute to the understanding of others about occupational therapy

Policies Related to Fieldwork:

1. Level II Fieldwork may be completed on a part-time basis as defined by the Fieldwork Placement in accordance with the Fieldwork Placement's usual and customary personnel policies as long as it is at least 50% of a Full-time Equivalent at that site.

2. Level II Fieldwork must be completed prior to receiving your degree and taking the NBCOT Certification Exam. Both Level II Fieldwork experiences must be completed within 24 months of completion of coursework.

Sample Contract:University of Wisconsin-Madison

Occupational Therapy Clinical Education Program Agreement

This affiliation agreement (“Agreement”) is entered into by ("Facility"), and the Board of Regents of the University of Wisconsin System on behalf of the University of Wisconsin-Madison, School of Education, Department of Kinesiology, Occupational Therapy Program (“University”) to provide practical learning and clinical experiences for the University’s students and to establish and operate an Occupational Therapy Clinical Education Program (“Program”) at the Facility.

This Agreement shall become effective on the ____ day of ________, 20__ and shall automatically renew on an annual basis unless terminated as provided by this Agreement.  Either party shall have the right to terminate this Agreement for any reason on sixty days written notice to the other party.  In the event of termination, the parties agree that any students placed at the Facility will be able to complete their activities in connection with the Program.

General

1. The beginning and ending dates for the placement of each student (“Placement”) in the Program will be mutually agreed upon in writing by the Facility and the University.

2. The number of students eligible to participate in the Program will be mutually agreed upon by the Facility and the University and may be altered by mutual agreement.

3. The University will place with the Facility only those students who have satisfactorily completed the prerequisite academic portion of the University’s curriculum.

4. Facility actions regarding students:

A. The Facility may cancel, by notice in writing to the University, the placement of any student whose performance or conduct is unsatisfactory, whose personal characteristics interfere with the development of professional relationships within the Facility, or whose health conditions interfere with the student's successful completion of his or her assignment at the Facility.

B. The Facility may immediately suspend any student’s Placement if the student’s performance adversely affects the safety or welfare of the Facility’s patients or clients.

C. Prior to cancellation of any student’s Placement, the Facility shall notify the University, provide the student and the University with written justification for the Facility’s proposed cancellation, consult with the University about the proposed cancellation, and make reasonable efforts with the University to resolve the matter.

5. The University and the Facility shall not discriminate with respect to race, color, sex, creed, national origin, disability, age, public assistance status, marital status, sexual orientation, and religion in their on-going practices.

6. The University and the Facility shall make reasonable accommodations to provide accessibility for students with disabilities.  If a student requests an accommodation in his or her assignment to the Facility, the University will encourage the student to disclose directly to the Facility information in support of the student's request.

7. This Agreement does not create any third-party beneficiaries.

8. The University’s personnel, faculty, and students are not eligible for coverage under the Facility's Workers' Compensation or Unemployment Compensation insurance programs.  The University shall provide, if any, Workers' Compensation or Unemployment Compensation coverage as required by Wisconsin law.  Neither the University nor the Facility shall compensate students for their activities during their Placement, and this paragraph does not extend Workers' Compensation or Unemployment Compensation coverage beyond the specific requirements of Wisconsin law.

9. The Facility shall send to the University a list of required immunizations and titers, special training, applicable deadlines, and other conditions of participation in the Program.  The University shall inform students of the Facility's requirements.  Students are responsible for providing to the Facility timely documentation of completion of all the Facility’s requirements.

10. Neither party may assign any rights or obligations under this Agreement without the prior written consent of the other party.

11. The parties agree that any student placed at the Facility under this Agreement is considered a member of the Facility’s “workforce,” as defined in 42 C.F.R. 160.103, for the limited purposes of the Health Insurance Portability and Accountability Act of !996 (HIPAA).  The parties also agree that the University, its employees, and its students are not “business associates” of the Facility, as defined in 42 C.F.R. 160.103, for the limited purposes of HIPAA.

Responsibilities of the University

12. The University shall send to the Facility a personal data form for each student placed with the Facility at least four (4) weeks before the commencement of each student's Placement.  This form will include the dates on which each of the Facility’s requirements was completed. 

13. The University shall recommend hepatitis immunizations to each student and shall provide opportunities for training about:

  • bloodborne pathogens and universal precautions as required by OSHA.
  • HIPAA Privacy Rule requirements

14. A University faculty member and a designee of the Facility shall coordinate the University’s academic requirements with the Program activities of each student at the Facility.

15. The University shall notify each student that he or she is responsible for:

  • complying with the policies, procedures, standards, and practices of the Facility;
  • obtaining any uniforms required by the Facility;
  • providing his or her own transportation and living arrangements;
  • reporting for Program activities on time;
  • maintaining his or her own health records and providing his or her own health insurance coverage and documentation as required by the Facility;
  • complying with the policies, procedures, standards, and practices of the University;
  • granting the Facility a 30-day review prior to presenting or publishing any materials involving the student’s activities at the Facility, and
  • maintaining the confidentiality of patient or client records and information.

16.  The University, as a unit within an agency of the State of Wisconsin, provides liability coverage for its students and faculty consistent with section 895.46(1) of the Wisconsin Statutes.  The University’s students and faculty who participate in the activities resulting from this Agreement are agents and employees, respectively, of the State of Wisconsin.  While participating in such activities, students and faculty are acting within the scope of their agency or employment.  The liability coverage provided by the State of Wisconsin under Section 895.46(1) is self-funded, unlimited, and continuous.  Such liability coverage includes, but is not limited to claims, demands, losses, costs, damages and expenses of every kind and description (including death), or damage to persons or property arising out of Program activities at the Facility.

17. During the term of this Agreement, the Board of Regents of the University of Wisconsin System agrees to hold harmless the Facility from any and all liability that is based the acts or omissions of its officers, employees, or agents while acting within the scope of their employment or agency consistent with sections 895.46(1) and 893.82 of the Wisconsin Statutes.

Responsibilities of the Facility

18. The Facility shall provide a planned, supervised program of clinical experiences, as specified in writing to the University, for each student’s Placement.

19. The Facility shall maintain complete records and reports on each student's performance, providing evaluations to the University on forms provided by the University.

20.  In all cases, the Facility shall retain ultimate responsibility for the care of its patients or clients.

21.  The Facility shall, on reasonable request, permit representatives of the University and academic accreditation agencies to inspect its facilities, the services made available for the Placement of students, student records, and other information relevant to the Program.

22.  The Facility shall designate in writing to the University the name of the person responsible for the Facility's Program and shall also submit to the University information requested regarding the professional experience of that person and of other professional staff participating in its Program.  The Facility agrees to notify the University in writing of any change or proposed change in its designation of the person responsible for the Facility's Program, or of any other staff that may affect student Placements.

23.  The Facility shall have primary responsibility for ensuring student compliance with his or her responsibilities as set forth in subparagraphs A, B, and D of paragraph  15 of this Agreement.  The University agrees to assist the Facility in achieving student compliance on request of the Facility

24.  The Facility shall, at the commencement of a student's Placement, provide the University’s faculty and the student with a thorough orientation about the Facility's policies, procedures, standards and practices relevant to the student’s Placement.

25.  At regular intervals, as specified by the University, the Facility shall provide the University with an outline of the curriculum for the Facility’s Program.

26.  In the event a student is absent because of illness for more than three (3) days during the student’s Placement, the Facility shall promptly arrange for the student to make up the lost time or shall inform the University of its inability to do so.

27.  Except for personal emergencies, the Facility shall not grant leaves of absence from regularly scheduled activities to students during their Placements without prior approval from the University.

28.  The Facility shall promptly advise the Vice Chancellor for Legal and Executive Affairs, University of Wisconsin-Madison, 361 Bascom Hall, 500 Lincoln Drive, Madison, Wisconsin 53706-1380, if it has any reason to believe a claim may exist against an officer, employee, or agent of the University in connection with any activities performed under this Agreement.  Notification is for informational purposes only and shall not eliminate Facility’s duty to follow the statutory claim procedure in section 893.82 of the Wisconsin Statutes prior to instituting a lawsuit against the University.

29.  The parties to this Agreement agree to revise or modify it only by written amendment signed by both parties.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement

The Board of Regents of the                         Facility

University of Wisconsin System

By                                                                    By_____________________                                                 

Darrell Bazzell                                                  ______________________                                                    

Vice Chancellor for Administration                                Name   (print) and Title

                                                                        ________________________                                                    

Date                                                                             Date

School of Education

Department of Kinesiology

Occupational Therapy Program

BY                                                                                                                    

Deborah Bebeau MS, OTR 

Academic Fieldwork Coordinator

Potential Employment:

www.otjoblink.org

Legislative Update:

(The following information from www.aota.org)

OT/OTA Student Services

Historically, OT and OTA students have participated in the delivery of occupational therapy services under the supervision of occupational therapy personnel in a variety of fieldwork sites. The changes to Medicare payment systems over the last few years have brought concurrent changes to the way in which the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), interprets how and whether the Medicare program should provide payment for services provided by students. In the article, "Strategies for Creative Fieldwork Opportunities," AOTA’s Academic Affairs, Federal Affairs, Practice, and Reimbursement and Regulatory Policy staff provide guidance to help occupational therapy programs, fieldwork sites, and facilities understand and adapt to these changes.

For those settings that serve Medicare patients, it is important to be aware of both new and existing Medicare payment policies. Although Medicare does not state that students cannot provide services, CMS has published specific criteria relating to how and when the program will pay for services provided by students. When developing fieldwork plans for sites that serve Medicare patients, two issues must be considered:

  • Whether Medicare payment rules specifically allow or restrict coverage of services provided by students, and
  • What type and level of supervision are required to raise those services provided by students to the level of covered "skilled" occupational therapy as defined by the Medicare program.

All relevant Medicare coverage criteria must be reviewed if reimbursement is sought for services. In addition, many State practice acts and regulations provide requirements (legal statutes) and guidance for occupational therapy services provided by students. You can find the regulatory board contact information on the State-by-State OT Law Database located in the Licensure section of this Web site.

The following chart sets out for each Medicare setting whether Medicare payment rules specifically allow or restrict coverage of services provided by students and what type and level of supervision Medicare requires to raise the services provided by students to the level of covered "skilled" occupational therapy. Practitioners should take care to assure an appropriate level of supervision, whether or not a specific CMS rule regarding students has been issued.

Setting/Payer

Medicare Coverage of Services Provided by Therapy Students

Type and Level of Supervision of Student Required

Medicare Part A Hospital and Inpatient Rehabilitation

CMS has not issued specific rules.

CMS has not issued specific rules. See relevant state law for further guidance on supervision for the services to be considered occupational therapy.

Medicare Part A

SNF

The minutes of therapy services provided by OT and OTA students may be recorded on the MDS as minutes of therapy received by the beneficiary.

Services of OT and OTA students must be provided in the "line of sight" of the OT. OTAs can provide clinical supervision to OTA students; however, if the services are to be recorded for payment purposes, they must be performed in "line of sight" of an OT

Medicare Part A Hospice

CMS has not issued specific rules.

CMS has not issued specific rules. See relevant state law for further guidance on supervision for the services to be considered occupational therapy.

Medicare Part B

Partial Hospitalization

CMS has not issued specific rules.

CMS has not issued specific rules. See relevant state law for further guidance on supervision for the services to be considered occupational therapy.

Medicare Part A

Home health

Regulations (§484.115) specifically cite definitions for "qualified personnel", which do not include students. However, CMS has not issued specific restrictions regarding students providing services in conjunction with a qualified OT or OTA.

Services by students can be provided (as allowed by state law) as part of a home health visit, when the student is supervised by an OT or OTA in the home

Medicare Part B

Private Practice, Hospital Outpatient, SNF, CORF, ORF, Rehabilitation agency, and other Part B providers including home health agencies when providing Part B services

Under the Medicare Part B outpatient benefit, the services of students directly assisting a qualified practitioner (OT) are covered when the type and level of supervision requirements are met.

Students can participate in the delivery of services when the qualified practitioner (OT) is directing the service, making the skilled judgement, responsible for the assessment and treatment in the same room as the student, and not simultaneously treating another patient. The qualified practitioner is solely responsible and must sign all documentation.

AOTA continues to work with a coalition of practitioner organizations to advocate for additional government support for education of allied health providers and to develop long-term solutions to the problems caused by Medicare’s limitations on reimbursement for student services.