December 19, 2025

Erin Barrett

Director of Legislative and Regulatory Affairs

Board of Medicine

Perimeter Center

9960 Mayland Drive, Suite 300

Henrico, VA 23233

RE: Comments on proposed occupational therapy regulations 18VAC85-80-72 and 18VAC85-80-80

Dear Ms. Barrett:

The American Occupational Therapy Association (AOTA) is the national professional association representing the interests of more than 213,000 occupational therapists, occupational therapy assistants, and students of occupational therapy, including 1164 members in Virginia. The practice of occupational therapy is science-driven, evidence-based, and enables people of all ages to live life to its fullest by promoting health and minimizing the functional effects of illness, injury, and disability. AOTA supports the Board of Medicine and the Occupational Therapy Advisory Committee in its mission to protect the health, safety, and welfare of Virginia consumers and the authority of the Board to create regulations to achieve this mission.

On behalf of AOTA, I am writing to provide comment on the proposed changes to 18VAC85-80-72 and 18VAC85-80-80. AOTA supports the proposed changes as they offer licensees seeking to reactivate their license and former licensees seeking to reinstate their license multiple pathways to do so as well as multiple pathways to demonstrate competency. Providing multiple options to reactivate or reinstate a license respects the fact that individuals become inactive or let their license lapse for differing reasons, protects the public by ensuring access to occupational therapy services, and supports the Governor of Virginia’s priority of removing barriers to practice regulated professions.

Thank you for the opportunity to comment on the proposed changes and if it would be helpful, we could be available at a future meeting to discuss our proposal. Please contact me at kneville@aota.org or 240-800-5981 if you have questions or need additional information about AOTA’s position.

Sincerely,

Kristen Neville

Manager, State Affairs

cc: Savanah Howe, OTR/L, QMHP-A, President, Virginia Occupational Therapy Association

Dear Director Barrett:

On behalf of the National Board for Certification in Occupational Therapy (NBCOT), we respectfully oppose the proposed amendments to 18 VAC 85-80-72 and VAC 85-80-80. 

NBCOT's mission is to protect the public through the validation of essential competencies for effective and safe occupational therapy practice which directly aligns with the Board's objective of protecting public health and safety.

NBCOT certification provides a rigorous, standardized assessment of practitioner competence, including passage of the national examination, adherence to a professional code of conduct, and completion of 36 units of professional development per renewal cycle. For practitioners seeking to reinstate a lapsed license, maintaining NBCOT certification support public protection by ensure they demonstrate appropriate knowledge and skills before returning to practice.

Maintaining NBCOT certification is both accessible and affordable. The renewal fee is $65 for a three-year-renewal cycle. This modest cost helps ensure the requirement is not financially prohibitive for those seeking to return to practice. 

Multiple states recognize the value of maintaining NBCOT certification and accept evidence of current certification as a means of meeting licensure requirements for professional development. For example, South Carolina requires all licensees to maintain their NBCOT certification throughout their professional careers, and D.C. has instituted statues/regulations that require NBCOT certification after a lapsed license.

Requiring NBCOT certification for reinstatement after an extended absence aligns with growing national trends for practitioners who have been working in other states. For those returning after personal circumstances such as family emergencies or illness, the certification requirement aids in ensuring they are prepared to provide safe, competent care upon their return while remaining financially accessible.

While the proposed amendments introduce alternative pathways for reactivation or reinstatement, these proposals do not uniformly ensure the same level of standardized, objective assessment as NBCOT certification.

We welcome collaboration with the Occupational Therapy Advisory Board to support licensure frameworks that protect the public and sustain a competent, qualified occupational therapy workforce. Please contact us by phone (301-990-7979) or email (am@nbcot.org or bwilliams@nbcot.org) if you require further information.

Sincerely,

Angela Macauley, President and CEO                                Barbara Williams, Vice President of 

                                                                                            External and Regulatory Affairs

January 6th, 2026

Erin Barrett

Director of Legislative and Regulatory Affairs

Virginia Department of Health Professions

Perimeter Center

9960 Maryland Drive, Suite 300

Henrico, VA 23233

RE: Comments on proposed occupational therapy regulations 18VAC85-80-72 and 18VAC85-80-80

Ms. Barrett:

On behalf of the Virginia Occupational Therapy Association (VOTA), I am writing to provide comments in support of the proposed changes to 18VAC85-80-72 and 18VAC85-80-80.

VOTA strongly supports the availability of reasonable options for occupational therapists (OTs) and occupational therapy assistants (OTAs) to reactivate or reinstate their license. There are multiple ways that OTs and OTAs can demonstrate their competency to practice while also ensuring adequate oversight. We believe the regulatory changes to 18VAC85-80-72 and 18VAC85-80-80 adopted by the Board strike this balance.

The current language of 18VAC85-80-72 and 18VAC85-80-80 create significant barriers to OTs and OTAs seeking to reactivate or reinstate their license. While VOTA holds the National Board for Certification in Occupational Therapy (NBCOT) in the highest esteem and believe passing the national exam is a crucial component of initial licensure, we do not agree that NBCOT certification or retaking the national exam should be the only pathways to licensure reactivation or reinstatement. Many of our members have expressed concern with the current lack of flexibility and specifically the NBCOT requirements. NBCOT certification is a barrier to reactivation and reinstatement for many OTs and OTAs due to the required additional fees and their personal values.

Further, the additional pathways for licensure reinstatement and reactivation adopted by the Advisory Board do not present any public health or safety issues. These pathways do not significantly differ in rigor when compared to the requirements for renewal of NBCOT certification. For this reason, we do not believe that NBCOT certification at the time of licensure reinstatement or reactivation is necessary or promotes public health or safety. In fact, NBCOT certification is not required for reactivation or reinstatement in most states.

In summation, we strongly support the proposed amendments to 18VAC85-80-72 and 18VAC85-80-80. These regulatory amendments provide reasonable options to OTs and OTAs for licensure reactivation and reinstatement, while also ensuring adequate public safety. Moreover, the amendments align with Governor Youngkin’s executive order regarding licensure and regulatory efficiency. 

Thank you for the opportunity to comment on the proposed changes and if it would be helpful, VOTA is available at a future meeting to discuss this matter further. Please contact me at president.vota@gmail.com if you have questions or need additional information about
VOTA’s position.

Sincerely,

Savanah Howe, MOT, OTR/L

President, Virginia Occupational Therapy Association