HB 4104 MI

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Became Law

Act No. 44 Public Acts of 2026 Approved by the Governor July 21, 2026 Filed with the Secretary of State July 22, 2026 EFFECTIVE DATE: January 22, 2028

state of michigan 103rd Legislature Regular session of 2026 Introduced by Reps. Wozniak, Rogers, Roth, Bierlein, Kunse, Outman, Bollin, Aragona, Thompson, Rheingans, Frisbie, Schmaltz, St. Germaine, Glanville, B. Carter, Scott, Fitzgerald, Longjohn, Neeley, Edwards, Paiz, MacDonell, Whitsett, McKinney, Miller, Price, Coffia, Skaggs, Martus, Wilson, Conlin, O�Neal, Byrnes, Wooden, Foreman, Tsernoglou, Young, Brixie, McFall, Weiss, Morgan, Hoskins and Farhat ENROLLED HOUSE BILL No. 4104 AN ACT to amend 1978 PA 368, entitled �An act to protect and promote the public health; to codify, revise, consolidate, classify, and add to the laws relating to public health; to provide for the prevention and control of diseases and disabilities; to provide for the classification, administration, regulation, financing, and maintenance of personal, environmental, and other health services and activities; to create or continue, and prescribe the powers and duties of, departments, boards, commissions, councils, committees, task forces, and other agencies; to prescribe the powers and duties of governmental entities and officials; to regulate occupations, facilities, and agencies affecting the public health; to regulate health maintenance organizations and certain third party administrators and insurers; to provide for the imposition of a regulatory fee; to provide for the levy of taxes against certain health facilities or agencies; to promote the efficient and economical delivery of health care services, to provide for the appropriate utilization of health care facilities and services, and to provide for the closure of hospitals or consolidation of hospitals or services; to provide for the collection and use of data and information; to provide for the transfer of property; to provide certain immunity from liability; to regulate and prohibit the sale and offering for sale of drug paraphernalia under certain circumstances; to provide for the implementation of federal law; to provide for penalties and remedies; to provide for sanctions for violations of this act and local ordinances; to provide for an appropriation and supplements; to repeal certain acts and parts of acts; to repeal certain parts of this act; and to repeal certain parts of this act on specific dates,� by amending sections 16345, 18301, and 18305 (MCL 333.16345, 333.18301, and 333.18305), as amended by 2008 PA 523, and by adding sections 18303a and 18303b. The People of the State of Michigan enact: Sec. 16345. (1) Fees for an individual licensed or seeking licensure to engage in the practice of occupational therapy, or to engage in practice as an occupational therapy assistant, under part 183 are as follows: (a) Application processing fee $ 20.00

(b) License fee, per year 75.00

(2) The fee for an individual seeking to hold a compact privilege under the occupational therapy licensure compact enacted in section 16188 is $75.00 per year.

Sec. 18301. (1) As used in this part: (a) �Occupational therapy assistant� means an individual who is licensed under this article, or authorized under section 18303b, to engage in practice as an occupational therapy assistant. (b) �Occupational therapist� means an individual who is licensed under this article, or authorized under section 18303a, to engage in the practice of occupational therapy. (c) �Occupational therapy services� means those services provided to promote health and wellness, prevent disability, preserve functional capabilities, prevent barriers, and enable or improve performance in everyday activities, including, but not limited to, the following: ( i ) Establishment, remediation, or restoration of a skill or ability that is impaired or not yet developed. ( ii ) Compensation, modification, or adaptation of a person, activity, or environment. ( iii ) Evaluation of factors that affect activities of daily living, instrumental activities of daily living, and other activities relating to education, work, play, leisure, and social participation. Those factors include, but are not limited to, body functions, body structure, habits, routines, role performance, behavior patterns, sensory motor skills, cognitive skills, communication and interaction skills, and cultural, physical, psychosocial, spiritual, developmental, environmental, and socioeconomic contexts and activities that affect performance. ( iv ) Interventions and procedures, including, but not limited to, any of the following: (A) Task analysis and therapeutic use of occupations, exercises, and activities. (B) Training in self-care, self-management, home management, and community or work reintegration. (C) Development remediation, or compensation of client factors such as body functions and body structure. (D) Education and training. (E) Care coordination, case management, transition, and consultative services. (F) Modification of environments and adaptation processes such as the application of ergonomic and safety principles. (G) Assessment, design, fabrication, application, fitting, and training in rehabilitative and assistive technology, adaptive devices, and low temperature orthotic devices, and training in the use of prosthetic devices. For the purposes of this sub-subparagraph, the design and fabrication of low temperature orthotic devices does not include permanent orthotics. (H) Assessment, recommendation, and training in techniques to enhance safety, functional mobility, and community mobility such as wheelchair management and mobility. (I) Management of feeding, eating, and swallowing. (J) Application of physical agent modalities and use of a range of specific therapeutic procedures, including, but not limited to, techniques to enhance sensory-motor, perceptual, and cognitive processing, manual therapy techniques, and adjunctive and preparatory activities. (K) Providing vision therapy services or low vision rehabilitation services, if those services are provided pursuant to a referral or prescription from, or under the supervision or comanagement of, a physician licensed under part 170 or 175 or an optometrist licensed under part 174. (d) �Practice as an occupational therapy assistant� means the practice of occupational therapy under the supervision of an occupational therapist licensed under this article. (e) �Practice of occupational therapy� means the therapeutic use of everyday life occupations and occupational therapy services to aid individuals or groups to participate in meaningful roles and situations in the home, school, workplace, community, and other settings, to promote health and wellness through research and practice, and to serve those individuals or groups who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. The practice of occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect an individual�s health, well-being, and quality of life throughout the individual�s life span. The practice of occupational therapy does not include any of the following: ( i ) The practice of medicine or osteopathic medicine and surgery or medical diagnosis or treatment. ( ii ) The practice of physical therapy. ( iii ) The practice of optometry. (2) In addition to the definitions in this part, article 1 contains general definitions and principles of construction applicable to all articles in this code and part 161 contains definitions applicable to this part.

Sec. 18303a. (1) An individual who holds a compact privilege to practice occupational therapy as an occupational therapist under the occupational therapy licensure compact is authorized to engage in the practice of occupational therapy under this article. (2) For purposes of this article, including the obligations of an individual who is licensed as an occupational therapist, an individual who holds a compact privilege to practice occupational therapy as an occupational therapist under the occupational therapy licensure compact is considered an occupational therapist who is licensed under this part.

Sec. 18303b. (1) An individual who holds a compact privilege to practice occupational therapy under the occupational therapy licensure compact as an occupational therapy assistant is authorized to engage in the practice as an occupational therapy assistant under this article. (2) For purposes of this article, including the obligations of an individual who is licensed as an occupational therapy assistant, an individual who holds a compact privilege to practice occupational therapy as an occupational therapy assistant under the occupational therapy licensure compact is considered an occupational therapy assistant who is licensed under this part.

Sec. 18305. (1) The Michigan board of occupational therapists is created in the department and shall consist of the following 9 voting members who must meet the requirements of part 161: 5 licensed occupational therapists and 4 public members, 1 of whom is a physician licensed under part 170 or 175. (2) The terms of office of individual members of the board created under this section, except those appointed to fill vacancies, expire 4 years after the appointment on December 31 of the year in which the term expires. (3) The board shall select the director to act as this state�s delegate for purposes of the occupational therapy licensure compact.

Enacting section 1. This amendatory act takes effect 18 months after the date it is enacted into law.

Enacting section 2. This amendatory act does not take effect unless House Bill No. 4103 of the 103rd Legislature is enacted into law. This act is ordered to take immediate effect.

Clerk of the House of Representatives

Secretary of the Senate Approved___________________________________________

____________________________________________________ Governor