Advocacy is a vital part of the Occupational Therapy profession. Advocacy is at the core of NCOTA’s mission and we strive to advocate for changes that our membership feels are important for the OT profession.

Each year the NCOTA Board of Directors, with support from our lobbyist, identifies legislative priorities. These priorities guide our actions and decisions, how we allocate resources, and our messaging to our membership.

Our 2024 legislative priorities are listed below. If you have ideas about other priorities or changes we should know about, please reach out to us at [email protected]!



2024 Legislative Priorities


Increase Salaries and Bonuses for School-Based OT Practitioners.  In order to recruit and retain school-based occupational therapists that provide students with essential OT services in grades K through 12 throughout North Carolina schools, the General Assembly should pass legislation that will increase school-based OT salaries so that they are in line with the salaries of other school-based masters level health professionals.  School-Based OTs should be ensured predictable, progressive compensation over a reasonable number of employment years (no more than 35) across the entirety of the salary range currently identified for the profession by NCDPI. In addition, OTs should be provided the same employment protections and salary increases, as well as State and local supplements and bonuses, as allotted to other master’s level professionals like speech/language pathologists and school psychologists. These provisions might be met while keeping OTs on the Classified Salary Schedule or by moving OTs to the Certified Salary Schedule while retaining the salary range currently identified for this profession by NCDPI. Occupational therapists’ level of education, licensure requirements, and continuing education requirements are all comparable to that of the other master’s level professions included in the certified pay scale. Current provisions for OTs on the Classified Salary Schedule result in unpredictable and unreliable compensation changes across employment tenure and between neighboring LEAs and no access to the same increases, supplements, and bonuses afforded professions with highly similar educational requirements and job responsibilities, resulting in significant challenges for most LEAs in recruiting and retaining OTs.


Expansion of Telehealth opportunities for occupational therapy in North Carolina: We urge the General Assembly to support telehealth opportunities for occupational therapists like those adopted in other states with great success.  Occupational therapy is an excellent example of a health care service that can be effectively utilized in the telehealth environment.  Utilization of telehealth for occupational therapy during the COVID-19 pandemic has resulted in positive outcomes for patients throughout North Carolina.   


Need for expanded resources for OTs who practice in the public school setting:  We urge the North Carolina General Assembly to increase funding for children with disabilities. We also support allowing schools to access Medicaid reimbursements for services to students in both traditional public schools and public charter schools. 


Increased access to occupational therapy should be an essential part of Medicaid Transformation:   Occupational Therapy benefits patients with a cost effectiveness that often keeps patients from having to endure more extensive and costly procedures.  As the Legislature works to implement Medicaid Transformation, increased access to occupational therapy should be included in the transformation framework. 


The General Assembly should pass legislation to close the Medicaid coverage gap:  Closing the Medicaid coverage gap would cover an estimated additional 500,000 North Carolinians and would provide those individuals with essential health care, including occupational therapy.  NCOTA supports effort to expand Medicaid and provide individuals with greatly needed health coverage. 


Medicaid should cover occupational therapy for individuals over 21 in a private practice setting.  Currently, North Carolina’s Medicaid policies fail to provide coverage for occupational therapy for individuals over 21 seen in a private practice setting.  This often means that individuals in need of occupational therapy go without these services and end up in a much more severe health crisis.  Medicaid policies should be updated to include Medicaid coverage for occupational therapy for individuals over 21 seen in a private practice setting. 


The mental health benefits of occupational therapy should be supported via legislation and policy.  Occupational therapy not only provides individuals physical health benefits but also significant mental health benefits.  Occupational therapy empowers individuals to reach their individual potential and gives them the skills to successfully conduct their daily lives and maintain safe and healthy routines.  Occupational therapy addresses performance deficits, regardless if the issues is mental or physical in nature. Legislation and health policies should be updated to reflect the beneficial outcomes on mental health provided by occupational therapy.