Is It Worth It To Get A Temporary OT or PT License In California

If you’ve already started researching what travel therapy is like for an occupational or physical therapist, you’ve probably been recommended to look to the West Coast. California, in particular, is well-known among the travel therapist community as being an area that is typically abundant with jobs for all disciplines. However, the other fact that is well-known about this state is the involved application process: both the OT and PT licensure requirements are stringent, and every therapist has a colleague with a horror story of the process taking months on end. It’s only natural to look into other options that can get you working in the state more quickly, which is where a temporary license comes into play.

But is it worth it to apply for temp licensure?

In most cases, no, probably not. But let’s look at the data that way you can make that decision for yourself:

Let’s say you’re a new grad OT or PT and have decided that you want to do travel therapy as soon as you can, and California is where you plan to start. You schedule your board exam and begin the California licensure process. The terminology between disciplines is a little different here – for occupational therapists you are granted a “limited permit,” for physical therapists you become a “physical therapy license applicant,” but the end result is the same: you are granted a temporary license that allows you to work while you prepare to take your board exam in the next 90 days. Seems like this would be perfect to line up for a first 13-week travel assignment, right?

In reality, there are a lot of other factors that make this difficult.

Supervision

Perhaps the most significant is the amount and type of supervision required for temporary permit holders. For physical therapist license applicants, “direct and immediate supervision” is required at all times. While it seems like there may be some grey area to this, the law goes on to state that the supervising therapist must be in close proximity any time the license applicant is rendering PT treatment. The supervisor must also countersign all daily notes the license applicant writes. Furthermore, the supervising therapist takes on a certain amount of responsibility/risk – they are required to know when you are scheduled to test and when the temporary permit expires – or is canceled due to failure of the NPTE. If the supervising therapist allows an applicant to work beyond that, they are liable for disciplinary action against their own license. This can be an especially hairy situation if an applicant fails the exam but lies about it to their supervisor, as the licensed therapist can still be responsible for not fully verifying passing status. So, at the end of the day, many physical therapists are not willing to take the risk – especially for a stranger.

Limited permit supervision requirements are slightly different for OT. The CBOT explicitly states that a supervising occupational therapist does not need to be at the same facility to meet supervision requirements, but rather that “the level of supervision for all personnel is determined by the supervising occupational therapist whose responsibility it is to ensure that the amount, degree, and pattern of supervision are consistent with the knowledge, skill, and ability of the person being supervised.” However, the same rules apply for disciplinary action – if something bad happens during treatment, it’s the supervisor’s license on the line. For that reason, most OTs would be hesitant to take on a new grad supervisee without observing them in person at least a few times. And like PT, all notes must be reviewed and cosigned. For both disciplines, temporary license holders will not be able to supervise other employees like PTAs or COTAs.

So it’s definitely an uphill battle to get the supervision needed to have a temporary license. Especially because as a travel therapist, you may actually be the only therapist of your type in a facility. For example, in my first travel assignment, I was the only occupational therapist for the entire school district. And it was in such a rural area, that I would wager there were maybe 25 or fewer occupational therapists working across settings in the county – and they were understandably busy. It would’ve been really challenging to find someone who could provide me with appropriate supervision had I needed it. 

Other Logistics

Beyond the supervision needed, other logistics can also become an issue when going this route. Since you still need to take your board exam, you’ll have to decide where to schedule that. If at home, you’ll have to find a way to get back there, and possibly miss some time at your travel assignment. If you schedule near your facility, there’s always the possibility that your assignment gets cut short and you won’t be in the area anymore. Then there’s the fact that while you are learning the ropes of your first “real” job, and learning the ins and outs of travel therapy, and balancing time to actually enjoy your location, you’ll have to fit in time to study. And worst-case scenario, if you don’t pass, you’ll have to stop working immediately – which means you’ll stop getting paid immediately – which could put you (and the facility!) in a really rough spot. 

So, with all this being said, even if you personally feel up to the challenge, most hiring managers and travel companies will hesitate to push a candidate with this profile forward unless there are no other interested applicants. And while this is not necessarily the mark of a bad assignment, it is worth taking with a grain of salt. Especially as a new grad traveler, you really want to spend some time vetting an assignment to make sure it is a good fit for you – you want an environment where you will be supported and not just thrown to the wolves. If you are the only applicant, it can be indicative that the assignment has larger problems that may not be obvious yet. 

So what if you’re not a new grad and already hold licensure in another state?

Does the process look any different?

Not in any meaningful way. It’s important to note that for both disciplines, the “temporary” and “permanent” application process are one and the same, so there’s no quicker way to avoid some of the paperwork. For OTs, there is a grace period of 60 days to work in California once a licensure application is received. The board must receive all application materials, including fees, and you must request a return receipt that confirms the date the application is received and starts the 60-day timeline. While the supervision requirements are not specifically listed, the Board does state that a licensure applicant working in this manner must “work in association with a California-licensed OT.” For physical therapist license applicants, even those that are already licensed in other states must work under “direct and immediate supervision of a physical therapist licensed in this state.” PTs don’t have any specific expiration date here like OTs do; instead, an applicant can work in this manner until their full license is granted.

So, not much changes here in the eyes of a hiring manager. While the therapist is a little more seasoned and perhaps more trustable, supervision of some sort is still required. And there’s always the possibility that a paperwork snafu could cause a delay or denial of licensure. No facility wants to be out a licensed therapist in the middle of an assignment – so most places will go with the therapist who has their license in hand, given the choice. This isn’t to say that you will never find a recruiter and facility that would be willing to make the process work – but again, be a little wary if there are no other applicants. 

The good news is that neither the OT nor the PT permanent license process should take months and months if all of your paperwork is submitted correctly. While it’s easy to read horror stories online and get scared, this is not the typical experience. Personally, my California license only took about 5 weeks once I had everything submitted – and honestly, I was grateful for the time to wrap up loose ends at home before jet-setting across the country. So while you may be tempted to put energy into finding an assignment that will allow you to work with temporary licensure, I would instead suggest investing that momentum into getting all your paperwork submitted and then going over it with a fine-tooth comb. You’ll have your permanent California license sooner than you think.

Author Bio:

Devon graduated with a B.S. in Health Science from Spalding University in 2014. She continued on at Spalding to finish her M.S. in Occupational Therapy in 2015. Devon presented her master’s research project, Strategies to Promote Safe, Healthy, and Appropriate Sexual Behavior in Individuals with Disabilities, at the AOTA conference in 2016. Devon’s primary clinical experience is with the pediatric population, which she has served in a variety of settings including outpatient, early intervention, and the public school system. She has additional experience working with adults with developmental disabilities as well as in skilled nursing and home health settings.

Beyond clinical practice, Devon also enjoys writing and educating other therapists through continuing education courses, test prep questions, and blog posts. She enjoys many aspects of occupational therapy; her current subject interests include assistive technology, executive function, and program development. In her personal time, Devon enjoys board games, hunting down great restaurants, and community building. She has been a travel therapist for two years now and has no intention of stopping. You can learn more about Devon at her website https://devonbreithart.com/.