Abstract
The occupational therapy profession faces critical workforce shortages, and the demand for services to meet the needs of diverse communities continues to rise. Underdocumented individuals represent a diverse pool of potential practitioners who face barriers to licensure if they pursue a career in occupational therapy. Despite being eligible for occupational therapy education and the National Board for Certification in Occupational Therapy exam, inconsistent state licensure requirements, which often mandate a Social Security number (SSN), pose a significant barrier to licensure and employment. We examine the challenges underdocumented individuals encounter in pursuing occupational therapy education and careers and argue for removing such barriers to enable them to become licensed practitioners. Addressing these barriers could diversify the workforce, enhance access to culturally responsive care, and alleviate shortages in underserved areas. We propose six actionable steps for the profession: (1) investigating and clarifying state licensure requirements; (2) ensuring accurate information dissemination to the public and students; (3) advocating for inclusive licensure policies, such as accepting Individual Taxpayer Identification Numbers instead of SSNs; (4) addressing inconsistencies in reciprocity agreements across states; (5) funding research to better understand workforce demographics and needs; and (6) advocating for increased tuition equity and scholarship opportunities. By fostering an inclusive pathway to licensure and embracing diversity in cultural backgrounds, languages, and life experiences, the occupational therapy profession can become a meaningful career option for underdocumented individuals who can contribute to the development of a more resilient and representative workforce to effectively serve diverse populations and address health disparities.
The authors examine the challenges underdocumented individuals face in pursuing occupational therapy education and careers.
The profession of occupational therapy is experiencing workforce shortages while the public’s need for occupational therapy services is growing. Our organizations profess a desire to improve access while simultaneously lamenting the decline of applications to occupational therapy educational programs (American Occupational Therapy Association [AOTA], 2021; Harvison, 2023; National Board for Certification in Occupational Therapy [NBCOT], 2024). Because of barriers to entry, one largely untapped group of potential occupational therapy practitioners are individuals who are underdocumented. The term undocumented typically refers to individuals born outside the United States who do not have a visa or other immigration documentation. In this column, we use underdocumented for two reasons. First, this term is often preferred by persons with this status (Irwin, 2022; Phillips, 2019). Second, underdocumented is also meant to describe a person who entered the country under a student visa or work permit but was unable to renew it (Wong et al., 2017), or to refer to those who have some form of documentation that is considered incomplete or insufficient to satisfy the requirements for legal status or permanent U.S. residency.
Although occupational therapy programs may accept underdocumented individuals, and NBCOT allows underdocumented students to take the certification exam 1 (L. Foster, personal communication, June 18, 2024), obtaining state licensure in a majority of states requires a Social Security number (SSN). This presents an often-unassailable barrier to becoming an occupational therapy practitioner for those who meet all other qualifications. In this column, we argue that as a profession, we should advocate for the removal of such licensing barriers for underdocumented students. By removing these obstacles, we address the ethical dilemma of underdocumented students investing in graduate occupational therapy programs—earning degrees and incurring potential student loan debt—only to discover that they cannot practice because in many states they are ineligible for licensure. Removal of these barriers will promote equity and inclusivity in our profession and ensure that capable, qualified individuals are not prevented from contributing to the community as licensed occupational therapy practitioners. Moreover, by allowing these skilled professionals to enter the workforce we can alleviate the pressing issue of workforce shortages in the field.
Workforce Shortages
Although there is scant research on the occupational therapy practitioner workforce (Jesus et al., 2023), the U.S. Bureau of Labor Statistics (2024) predicted an increased need for occupational therapy practitioners, with a 12% increase in the number of jobs from 2022 to 2032 and almost 10,000 new jobs in occupational therapy each year for that decade. The current workforce shortages were predicted years ago and were exacerbated by the coronavirus 2019 pandemic (Bourgeault et al., 2020; Lin et al., 2015). Shortages are especially noticeable where there are disproportionate numbers of individuals from historically marginalized groups (AOTA, 2024b), and there are specific shortages of health care workers of color (Goode & Landefeld, 2019; Zephyrin et al., 2023).
An Untapped Pool of Potential Health Care Practitioners
The United States is facing a significant workforce shortage in the field of health care, and immigrants represent a large untapped pool of potential professionals who could help address this critical issue. In 2022, there were 46.1 million foreign-born individuals in the United States (Moslimani & Passel, 2024). Despite making up only 13.6% of the U.S. population, immigrants already account for 18% of health care professionals, which demonstrates their valuable contributions to the health care system and their potential to alleviate workforce shortages (National Conference of State Legislatures, 2023). However, of the more than 200,000 undocumented individuals working as health care practitioners or support staff, such as laboratory technicians, the majority are limited to positions that do not require licensure (Svajlenka, 2021). According to the American Medical Association (2023), an estimated 27,000 health care workers are dependent on the Deferred Action for Childhood Arrivals (DACA; 2022) program for authorization to work. Enacted in 2012, DACA is for children who were brought into the United States before they were age 16. Individuals who receive DACA protection must be enrolled in school, have graduated or received a General Educational Development Test certificate, or be an honorably discharged veteran. Individuals request DACA protection for 2 yr and may renew for an additional 2 yr. While someone has DACA status, they are not considered to be in the United States unlawfully and are authorized by the U.S. Department of Homeland Security for the duration of the deferred action period. Therefore, they are able to work. In September 2023, a court injunction denying the approval of any new DACA recipients was issued, all recipients who received their initial DACA status before July 16, 2021, are still eligible for renewal (U.S. Citizenship and Immigration Services, 2024). Approximately 580,000 individuals hold DACA status, the majority of whom are under age 36 and female (KFF, 2023), so this represents a significant opportunity to expand the health care workforce by tapping into the skills and expertise of these individuals.
Education and Underdocumented Individuals
Given the critical workforce shortages in health care, the education enrollment trends of underdocumented students are of interest (American Immigration Council [AIC] & Presidents’ Alliance on Higher Education and Immigration, 2023). More than 408,000 underdocumented students are enrolled in U.S. institutes of higher education, of whom 1.9% are college students (AIC & Presidents’ Alliance on Higher Education and Immigration, 2023). Forty-six percent of underdocumented students are Hispanic, 27% are Asian American/Pacific Islander, approximately 14% are Black, and the remaining 10% are White (AIC & Presidents’ Alliance on Higher Education and Immigration, 2023). The majority are enrolled in public 2- and 4-year institutions. However, 14.2% of undocumented students are pursuing graduate or professional degrees. Of underdocumented graduate students, 23.1% have a bachelor's degree in a health care–related field. Given the severe shortages of health care workers, this group represents an important pipeline. Among graduate students eligible for DACA who have an undergraduate degree in a field related to science, technology, engineering, or mathematics, 30.5% pursued a degree in a health care field (AIC & Presidents’ Alliance on Higher Education and Immigration, 2023). However, most underdocumented students pursuing graduate degrees do not have DACA, even though 75% of them came to the United States at a young age (AIC & Presidents’ Alliance on Higher Education and Immigration, 2023).
Barriers to Pursuing Occupational Therapy Education
Federal law does not prohibit the enrollment of underdocumented students in occupational therapy practitioner programs, and some occupational therapy programs are situated in universities that welcome and provide assistance for these students (e.g., Duke University School of Medicine, 2024; Southern Connecticut State University, 2024a, 2024b; USC Chan Division of Occupational Science and Occupational Therapy, 2024). However, underdocumented students who aim to become occupational therapy practitioners face a series of barriers that hinder their access to, and success in, higher education.
Financial and Legal Barriers
The pathway to higher education is fraught with legal obstacles. Nine states explicitly block underdocumented students from accessing in-state tuition, and three states go as far as prohibiting their enrollment in public colleges (Higher Ed Immigration Portal, 2024). These legal barriers create substantial financial hardships and effectively limit educational opportunities for those aspiring to become occupational therapy practitioners. Underdocumented students are ineligible for federal financial aid; this is one of the most considerable obstacles they face. Some states have implemented inclusive policies to extend in-state tuition and state financial aid to eligible underdocumented students; however, as of June 2023 almost half of the top 25 states with the highest populations of underdocumented college student populations do not provide consistent access to in-state tuition or state financial aid (AIC & Presidents’ Alliance on Higher Education and Immigration, 2023). Although DACA may offer some temporary relief, its uncertainty leaves underdocumented students with the perception that higher education is unattainable (Sahay et al., 2016). This perception is exacerbated by the inconsistent implementation of supportive policies across states, creating disparities in higher education access.
Institutional Barriers
Many higher education institutions lack dedicated services and resources tailored to the specific needs of underdocumented students, such as legal advice, mental health services, and career counseling. The absence of this support can lead to feelings of isolation and hinder academic success. Underdocumented students also face continual fear of deportation and legal repercussions, which contribute to substantial psychological stress. In addition, language and cultural barriers in academic and health care settings can further impede their educational and professional progress. One study emphasized the need to provide training for educators and advisors that focuses on the unique issues faced by DACA students, particularly with respect to financial aid and eventual employment or professional practice (Iwai et al., 2023).
Training Barriers
A critical component of occupational therapy training is fieldwork, which can be particularly challenging to secure for underdocumented students. Health care facilities may be unable or hesitant to accept underdocumented students because of legal uncertainties, further limiting their opportunities to gain essential practical experience (Dennis, 2023). That said, even if fieldwork is successfully secured, barriers to employment remain.
Barriers to Employment in Occupational Therapy
In the United States, occupational therapy licensing is regulated by individual states (Harris, 2024), with all 50 states requiring licensure for employment in the field (AOTA, 2024b). The primary purpose of licensure is to protect the public by ensuring that services are provided by qualified professionals. Thus, state licensure boards wield significant power in limiting who can practice (Knepper et al., 2022), and the licensure process generates substantial revenue for state governments. For many undocumented individuals, obtaining state licensure is impossible because it often requires an SSN. However, some states have implemented policy changes and updated their licensure laws to allow undocumented individuals to obtain a license to practice, although the specific provisions vary by state.
Arkansas, for example, permits DACA recipients who have completed all education requirements needed for their chosen career and who have work authorization to obtain professional licenses in various career fields (To Authorize Occupational or Professional Licensure for Certain Individuals, H.B. 1735, 2021). California offers professional licenses to anyone who completes the required training and other state licensing requirements, regardless of immigration status, and allows the use of an Individual Taxpayer Identification Number (ITIN) in place of an SSN (Professions and Vocations: License Applicants: Individual Tax Identification Number, S.B. 1159, 2013–2014). Mississippi allows individuals with work authorization to apply for licensed professional counselor positions (An Act Relating to the Regulation of Licensed Professional Counselors (LPC), H.B. 708, 2018), and Nebraska allows those with work authorization to apply for professional licenses in general (A Bill for an Act Relating to Aliens, L.B. 947, 2016). New York permits DACA recipients to apply for teaching certifications and licenses in 50 professions (New York State Education Department, 2016). Finally, Illinois (DFPR License-Immigration, S.B. 3109, 2018) and Nevada (Making Various Changes Relating to Professional and Occupational Licensing, A.B. 275, 2019) have amended their states’ laws by prohibiting officials from denying a license on the basis of immigration or citizenship status and allowing applicants to use an ITIN in place of an SSN when applying for a license (DFPR License-Immigration, S.B. 3109, 2018; Making Various Changes Relating to Professional and Occupational Licensing, A.B. 275, 2019).
Although occupational licensure has been shown to improve wages, in particular for DACA recipients (Brown, 2023; Liang, 2021), it remains a significant barrier for many, limiting job opportunities and access to higher-paying employment, such as in occupational therapy (Chung, 2023). For DACA recipients, legal and political wrangling has trapped [them] . . . in a confusing mix of federal and state interpretations of the program that grant them some rights of citizenship, but not others. For example, DACA recipients may be permitted to pursue a professional degree in a given state but prohibited from becoming licensed in that state. (Sofer, 2019, p. 12)
Health care workers who are DACA recipients have stated that concerns about obtaining licensure plagued them as students (Getrich et al., 2023).
Michael A. Olivas (2017), a lawyer who has been studying occupational licensure across states and the professions of medicine, nursing, law, and teaching, made the following statement: I have been shocked at the unanticipated absence of immigration criteria in a substantial number of professions, and in a number of jurisdictions, as well as the multiple ways in which the formal requirements do not mesh with the actual implementation. (p. 105)
A large number of licensing requirements for multiple professions cite U.S. citizenship as a prerequisite; however, “it is growing clear that most licensure or certification authorities have not thought through immigration and citizenship requirements for their professions in any systematic fashion” (Olivas, 2017, p. 67). States are inconsistent in their formal application of state law, either by requiring information not necessitated by statutes or by using inconsistent immigration categories across multiple licensing criteria (Olivas, 2017). Even within a particular state, there may be different requirements for varied professional licenses and therefore “a need for recodification or restatements, profession by profession” (Olivas, 2017, p. 106). In some states, although the law does not restrict licensure on the basis of immigration status, the application forms to obtain licensure do impose restrictions (Olivas, 2017).
Promoting Ethics and Diversity in the Profession
The predicament of underdocumented occupational therapy practitioner graduates who encounter significant barriers to licensure and employment despite their educational investment and potential debt creates an ethical concern for the profession. Anyone who is considering going into debt to obtain an education should have the opportunity to then pay that debt off by entering the workforce in that chosen occupation. Addressing this issue not only is a matter of ethical responsibility but also aligns with the profession’s commitment to increasing its diversity, which is crucial, for several reasons. First, a diverse and representative workforce enhances both client access to care and the quality of care given that practitioners with varied cultural backgrounds and experiences can better understand and address the unique needs and barriers faced by underserved populations (Khuntia et al., 2022). In addition, clients tend to seek out medical care and perceive the quality of care more positively when they can relate to and trust their health care providers, which is more likely when the workforce reflects the diversity of the population served (Khuntia et al., 2022). Furthermore, clients’ satisfaction with care improves when they feel understood and respected by culturally competent practitioners who can effectively communicate with them (Gomez & Bernet, 2019). Finally, health care outcomes are better when diverse populations receive care from a representative workforce that can provide culturally sensitive interventions and address social determinants related to health (Khuntia et al., 2022). In short, increasing diversity in the occupational therapy profession matters because it enhances client access, perceptions of care, satisfaction with care and, ultimately, health care outcomes. Because the majority of underdocumented individuals in the United States are from Latin America (Lopez et al., 2021), removing barriers to licensure could help increase diversity in the health care workforce and improve access to culturally responsive care for underserved communities.
Pathways to Change: Occupational Therapy Actions and Advocacy
There are a variety of actions that members of the profession and our professional associations could take to improve the situation for underdocumented students. These include education, multilevel advocacy, completing workforce research, and implementing creative and innovative curricular programming and community partnerships to address fieldwork and employment needs.
Ensuring Transparency in Program and Licensure Requirements for Prospective Students
Underdocumented individuals should easily be able to obtain the information necessary to make an informed choice before pursuing an occupational therapy career and entering an occupational therapy educational program. However, although documents exist that outline the basic licensure requirements for occupational therapy practitioners in each state (AOTA, 2024a; Trusted Health, 2024), none explicitly clarify the requirements concerning citizenship or immigration status. Research has highlighted a discrepancy between statutory requirements and the information requested on licensure applications (Olivas, 2017). To address this issue, a crucial first step would be to conduct a thorough investigation of each state's requirements, scrutinizing both statutory regulations and application forms to identify and rectify any inconsistencies that may pose barriers for underdocumented individuals. Making this information freely and publicly accessible at the national level is essential to ensure that students do not incur the financial burden of an occupational therapy degree without a viable path to employment. By doing this, we can help prevent students from facing insurmountable obstacles after graduation and promote a more equitable and transparent licensing process.
Applicants to occupational therapy practitioner programs should be fully aware of the possible avenues toward, or barriers to, their employment after graduation before enrolling. We must ensure that occupational therapy educators and student advisors have correct information about the licensure process for DACA recipients and underdocumented students, for their own state and others, so that they pass along the proper information to current students and prospective applicants. We could even go so far as to create a national committee or staff position to provide specific guidance for DACA recipients, or for advisors in our educational programs. DACA recipients have noted the difficulty in navigating the varied state-specific rules for obtaining licensure and their need to seek assistance and, at times, legal representation (Richardson & Welch, 2022). Occupational therapy practitioners could encourage NBCOT to clarify in their application materials that they do not pose a barrier for DACA or underdocumented applicants. They should also provide a detailed explanation on the application form and website about the process underdocumented individuals without an SSN must follow to register for the exam.
State-Level Advocacy
Although federal law prohibits states from issuing licenses to immigrants not lawfully present in the United States unless the state passes a law expressly providing eligibility for professional licensure, state licensure requirements can be altered through actions in each state. Therefore, one important avenue for improving options for underdocumented individuals is allowing the use of the ITIN in lieu of an SSN for licensure. The ITIN is a 9-digit number issued by the Internal Revenue Service to enable a person who does not have an SSN to file and pay taxes, although it can be used for additional purposes as well (The Dream.US, 2024).
At a minimum, occupational therapy practitioners could strongly advocate for state licensing bodies to allow the use of an ITIN as an alternative to an SSN, but a more optimal result would be the removal of immigration status from the application process for licensure altogether. This is not unprecedented; recall the examples we mentioned earlier of states, including California, Nevada, and Illinois, that have passed laws allowing underdocumented residents to obtain professional licensure if all other requirements are met (DFPR License-Immigration, S.B. 3109, 2018; Making Various Changes Relating to Professional and Occupational Licensing, A.B. 275, 2019; Professions and Vocations: License Applicants: Individual Tax Identification Number, S.B. 1159, 2013–2014). We recommend broadening access to occupational licensure in the states that have already taken action for specific professional licenses as well as in states where no action has been taken. People in health care professions—including, but not limited to, occupational therapy, physical therapy, speech-language pathology, social work, nursing, and physician associates—should consider working together and combining resources in a unified advocacy campaign and efforts to promote legislative changes.
One study of the impact of easing restrictions for licensure for underdocumented individuals found that employment did increase in this population (Chung, 2023). A path to occupational therapy licensure for underdocumented applicants may enable such individuals to start a private practice, “which provides more flexibility and pay . . . and while those without DACA status can’t be legal employees, they can start a business or work as independent contractors” (Dennis, 2023, para. 18).
In addition, state associations and AOTA should consider how reciprocity between states will be handled for occupational therapy practitioners in states with a licensure compact. Reciprocity agreements are independently established by each state. States with differing requirements, particularly concerning immigration or legal status, could impose these requirements as prerequisites for reciprocity (Olivas, 2017). This situation could lead to challenges in cross-border practice opportunities, especially if some states mandate citizenship and others do not. Such discrepancies could potentially hinder underdocumented occupational therapy practitioners who have obtained licensure in states where it is permitted, thereby affecting their ability to practice across state lines.
Federal-Level Advocacy
At the federal level, initiatives specifically aimed at promoting the inclusion of underdocumented individuals in the health care workforce appear limited; however, some efforts have been made to support immigrants. One example is the introduction of the Immigrants in Nursing and Allied Health Act of 2023 (H.R. 3731, 2023–2024). This bill proposes the authorization and expansion of programs to reduce barriers immigrants face when entering the professional health care workforce. Occupational therapy practitioners can collaborate with AOTA, state chapters, and other professional health care organizations to unite in introducing and lobbying for legislative bills that make licensure more accessible across the country.
To support students at the federal level, occupational therapy practitioners could advocate for increased tuition equity and scholarship funding. Alternatively, the profession could establish its own program modeled after the Opportunity Scholars program, which is privately funded through TheDream.US. This program provides scholarships to underdocumented students at 70 universities across the United States. A similar mechanism specifically for occupational therapy educational programs could support underrepresented students in pursuing their careers.
Barriers to entering health care careers are not unique to the United States. Other countries, including Canada, also present challenges for underdocumented students and nonresidents in obtaining occupational licenses because of documentation or residency requirements. Canada, instead of removing local residency requirements, has taken a different national approach by fast-tracking residency applications through its Express Entry system, announced in 2023. This system targets individuals with specific skill sets pursuing 82 targeted careers, including occupational therapy (Singer, 2023). Canada’s approach may serve as a model for the United States to consider if it chooses to develop a national strategy by fast-tracking citizenship applications for students who have the required education and skill set needed for careers in areas of health care that are facing workforce shortages. This approach would not require each state to address its local licensure laws by removing citizenship requirements.
Research Needs
Funding could be allocated for research that would allow us to better understand the profession’s workforce demographics and needs with systematic lines of investigation. In addition to the issues faced by underdocumented students, the profession has little information with which to guide policy and advocacy related to our current and future workforce needs (Jesus et al., 2022, 2023). To develop an appropriate response to existing needs, we must better understand the occupational therapy practitioner workforce as a whole, and specifically both practitioners who are DACA recipients and non-DACA underdocumented students and practitioners.
Innovative Curricular Solutions and Education Partnerships
Universities and occupational therapy programs have a unique opportunity to lead the way in supporting underdocumented students interested in pursuing careers in occupational therapy. By equipping themselves with the necessary knowledge and resources, campuses can become beacons of innovation and inclusivity. One invaluable resource is the Higher Ed Immigration Portal, a cutting-edge digital platform that consolidates data, policies, and resources related to DACA and to undocumented, immigrant, international, and refugee students (Higher Ed Immigration Portal, 2024). This platform aims to support immigration reform, influence federal policy, and drive change at both state and campus levels while fostering a diverse coalition of advocates for these students. FWD.us is another great resource related to higher education support for immigrant students and educators; it includes how to mobilize a campus community to support students and ways to lobby and advocate to lawmakers and elected officials (FWD.us, 2024b).
Faculty and staff in occupational therapy practitioner academic programs can use guides such as “Empowering Undocumented Students” (FWD.us, 2024a) to learn best practices for building robust support systems on campus for advising and guiding underdocumented students. By collaborating with university partners, such as career services and financial aid staff, they can assess their institution's strengths and barriers in supporting underdocumented students. Furthermore, occupational therapy practitioner programs can integrate advocacy assignments or capstone projects into their curricula, guided by resources such as the Higher Ed Immigration Portal. These projects can focus on advocating licensure changes and improving access to the profession, potentially in partnership with local and state occupational therapy organizations.
Last, individual occupational therapy practitioner educational programs can also assist underdocumented students by implementing creative and innovative solutions to finding fieldwork and eventual employment. For example, initiatives like Immigrants Rising, a nonprofit in San Francisco that has helped immigrants get into college and start careers, provide valuable models for addressing barriers faced by underdocumented students. Through its Mental Health Career Program, Immigrants Rising has tackled the challenge of earning the clinical hours that are required in mental health fields to become a licensed psychotherapist (Dennis, 2023). This work may serve as a model for occupational therapy practitioner programs to explore acquiring fieldwork opportunities for students who may be underdocumented.
Conclusion
The profession faces significant challenges, including workforce shortages, declining applications to educational programs, and barriers to licensure for underdocumented individuals. Addressing these issues requires a multifaceted approach that prioritizes equity, diversity, and inclusion. Allowing underdocumented individuals to become licensed occupational therapy practitioners by accepting ITINs in place of SSNs, removing immigration status as a licensure criterion, or fast-tracking citizenship status for those who have the required education and skills to become an occupational therapy practitioner, can help alleviate workforce shortages while diversifying the profession. Moreover, making this information clear and publicly available can also support efforts to recruit prospective students into occupational therapy degree programs.
Increasing access to the profession also helps improve the outcomes of occupational therapy services given that clients often have better outcomes when treated by providers who share their cultural background (Salsberg et al., 2021). Underdocumented immigrants bring valuable linguistic and cultural skills, and their life experiences can significantly enhance the quality of care and trust levels of clients who have similar backgrounds. Allowing underdocumented individuals to become licensed occupational therapy practitioners can improve access to health care in underserved areas because health care professionals from underrepresented groups are more likely to work in these regions. Leveraging the unique perspectives of diverse immigrant populations will strengthen the profession’s ability to better serve marginalized communities and address health disparities (Salsberg et al., 2021). Although the inclusion of underdocumented individuals in the workforce should not be viewed as the sole solution to diversifying the profession, it can be an important facet of a comprehensive effort that also recruits, supports, and retains occupational therapy students and practitioners from diverse backgrounds who are U.S. citizens and legal residents.
To increase access to the occupational therapy profession and thereby increase community access to occupational therapy services, we must take action to advocate for consistent licensing reforms across all states. We must unite our efforts to ensure that qualified individuals, regardless of their immigration status, have the opportunity to contribute their skills and expertise to our communities as licensed occupational therapy practitioners. By working together to push for uniform policies that remove barriers to licensure, we can address the ethical dilemma faced by underdocumented students who invest in their education only to find themselves unable to practice because of inconsistent state regulations. We can call upon our professional organizations, state licensing boards, and legislators to enact the necessary changes to promote equity, inclusivity, and access to professional licensure for all qualified individuals to create a more just and equitable future for our profession and the communities we serve.
The call to action is clear: Occupational therapy practitioners must champion changes to create a more equitable and accessible profession, advocating for inclusive licensure policies and embracing a multifaceted approach to diversity and inclusion. By upholding the values of inclusivity that are foundational to our practice, we can build a more resilient and representative practitioner community that effectively serves diverse populations in need of occupational therapy services. The future of occupational therapy depends on our commitment to removing barriers and creating a more inclusive path to licensure and practice for all qualified individuals, regardless of their immigration status.
Footnotes
1To be allowed to take the NBCOT exam, an underdocumented student needs to call and make a request to bypass the Social Security number (SSN) requirement on the online form.