Dismantling occupational therapy provider licensure barriers for individuals who are underdocumented

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.