This article describes the registered occupational therapist (OTR)-certified occupational therapy assistant (COTA) team within the home health setting. It reviews regulations and guidelines for supervision, team interactions, and collaboration with other health care professionals and paraprofessionals. With the complexities of providing treatment in a client’s home, the team members must combine their resources to successfully achieve desired outcomes. The article addresses various areas in which quality OTR-COTA collaboration enhances therapy effectiveness in reaching established treatment goals in a realistic and creative manner.