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Another state’s regulatory (licensing) board has passed a ruling to provide guidance to their licenses regarding the use of technology-assisted services with their citizens. Texas has now joined the ranks of Georgia, whose Composite Board for counselors, marriage and family therapists and social workers passed a set of rulings that provide very specific regulations related to what they termed, “telemental health” practice starting October 1, 2015. The Marriage and Family Licensing Board for the state of Texas passed a similar ruling related to telehealth and technology in the spring of 2017. Using the term “Technology-Assisted Services” to refer to both telehealth and technology by MFTs in their ruling (§801.58. Technology-Assisted Services), they state:
- (d) A licensee may provide technology-assisted services. To ensure the competent delivery of services by technology-assisted means, a licensee must maintain an appropriate level of education, training, or experience in using relevant technology.
It may be of interested to note that the Georgia board required a minimum of 6 hours of telemental health training for therapists and an extra three hours of training for telesupervision (for a total of 9 hours). What we can see then, is that leading states not only can be expected to use different terms, but to also structure their requirements differently, leaving professionals licensed in more than one state to fend for themselves when trying to comply with the rulings of multiple states.
As state regulatory boards and their associations organize themselves to address technology, it is expected that they will increasingly release such statements to help their licensees better understand the use of technology when working with clients and patients. However, it is apparent that this is an industry begging for a set of underlying competencies to assist in developing guidance for licensees by regulatory boards. Ultimately, different rulings by different states will serve to not only simplify practice within a state, but also further complicate practice delivery for those practitioners seeking to not only adapt to marketplace forces by using technology, but also to be allowed to reasonably practice over state lines, without the complications of incompatible state terminology and requirements.
It may be useful to note alternative approaches to such rulings as currently being advanced through the regulatory associations for both psychology and medicine. In psychology, the Association of State and Provincial Psychology Boards has received a grant from the Office for the Advancement of Telehealth, which as has led to the development of the PsyPACT, whereby psychologists licensed in any of the states adopting the PsyPACT‘s model act can freely practice in any other PsyPACT state without further complications from the foreign state’s licensing board. The model act then, provides shared requirements of all licensees in member states.
Similarly, the Federation of State Medical Boards has also received a grant from the Office for the Advancement of Telehealth, which they also used to develop their model act, called the “Resolution 13-5: Development of an Interstate Compact to Expedite Medical Licensure and Facilitate Multi-State Practice.” A quick summary of the FSMB model act is available here, and a model act update is available here. It is also of note that the FSMB Guidelines for Telehealth Favor Video Rather Than Telephone.
Introduction to Telehealth Theory & Practice
Enjoy a fast-moving overview of telebehavioral and telemental health. Understand the key points related to telehealth clinical, legal, ethical, technology, reimbursement, social media and other pivotal issues.
Due to the current situation with COVID-19, I have bumped up telehealth on my priority list. I have a practice and two LPCs who are contractors. I have looked into requirements and was surprised to find such stringent requirements for MFTs but not for LPCs. MFTs are required to do a 15 hours of CEUs or have supervision while all that is stated in the rules for LPCs is “Technological means of communication may be used to facilitate the therapeutic counseling process.” I was originally licensed and am currently in CA and now have been licensed in TX for the past 5 years. The rules around MFTs and the restrictions seem to outweigh those of LPCs. I’m curious as to why as when I look at academic requirements and overall licensing requirements MFTs have more and seem to be held to a higher standard overall. I found that some hospitals said that I needed to be a LPC or LCSW for billing purposes (not true in CA). Perhaps this is just my perception and experience, but I would greatly appreciate some clarification. Thank you!
Cari, Rules around telehealth have nothing to do with being a good, well-trained therapist and everything to do with being a good, well-trained teletherapist. The distinction is quite important.The other side of the argument is that the Texas MFT board years ago realized that their licensees didn’t know enough about telehealth. They starting requiring 15 hours as a minimal requirement for training, and I am sure that their licensees are much better off for having been required to get telehealth training.
At our Institute, we offer a 15, a 36 and 66-hour program – for a reason. It takes that much training to fully grasp the needed competencies. Unfortunately, many people who have been practicing online for a decade or two are the ones who need the training the most. Their assumptions are often quite wrong.