State-by-State Coronavirus (COVID-19) News

Effective March 17, 2020: The Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) is responsible for enforcing certain regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act, to protect the privacy and security of protected health information, namely the HIPAA Privacy, Security and Breach Notification Rules (the HIPAA Rules). OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency. Please read the entire OCR Notification of Enforcement Discretion.

News for All States

Open Testing Sites in Each State

Candidates who have applied for the exam should periodically check their application on PTC, and the Prometric website, for notices. Candidates are also encouraged to check their state websites, weekly, for any updates or temporary orders.

March 17

President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak

The Trump Administration today announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. Beginning on March 6, 2020, Medicare—administered by the Centers for Medicare & Medicaid Services (CMS)—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.

Here is the complete news release.

Apple Facetime or Facebook Messenger Video and HIPAA Compliance? Yes! (For Now)

—Roy Huggins, LPC NCC of Person Centered Tech

Whoa. Up is down. Dogs and cats are living together. Everything is topsy-turvy, everyone! (But for a good reason.)

HHS just announced today that they are lightening restrictions on the videoconferencing service you use to deliver telehealth services. They explicitly cite “Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype” [emphasis added] as copacetic with emergency-time HIPAA rules.

Yes, I just said that Facetime, Skype, and friggin’ Facebook Messenger Video are explicitly mentioned as compatible with your HIPAA compliance for so long as the COVID-19 state of emergency is in effect.

I’ve been working much of the day on trying to incorporate this into my schema of understanding the world. It’s a bit rough to do after 10 years of constantly discouraging people from Skype and Facetime for telehealth. But there’s a good reason for this change.

Everyone needs telehealth right now. And I don’t mean “everyone” in a hyperbolic way. I mean, everyone.

Our favorite free, HIPAA-friendly videoconferencing services are straining to support all the traffic on their free tiers. We need to spread the traffic around. We also need to make sure we can literally meet clients where they are with software that the client can and will use. (But don’t get too complacent — more on that later.)

I Don’t Believe You. Prove It.
I quote to you from the relevant guidance on the HHS site, findable here:

OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.

Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.

That’s way more clear than the HIPAA people typically get. They’re serious about this. And to show just how serious they are, they even weigh in on whether it’s acceptable to do therapy via Tiktok! (Hint: it’s not.)

Under this Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.

Okay, We Can Use Skype or Facetime Now. But Should We?
I think that’s the sixty-four thousand dollar ethics question. Skype does present some real privacy risks. Facetime is much better, but Apple might know who is talking to whom (even if they know nothing about what you said during the call.)

This is the point where I think it’s worth noting another item from the guidance:

…including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype… Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.

I think that means we can’t use World of Warcraft as a therapy medium, either. Shame.

Reducing the Load
I think one good reason to turn to less rigorously secure options is to spread some of the load around different services. If we’re still thoughtful about what alternatives we use and why, we can do this without putting clients at an excess of additional risk.

Meeting Clients Where They Are
Ever since the beginning of March, we’ve been quite worried about older seniors living in care facilities. For their own protection, family are social distancing from them. Or the family is being barred from visiting. Liath, our Deputy Director, has spoken with many therapists who are highly concerned that older seniors won’t be able to operate typical videoconferencing software to receive services.

Following that thread: I’m imagining an older senior who has an iPhone. If they often use it to talk to kids and grandkids by phone, it’s just one button push away to do so by Facetime. Setting up any other videoconferencing option would require quite a few more steps.

In a time when everyone needs telehealth, the value of choosing an option which is more likely to be usable by a client goes up dramatically. Thus the risk-benefit analysis on using less rigorously-secured software options looks far more favorable to those less secure options. In my opinion.

So What Should We Use?
Here’s a list of options I think would be good. The list is probably not exhaustive. We will likely add to it over time.

  • VSee or Doxy.me paid tiers. Start paying, and they can in turn pay to increase their capacity.
  • Your practice management system’s telehealth feature, if it has one.
  • Spruce Health.
  • Zoom — preferably Zoom for Healthcare with a BAA.
  • Clocktree.
  • Signal. Signal has a videoconferencing option. This has likely always been HIPAA-friendly, but is now even more relevant.
  • Google Meet — preferably on your GSuite account where you have a Business Associate Agreement in place. That has actually been HIPAA-friendly for a very long time.

I personally think Facetime’s privacy protections are sufficient to make it usable under this new guidance without sacrificing that much — when clients would prefer it. Make sure clients know that while your conversations are quite private, Apple can likely know that you and the client did a call together. Also bear in mind that you have to log in to Facetime with an Apple ID. Make sure you use the Apple ID that you want to use with your practice. Remember that you and your client would both need to have Apple products in order to use Facetime.

Personally, I would draw a line against using anything owned or operated by Facebook. That includes Facebook Messenger and WhatsApp.

How Long Will This Last?
Who knows? It will certainly end if the declared state of emergency ends. But I’m curious if this decision will have an impact on future HIPAA rule making. Everything is in flux right now. It’s an exciting time, for sure.

Please, do take care of yourselves and each other. And happy telehealth-ing!

Colorado

Guidance for Healthcare Professionals Not Currently Licensed in Colorado

On April 1, 2020, Gov. Jared Polis issued Executive Order D2020 020, Ordering the Temporary Suspension of Certain Statutes to Expand the Use of Telehealth Services Due to the Presence of COVID-19.

Among the directives, aimed at protecting the public health and mitigating exposure to and the spread of Coronavirus, is the temporary suspension of the requirements in Section 12-245-217(2)(e)(II), Colorado Revised Statutes, which state that “a person residing in and licensed or certified in another state as a psychologist, marriage and family therapist, clinical social worker, professional counselor, or addiction counselor does not exceed twenty (20) days per year of performing activities or services in Colorado.”

The Order states that the use of telehealth services, including low-cost telephone, internet, audio-only, and live video, are widely available and accessible to health care providers and patients, and that Colorado healthcare providers must be able to use telehealth services whenever possible.

We are working diligently to issue regulatory guidance in the coming days to provide you with further clarity related to the Order. As further guidance on the use of telehealth services is forthcoming, please check your email regularly and DORA’s COVID-19 informational website for these updates as they become available.


The State of Colorado is seeing an increasing demand for qualified healthcare professionals to assist in the testing, treatment, and care of patients with COVID-19. Under the direction of Governor Jared Polis, the Division of Professions and Occupations at the Department of Regulatory Agencies (DORA) has conducted a review of existing licensing exemptions that allow for individuals in the healthcare field who either hold licenses in other states or who have allowed their license to expire in Colorado to immediately resume work within their scope of practice, provided their out-of-state or expired license is/was in good standing. Healthcare providers who are being called upon to assist in caring for patients, but who are wondering if they can lawfully practice without a current Colorado license should consider the following exemptions and provisions that will allow them to immediately resume work in the field:

● Mental Health Providers
Psychologists, social workers, addiction counselors, marriage family therapists, psychotherapists and professional counselors may practice in Colorado for a cumulative period of 20 days under C.R.S. §12-245-217(2)(e), as long as the services performed meet the individual’s scope of practice. Please note: The above provisions are those that currently exist in statute or through interstate compacts. In the coming days, the Division of Professions and Occupations will be announcing temporary measures that will allow for expedited licensing and expanded scope of practice to better address the increasing demands on Colorado’s healthcare system. In the meantime, we appreciate your patience as we implement this course of action. We continue to encourage online applications for licensure through our website at http://dpo.colorado.gov .

March 13, 2020
The Division of Professions and Occupations has assembled the attached document detailing existing provisions and exemptions that can be used to bolster the healthcare workforce as part of the state’s ongoing efforts to combat the spread of Coronavirus.

This guidance will allow individuals in the healthcare field who hold licenses in other states, who have an inactive license, or who have allowed their license to expire in Colorado to immediately resume work within their scope of practice, provided their out-of-state, inactive or expired license is/was in good standing.

These measures will bolster the workforce’s ability to test, treat and care for patients amid this growing crisis by augmenting the number of qualified professionals while creating the ability to backfill positions, as necessary.

The temporary licensure provisions are part of an emergency directive from Gov. Jared Polis to provide support to a taxed healthcare system.

Healthcare providers who are being called upon to assist in caring for patients, but who are wondering if they can lawfully practice without a current Colorado license, should consider the attached exemptions before resuming work in the field, and should contact the Division with questions.

Please monitor your email for communications regarding any future regulatory measures aimed at combating the spread of COVID-19 in Colorado.

Illinois

April 11, 2020

Illinois Gov. J.B. Pritzker (D) announced Saturday that the state has launched a free support text line for residents experiencing stress and anxiety stemming from the coronavirus pandemic.

Read the complete Huffington Post article here.
The Illinois State site goes into more detail.

Minnesota

April 6 Update.
Here is the most recent Executive Order action

MN Board of MFT currently open

The MN Board of MFT remains open during MN’s peacetime emergency declaration. However, given the COVID-19 pandemic and our commitment to serving you as safely as possible, we ask you conduct all possible Board business via email, phone or US Mail. Walk-in guests to the Board office will be limited to one person at a time so Board staff may insure appropriate social distancing, as recommended by the CDC and MN Department of Health. The Board office may be closed by Executive Order in the future. Any such closing would be posted on the Board’s website.

MFT National Exam & MN LMFT State Exam

At this time, all MFT National Exam testing has been cancelled through April 16, 2020. The Prometric testing centers closed March 18, 2020. March examinees who had not yet taken the test will be notified of their transfer to the June 2020 testing window. Applicants remain able to register for 2020 exam testing dates. It is not yet known whether the April 2020 exam testing window (April 18-25) will be impacted. AMFTRB, the national entity which promulgates the exam, and Professional Testing Corporation (PTC), the national exam administrator, have implemented special reschedule rules. If an applicant wishes to reschedule an MFT National Exam as a result of COVID-19, they should contact PTC at 212-356-0660.

The MN Board of MFT cancelled the LMFT State Exams scheduled for March 18, 2020. Those scheduled to test on March 18, 2020 will be rescheduled for an April 2020, or later, exam date. The Board will make a decision whether to cancel the April 15 & April 17 exams in the near future and impacted exam candidates will be notified.

Federal Notices Impacting HIPPA & Telehealth

The Board’s ethical practice regulations related to client privacy obligate licensees to safeguard client data and client privacy. On March 17, 2020, the Office for Civil Rights at the US Department of Health and Human Services (HHS) published a Notification of Enforcement Discretion for Telehealth Remote Communications during the COVID-19 Nationwide Public Health Emergency. With respect to telehealth remote communications referenced in the notice, the Board will consider HHS guidance as the professional standard to which licensees will be held during this National Public Health Emergency. The notice can be found on the HHS website: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html.

On March 15, 2020, the US Department of HHS finalized licensure waivers that would permit certain health care providers participating in Federal health care programs to receive payment for telemedicine services in states where they do not hold a license during the coronavirus (COVID-19) emergency. The notice can be found on HHS’s Public Health Emergency website: https://www.phe.gov/emergency/news/healthactions/section1135/Pages/covid19-13March20.aspx.

Note: These waivers are limited in scope and State law continues to govern whether a provider can practice in a state without holding an active license. Several states have enacted emergency orders authorizing practice by health professionals licensed in another jurisdiction, subject to varying restrictions. Minnesota has not issued such an order at this time. A list of some states having issued COVID-19-related orders regarding practice by out-of-state licensed professionals can be found here: https://www.jdsupra.com/legalnews/hhs-and-states-relax-telehealth-83893/.

MN Executive Orders to Suspend Evictions, Support Small Business Owners & Address Hospital Equipment Shortages

At the request of the Office of Governor Walz, the MN Board of MFT is advising licensees of three Executive Orders issued March 23, 2020.

EO 20-14 suspends eviction proceedings during the COVID-19 peacetime emergency declaration. Tenants who can must continue to pay rent, but landlords cannot begin or must suspend eviction proceedings.

EO 20-15 creates an emergency small business loan program to help small businesses impacted by COVID-19. The program will be administered by the MN Department of Employment & Economic Development (DEED). More information is available on the DEED website: https://mn.gov/deed/business/financing-business/deed-programs/peacetime/

EO 20-16 directs all non-hospital entities to conduct an inventory of their personal protective equipment, ventilators, respirators, and anesthesia machines, report the result to the state, and either donate such equipment to a local coordinating entity or preserve it.

These Orders address topics relevant to licensees and which may be useful when providing care to clients during the COVID-19 pandemic. The full text of the Governor’s announcement can be found here: https://mn.gov/governor/news/?id=1055-424399.

Graduate Students in Minnesota

Apr 2, 2020
From Jennifer Mohlenhoff
For graduate students seeking an MFT degree or a related behavioral health graduate degree which meets Minnesota MFT educational requirements for licensure—The MN Board of MFT recently addressed graduate practicum issues arising from the COVID-19 pandemic. A summary of the Board’s action/discussion can be found on the Board’s website and CLEAR’s Graduate Practicum Issues.

Mississippi

Download their Proclamation (PDF)

New Jersey

To all Licensees of Healthcare Boards within the New Jersey Division of Consumer Affairs
March 14, 2020

The purpose of this communication is to provide guidance to healthcare professionals licensed by New Jersey’s professional boards as the State responds to the global Coronavirus disease (“COVID-19”) outbreak.

COVID-19 is a respiratory infection caused by a novel virus that arose in December 2019. Once a person is infected, the virus may cause respiratory illness. Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on the characteristics of the virus, including how readily it spreads between people, the severity of the resulting illness, and medical or other measures available to control the impact of the virus (for example, medications or vaccines).

In partnership with the New Jersey Department of Health (NJDOH), the Division of Consumer Affairs is requesting that New Jersey’s licensed healthcare providers familiarize themselves with the guidance available at the links below. Because information is changing rapidly, we urge you to check these websites regularly.

Additionally, at the bottom half of this document, please see important information from Governor Philip D. Murphy regarding practitioners’ elimination of cost sharing requirements (e.g., copays, coinsurance) related to COVID-19. This information should be shared with your billing staff.

COVID-19 Guidance:

COVID-19 Information for Healthcare Professionals from NJDOH

NJDOH Monitoring and Movement Guidance for Healthcare Personnel (HCP) Exposed to Confirmed Cases of COVID-19 (March 9, 2020)

Purpose: Due to their often extensive and close contact with vulnerable individuals in healthcare settings, NJDOH recommends a conservative approach to HCP monitoring and restrictions from work to quickly identify early symptoms and prevent transmission from potentially contagious HCP to patients, HCP, and visitors. Healthcare facilities (HCFs) should have a low threshold for evaluating symptoms and testing symptomatic HCP, particularly those who fall into the high- and medium-risk categories described in this guidance. HCFs, in consultation with public health authorities, should use clinical judgment as well as the principles outlined in this guidance to assign risk and determine need for work restrictions.

To help HCFs document and assess HCP risk and exposure, NJDOH has developed the below series of tools and checklists:

NJDOH Healthcare Personnel (HCP) Exposure to Confirmed COVID-19 Case Risk Algorithm (March 9, 2020)
This document can be used to assess the type of potential exposure HCP may have experienced while caring for the COVID-19 patient and assign risk level (High, Medium, Low or No Risk). It also provides guidance on the management of exposed HCP.

Retrospective Assessment Tool for Healthcare Personnel Potentially Exposed to COVID-19 (March 9, 2020)
This tool can be used to assess HCP exposure risk prior to the patient being identified as having COVID-19.

NJDOH COVID-19 Healthcare Personnel (HCP) Exposure Checklist (March 9, 2020)
This tool can be used to monitor and assess the appropriate use of personal protective equipment (PPE) for HCP caring for the COVID-19 patient after they have been identified in the facility.

NJDOH COVID-19 Fever and Symptom Monitoring Log for Healthcare Personnel (March 9, 2020)
This tool can be used by a HCF or local health department (LHD) to assist HCP with daily symptom monitoring.

Healthcare Personnel Exposure Line List (March 9, 2020)
This tool can be used by a HCF or local health department (LHD) track HCP under active monitoring.

Cost Sharing Information

On March 10, 2020, Governor Phil Murphy announced administrative actions to support consumer access to COVID-19 testing and testing-related services. The Administration has directed that consumer cost sharing for all medically necessary COVID-19 testing, as well as services related to testing, is to be waived. This waiver includes emergency room, urgent care, and office visits related to COVID-19 testing for the state’s individual, small and large group markets; the State Health Benefits and School Employee Health Benefits Plans; NJ FamilyCare’s CHIP population; and the state’s uninsured population, eligible for the Charity Care program.

With the understanding that many residents rely on employer sponsored coverage, the Governor also encouraged employers to consider measures to support consumer access to medically necessary COVID-19 screening, testing, and testing-related services, including waiving cost sharing where appropriate.

Below are links to bulletins issued by several State agencies regarding the Governor’s actions:
DOBI’s bulletin can be found here.
DHS’s bulletin can be found here.
DOH’s bulletin can be found here.
Department of Treasury’s bulletin can be found here.

We ask that you please stay attentive to further communications. We plan to continue to use these messages to provide important information to licensees in the future.

Paul R. Rodríguez
Acting Director
New Jersey Division of Consumer Affairs

North Carolina

NC Marriage and Family Licensure Board —CORONAVIRUS IMPACT

In response to the COVID-19 pandemic, the Board has received many questions from anxious licensees as well as students. We are sharing the answers we have at this time and will provide updates and information as the situation evolves. At this point we have received the most questions regarding telehealth and License Renewal/Continuing Education (CE) requirements.

First, please note that Board staff will be working remotely. While this may impact speed of internet and delivery of mail and processing times, the expectation is that Board functions will be minimally impacted. However, if you do experience a delay in receiving a response from Board staff during this fluid and unprecedented situation, your understanding and patience will be appreciated, keeping in mind that the Board and staff have responsibility for the safety of their health and family as well. You are encouraged to first review information available on the Board’s website and then if you have additional questions, contact the Board office via email—ncmftlb@nc.rr.com.

Mail/Submission of Materials: As the Board office is closed to visitors at this time, you should send, and not hand deliver, all materials to the Board office. If possible, send .pdf attachments via email (i.e. ethical complaints, name changes, verifications for other states, etc.).

LMFTAs: Quarterly supervision reports or supervision agreements may be sent via email attachment, directly from the supervisor’s email (supervisors should copy the LMFTA on the email).

Tele-health: In response to telehealth, any licensee can practice telehealth within North Carolina. However, electronic practice must be in compliance with the Ethics Code and HIPPA. The Board cannot advise on how to implement telehealth services. If this is your first time implementing, you may wish to consult with colleagues or other licensees who have such a system in place. If you wish to practice telehealth into another state in which you are not licensed, we advise you to contact that state to determine if their laws and regulations would allow such practice.

Students and Tele-health: Students enrolled in university programs, who are completing practicums, should consult with their university and supervisors for guidance. While guidelines state “licensed” professionals may utilize telehealth/telemedicine services, there is no language that prohibits interns or students completing practicums from using telehealth. The university has jurisdiction and responsibility for enrolled students and for setting the parameters for their programs.

License Renewal: In response to the many people asking how they will complete their CEs required for this year’s renewal or if there is an extension for renewing,

  1. All CE may be completed on-line, including the ethics requirement. The course must be structured (meaning a course with a test component) and as always, the content must be MFT or related to the practice of MFT.
  2. In accordance with current statutes and rules, the Board is implementing a two-month extension (until September 1). While you are encouraged to renew by July 1 if possible, this will allow those who had planned to attend ‘live’ courses the opportunity to sign up for on-line courses. There is no need to contact the Board to request the extension as it will be automatically granted.

National MFT Exams: For those scheduled or planning to register for an exam with the exam service, please see this link for more information. https://amftrb.org/coronavirus/

APPLICANTS: Applicants for the exam and licensure, please be aware that processing time of your application may be impacted.

Board Meetings: The Board meeting scheduled for April will be virtual with a compressed agenda. Only essential matters will be addressed, specifically, application reviews/decisions and ethical complaints.

The NC MFT Board will continue to do our best to meet the needs of our applicants and licensees. Thank you for your patience, and please stay healthy.

Ohio

Providing Services to Existing Clients Temporarily Located in Ohio
March 13, 2020

The Ohio CSWMFT Board is aware that many colleges and universities have asked students to return home temporarily as a response to COVID-19. Other persons may also be returning to Ohio, from an out of state work assignments, for example. In some cases, these persons are receiving services from Counselors, Social Workers, and MFTs in the states in which they were residing before returning to Ohio.

Under Ohio Administrative Code Rule 4757-1-09, with the permission of the CSWMFT Board, Counselors, Social Workers, and MFTs holding a license to practice in another state may provide teletherapy services to existing clients temporarily located in Ohio. Out of state licensee will be considered in compliance with Rule 4757-1-09 if they contact the Board via an email application.

The email application should: 1). Indicate their intention to provide services to a client (do not disclose the client name) temporarily located in Ohio in response to COVID-19; 2). Include the license type and license number of the out of state license; 3). Confirm the licensee has training and experience in providing teletherapy or will have access to appropriate supervision and peer consultation. Submit the e-mail application to Tiffany Couts, Renewal Coordinator, at tiffany.couts@cswb.ohio.gov.

Upon receipt of the e-mail application, the Board will acknowledge receipt of the e-mail. The licensee may then begin providing teletherapy services. It is the Board’s expectation that professionals approved to provide such services will do so exercising the utmost care in protecting client confidentiality. Licensees may wish to refer to Ohio Administrative Code Rule 4757-5-13 for information regarding the Board’s expectations when using teletherapy.

If the out of state licensee does not have an existing therapeutic relationship with the client before the date of this memo, the licensee must apply to the Ohio CSWMFT Board for a license to practice Counseling, Social Work, or Marriage and Family Therapy. The intention of the temporary permission to practice rule is to facilitate continuity of care. It is not a general teletherapy rule.

Licensees approved under this memo will have temporary permission to practice in Ohio until May 1, 2020 at which time the Board will assess the need to extended permission based on current circumstances.

Ohio Counselor, Social Worker & Marriage and Family Therapist Board
77 South High Street, 24th Floor, Room 2468
Columbus, Ohio 43215-6171
614-466-0912 & Fax 614-728-7790
http://cswmft.ohio.gov & cswmft.info@cswb.ohio.gov

Oklahoma

Coronavirus (COVID-19) Information:

Due to concerns regarding the spread of COVID-19 and in accordance with Executive Order 2020-07 the Board of Behavioral Health Licensure (BBHL) is limiting face-to-face interactions with the public. In order to ensure the public’s health, safety and welfare are protected, if you would like to speak to a staff member we encourage you to call (405) 522-3696. You may also contact the Board staff via email, https://www.ok.gov/behavioralhealth/Contact_Us_-_BBHL.html

In the event our agency has to close our doors due to reducing the impact of COVID-19 to keep staff and the general public protected, we will maintain those operations that we are able to through tele-work. 

The current expectation is that all Rules and Regulations are still in effect and must be followed. However, the Board is mindful and takes into account the extraordinary conditions we find ourselves facing. As new information becomes available, it will be posted on this site.

The Board has received many inquiries regarding tele-counseling. In an effort to reduce barriers to tele-counseling the Board has not adopted any restrictions regarding tele-counseling. If you choose to provide tele-counseling you will need to ensure the service provider is HIPAA complaint. If you plan to provide services out-of-state, it is alsorecommend that you contact the State Board to see if they have adopted additional provisions. The Board is not promoting any service provider; however the lists of providers below have been deemed HIPAA complaint by OMES:

  • V-See
  • Doxy.me
  • Theranest
  • Vidyo.com
  • Simplepractice
  • Microsoft Teams
  • Skype for BUSINESS
  • Zoom

The Board of Behavioral Health Licensure along with other State agencies will continue to work with state and local government agencies to provide information to all licensees and the general public as we receive information on the Coronavirus (COVID-19).  We encourage you as healthcare providers to continue to communicate with staff on proper sanitary measures as well as communication to your clients.  You can access further information at the Oklahoma State Department of Health website.  In addition to visiting the State Department of Health website the Call Center number and hours are being provided to further assist in questions, you or your clients may have regarding Coronavirus (COVID-19).

March 24, 2020 Oklahoma Update

On Tuesday, March 24, 2020 at 10:00 a.m. the Board held a special meeting to address several issues that are a direct result of the COVID-19 crisis and voted on the stay of enforcement for many of our rules that require face-to-face interactions. The following motions were made and approved by the Board.

Candidates:

The Board has approved a stay of enforcement of the requirement to submit a Supervision Agreement in order to utilize technology-assisted supervision for the duration of Executive Order 2020-07. 

The Board approved a stay of enforcement for the requirement limiting 50 percent of supervised experience to be accrued through technology-assisted supervision for the duration of Executive Order 2020-07.

The Board has approved a stay of enforcement for the requirement of On-Site supervision to be on-site during the duration of Executive Order 2020-07.

The Board has approved a motion for a stay of enforcement of the requirement that two observations be required each six month period for all licensure candidates for the duration of Executive Order 2020-07.

The Board has approved a stay of enforcement on testing eligibility periods, as well as supervision hour eligibility periods for all licensure candidates, pausing the eligibility periods, for the duration of Executive Order 2020-07.

Licensure:

The Board has approved a stay of enforcement for all face-to-face CEU requirements, including Ethics and Supervision for the duration of Executive Order 2020-07.

The Board voted to allow any previously approved CEU’s to automatically be approved for face-to-face and technology-assisted CEU’s during the duration of Executive Order 2020-07.

The Board suspended the processing of any new CEU applications, pending further discussion and review by the Board, and to allow any previously approved CEU’s to automatically be approved for face-to-face and technology-assisted.

Tele-counseling/therapy:

The Board has received many inquiries regarding tele-counseling. In an effort to reduce barriers to tele-counseling the Board has not adopted any restrictions regarding tele-counseling. If you plan to provide services out-of-state, it is also recommend that you contact that states Board to see if they have adopted additional provisions. The Board is not promoting any service provider; however the lists of providers below have been deemed HIPAA compliant by OMES:

  • V-See
  • Doxy.me
  • Theranest
  • Vidyo.com
  • Simplepractice
  • Microsoft Teams
  • Skype for BUSINESS
  • Zoom

General Information:

The Board of Behavioral Health Licensure along with other State agencies will continue to work with state and local government agencies to provide information to all licensees and the general public as we receive information on the Coronavirus (COVID-19).  We encourage you as healthcare providers to continue to communicate with staff on proper sanitary measures as well as communication to your clients.  You can access further information at the Oklahoma State Department of Health website.  In addition to visiting the State Department of Health website the Call Center number and hours are being provided to further assist in questions, you or your clients may have regarding Coronavirus (COVID-19).

Texas

TAMFT Legislative Update: Emergency Rule for Telemedicine Announced by Governor Abbott
Governor Abbott announced on March 17 adoption of an emergency rule governing telemedicine and telehealth services provided by health professionals—specifically including mental health professionals—to reduce barriers to accessing services as a result of the coronavirus pandemic. Abbott directed the Texas Department of Insurance (TDI) to issue an emergency rule to help improve access to care, while mitigating the spread of COVID-19.

  • TDI filed an emergency rule requiring insurers to pay the same amount for telemedicine and telehealth services, including specific coverage for mental health services, as they do for in-person services.
  • The rule applies to in-network services for state-regulated health plans including Medicaid, Medicare, and TRS. In addition, health plans may not limit, deny, or reduce payments based on the platform used (i.e. Skype, FaceTime, and telephone) by the provider to deliver services, or require documentation beyond what is currently required for in-person visits. This applies specifically to HIPAA compliant platforms for telemedicine/technology-assisted services. Essentially, at the federal level, Health and Human Services relaxed HIPAA standards to allow providers to use platforms that are not specifically HIPAA compliant (like FaceTime and Skype). In the HHS statement, they continued the prohibition on sites like TikTok and others that would explicitly break client confidentiality. The goal of the action is to provide access to care, whether it’s the provider or client/patient who needs to use a noncompliant platform in order for the care to take place. The emergency rule can remain in effect for up to 120 days.

The emergency rule does not expand coverage beyond what is currently included in an individual’s health care plan or cover services provided before March 17, 2020. The rule allowing health plans to deny payment for services delivered by audio-only telephone, text, or fax remains in effect.

Although the Governor’s news release and the preamble to the emergency rules focus on telemedicine, the rule itself specifically includes telehealth services provided by mental health professionals. The inclusion of mental health professionals in this emergency rule is a direct result of the coordinated advocacy and collaboration between the Texas Counseling Association, the National Association of Social Workers–Texas, the Texas Association of Marriage and Family Therapists and the Texas Psychological Association and we are grateful for the willingness of Governor Abbott to recognize the importance of parity between physical and mental health.

TSBEMFT still awaits word on a waiver from Governor Abbott regarding something unique to LMFTs, related to the 15-hour certification/training requirement for MFTs before they can practice teletherapy. TAMFT reminds members who retain dual licenses, such as LPCs, that this requirement does not exist for LPCs or any of the other mental health licensees. We encourage both LMFTs and LPCs to review the rules for teletherapy as provided for under the Texas Administrative Code as well as the collection of teletherapy resources (including training courses and information) provided on the TAMFT website before beginning teletherapy.

TAMFT is excited about this emergency rule and what it means for people who need care in a social distancing environment, and we look forward to continuing to advocate for LMFT’s and to protect and advance constructive mental health policies and issues before the Texas legislature. If this message was forwarded to you and you’re not a member, please consider joining TAMFT and supporting advocacy work on behalf of Texas MFTs.

More Teletherapy Resources

Washington

Emergency Volunteer Health Practitioner Act

Volunteers Needed – State Licensing Conditionally Waived
March 12, 2020

As Washington takes more steps to reduce the spread of COVID-19 the Department of Health (DOH) will now enroll and activate emergency volunteer health practitioners in preparation for health system requests and surging. This will help the state meet emerging demands for healthcare workers.

The DOH can perform this work under the authority of the Uniform Emergency Volunteer Health Practitioner Act (chapter 70.15 RCW), if an emergency proclamation by the Governor is in effect – as is the case in Washington as of Feb. 29, 2020.

If volunteers are registered in the volunteer health practitioner system and verified to be in good standing in all states where they are licensed, they may practice in Washington without obtaining a Washington license once activated and assigned by DOH.

In-state practitioners can become volunteers in two ways:

  • Via RCW chapter 70.15 by registering and completing the Emergency Volunteer Health Practitioners Application which can be found here
  • Via registering with their local Medical Reserve Corps; more information can be found at: https://mrc.hhs.gov

Out-of-state practitioners may:

  • Become volunteers via RCW chapter 70.15 by registering and completing the Emergency Volunteer Health Practitioners Application which can be found here
  • Out of state MDs and DOs that would like an expedited Washington license and to volunteer, may use the Interstate Medical License Compact and become registered under RCW 70.15. At this time, we are limiting our request for health care practitioners to U.S. jurisdictions due to technical issues. We may expand the call to international jurisdictions in the future as needs arise, and if that remains available to us based on federal restrictions.

Applications will be screened by the DOH to ensure the potential volunteer’s health license is in good standing in each state they where they are licensed. The DOH will activate, deploy and deactivate approved volunteer health practitioners as needs are identified and requested. Please share this urgent request broadly with your sister organizations, national groups, stakeholders, followers and readers.

Frequently Asked Questions about RCW 70.15 are available here.

Questions can be emailed to WAserv@doh.wa.gov or 360-236-4090.

Micah Matthews
Deputy Executive Director
Washington Medical Commission
micah.matthews@wmc.wa.gov