What’s going on with our regulatory boards in the United States and licensure across disciplines for telehealth? The big challenges for our colleagues serving on these regulatory boards seem to include:
- Deciding how to best enforce their local laws when their licensees practice illegally in foreign areas
- How to handle the challenge/expenses when foreign licensees come to their states and harm their local citizens
- Getting the cooperation of 49 other states to make a shared licensure enforcement plan viable
States to date haven’t been able to agree on some fundamentals, such as basic licensing requirements that involve experience and exams, much less on who will carry the expense of enforcement across state lines. Plus, financial issues do come into play. Some states are bigger than others and have more licensees, and are more or less strapped for funds. For example, my state of California is repeatedly on the brink of financial collapse. So the added expense for prosecuting hundreds of therapists running a muck in foreign states and countries is a very expensive proposition.
How will a state regulatory board handle an infraction by one of its licensees in Sri Lanka? Should it care? Should it look the other way? Should they spend state funds enforcing their own licensing law over state lines? What if the licensee practices just 5 miles over the state border? How is that different? Should they spend the funds to enforce the law that is now in place to regulate that licensee?
Solutions also exist:
There are lesson to be learned by looking to each other’s disciplines as well as outside mental health. For example, psychologists associated with the Association of State and Provincial Psychology Boards also have made great strides toward the licensure challenges. They have a designation they call “CPQ” that is very promising. See the top tool bar on that website for the “Licensure Mobility” tab.
Also, we all would do well to heed the example offered by our nurse colleagues at the National Council of State Boards of Nursing (NCSBN). See the video their leadership group published this week.
These are some of my thoughts. What are yours?