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Telepsychology Across State Lines Officially Approved: PSYPACT

PSYPACT

On April 23rd, 2019, Georgia’s Governor Brian Kemp signed GA HB 26 into law, making Georgia the eighth state to enact the Psychology Interjurisdictional Compact (PSYPACT), and thereby officially legalizing interjurisdictional telepsychology for states who have joined the PSYPACT.

The PSYPACT involves the formal approval of a “model act” developed by the Association of State and Provincial Psychology Boards (ASPPB) to allow approved professionals from a PSYPACT state to legally practice over state lines in any one of the other PSYPACT member states. These states now include Arizona, Utah, Nevada, Colorado, Nebraska, Missouri, and Georgia. Illinois is slated to join this group as of January 1, 2020. States seeking to join the PSYPACT must formally accept the ASPPB model act into state law. 

Professionals licensed in PSYPACT states must apply, pay fees and comply with a number of regulations that are shared across member states. For example, professionals must be licensed in at least one PSYPACT state; cannot have been found guilty of a regulatory infraction, and be able to demonstrate having taken at least 3 CE hours of training related to licensure mobility.

In a press release dated April 23, 2019, ASPPB CEO Dr. Mariann Burnetti-Atwell is quoted as saying:

ASPPB is excited to announce with the recent signing by Georgia’s Governor Brian Kemp of GA HB 26, the much-awaited Psychology Interjurisdictional Compact is now ready to assist licensed psychologist to practice psychology across state lines. These are exciting times for the psychologist and for the individuals they will serve.

The ASPPB press release further explains: 

PSYPACT is an interstate compact specifically designed to facilitate the practice of telepsychology and the temporary face-to-face practice of psychology across state lines. Upon becoming operational, each PSYPACT participating state will select one Commissioner to serve as that state’s representative on the PSYPACT Commission. The PSYPACT Commission is the governing body of PSYPACT and is responsible for the drafting and publication of PSYPACT Bylaws and Rules. Upon completion of these documents and finalization of requirements for the ASPPB E.Passport Certificate (for telepsychology) and Interjurisdictional Practice Certificate (for temporary practice), the process will open for licensed psychologists to apply for/begin using these certificates and practicing under the authority of PSYPACT.

According to ASPPB President Dr. Gerald O’Brien, “PSYPACT will promote further cooperation and standardization of requirements among psychology licensing boards, and consequently will improve access to psychological services while serving to protect consumers.”

The Telebehavioral Health Institute (TBHI) is proud to have been instrumental in the development of this important process by introducing the former CEO of ASPPB to the Director of the Office for the Advancement of Telehealth (OAT), who awarded ASPPB a grant totaling more than $1,000,000 to examine models for interjurisdictional practice. TBHI currently offers a number of professional training web-based webinars, courses and certificate programs for psychologists seeking to meet application and renewal requirements for the PSYPACT.

ADDED NOTE: Oklahoma became the 9th PSYPACT state on April 29, 2019. See this TBHI post for details of the Oklahoma PSYPACT.

State Lines WebinarLegally Practice Over State Lines

Need specific information about legally practicing over state lines and the PSYPACT law? TBHI’s “How to Legally Practice Over State Lines with Telebehavioral Health and Telemental Health” online training will look at what has been accomplished, what is still left to be accomplished and more importantly, action-items for all practitioners who wish to expand their services over state and international borders. Basic issues regarding good clinical practice, regulatory boards, and resources for practitioners as well as decisions makers in hospitals, agencies, and clinics will also be included.

 

 

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23 comments on “Telepsychology Across State Lines Officially Approved: PSYPACT

    • Through the Association of State and Provincial Psychology Boards, psychologists applied for and won a licensure portability grant from the U.S. Office for the Advancement of Telehealth (OAT) several years ago. Monies from the grant were specifically awarded to study possible models for shared licensure for psychologists across borders within the United States. The model grew from that and is the direct product of psychology for psychology. The Federation of State Medical Boards won the other grant given that year. They developed their own model compact, but it does not lead to shared licensure. Rather, it allows physicians to more easily share documents from one state to another when applying for licensure in foreign states.

      In the counseling world, the American Mental Health Counselors Association (AMHCA) spearheaded a similar effort a few years back by organizing different groups at the MA level, but I haven’t seen anything of the licensure portability effort more recently, and they didn’t win U.S. federal dollars to catapult them forward as the psychologists did. Nonetheless, they have shown initiative in this area, so you may want to contact AMHCA here for an update. I expect that this landmark event will spark more productive conversation in all behavioral health associations.

      • Hi,
        So as an example, Does the psypact agreement allow a Psychologist licensed in Illinois, and who is staying in colorado for 30 days, to continue seeing her patients in Illinois through telepsychology?

        • CW,

          The PSYPACT does not directly impact the issue of your being in a non-PSYPACT state. However, any Illinois-licensed clinician visiting a foreign state can serve Illinois clients/patients through telehealth (as long as they are not visiting Florida — which has its own set of rules for professionals visiting Florida). In fact, very few states object to their licensees being somewhere other than their state of licensure for telehealth. For a definitive response related to your own license, contact your board.

          There are several other key issues related to licensure that you may want to better understand. I’d suggest you take either one of our two easy-to-access licensure-related courses:

          Webinar recording format: How to Legally Practice Over State Lines with Telebehavioral and Telemental Health 1 CME or CE Hour)
          Web-based, multi-media format: Legal/Ethical Issues I: Rules, Regulations & Risk Management (3 CME or CE Hours)

      • Steve,

        Thank you for your question. If you are a psychologist, write to the California Board of Psychology, tell them why you want them to adopt the ASPPB model act known as “PSYPACT” and ask them to get back to you in writing regarding their stance/progress on this issue. Then please, share their response with us here. I encourage professionals in any healthcare discipline to also post responses from your boards here. Let’s educate each other.

        • AMEN!
          Squeaky wheel ….oil …
          #GreaseLightening
          #PebblesInShoes… & Souls
          #Collaboration #TeleHEALTH@ALL… & I think I heard #TeleED is making head-way in a few places, too, now….

        • I wrote to both California and Minnesota as I am licensed in both states. I have yet to hear from California, but received the following information from Minnesota:

          Hello Dr. Donnelly,

          Thank you for your email. Dr. Alex Siegel, from ASPPB, is coming to present to the Board on PSYPACT at our May 17th meeting at 9:30am. I will pass on your request, and I would encourage you to attend and express your support.

          Kind regards,
          Sam Sands

          Executive Director
          Minnesota Board of Psychology
          612.548.2100

          • Thank you for posting, Brett! Alex is the main advocate from ASPPB. Please keep us all posted. This is exciting. It also proves what I have been saying about the value of writing to our boards. With a pile of letters from licensees, the boards have reason to take action. If licensees don’t ask, state boards have reason to ignore the issue.

        • Will do. I find it odd that as a licensed psychologist in California, I can’t work with someone whose residence is in Arizona, but according to Healthtap, I can work with someone who resides in South Africa. If this is true, we surely have a long way to go.
          BTW, I only like to get letters from the Board of Psychology every two years, that being renewal time. Any other letters from them make me nervous, but I’ll tough it out…. Maybe I’ll just call them.

          Steve Griggs

          • Steve,

            I’m not sure about Healthtap being a source of legal information, but you may want to review the CA Psychology board’s website if you don’t want to contact them directly. Last I learned, CA requires that we have a license to practice in the state and written approval from a foreign board before we practice out of state with our CA licenses. Let me know if you find a state regulation that says I’m wrong.

            And one last word about contacting our boards. I don’t know if anyone ever studied whether or not that contacting a board will get you into more trouble than not. Fascinating question, though. I’d think that it would only be a problem if they told you to go left and you went right. If anyone has hard data on this, please let me know that, too.

  1. Is this strictly for clinical psychologists? Or does it apply to other licensed telebehavioral health clinicians as well, such as social workers, MFTs, LPCs, or MHCs?

  2. Very disappointed that it is limited to ‘psychologists’. I guess PSYPACT will eventually cover master level practitioners but I assume it will take years.

    • Actually, MA-level counselors, therapists, social workers, nurses, and others don’t just need to wait. This isn’t for everyone, but if you have a fire in your belly about licensure portability or telehealth in general like I do, there’s plenty that you can do. Make some calls, send some emails, join some groups that are advancing the responsible use of technology in behavioral health. (See CTiBS, a non-profit dedicated to advancing the responsible use of technology in behavioral science through research and publications. Visit the website today.)

      BTW, we all can take a lesson from counselors. Their national association, the American Counseling Association, actually requires advocacy of all counselors as part of the ethical code. That means that if they see that something will benefit counseling and identify yourself as a counselor, it is their ethical duty to advocate for that type of change. I want to encourage all of us then, to be the “pebble” in our authority group’s “shoe” about licensure portability. When delivered using evidence-based competencies, it is 100% legal and ethical.

      BTW, PSYPACT started because I was a pebble. I was one of many telehealth advocate pebbles. When I heard of these licensure portability grants by OAT. I called Dr. Steve Demers at ASPPB and asked him if they had ever applied. He had never heard of the grant, so I introduced him to Dr. Dena Puskin, the Director of OAT, who I had invited her to speak at an APA convention. The rest is history — Dena met with Steve, explain the grant process, and ASPPB applied, then won the grant. Let me also publically state that I am not claiming responsibility for PSYPACT, but I did what I could.

      What can you do to advance licensure portability in your profession? I encourage you to something. It will happen sooner if we all push together.

      • I wanted to know if the PSYPACT includes providers that are licensed as a licensed counselor. I am not a psychologist. My credential is in the state of Nebraska and I am a Licensed Independent Mental Health Practitioner (LIMHP). If my license is included in this who could I call to speak with to find additional information? Thank you.

      • Great feedback. All counselors are agents of change, but we seldom apply that to ourselves. Everyone’s effort counts for something!

    • Judy,

      PSYPACT is only for psychologists, but here’s a little more background, and a suggestion if you are up for it.

      The needed change is two-fold — we need licensure portability in all professions and in all states.

      PROFESSIONS: Coordinating efforts within a single discipline is hard enough for many professions. In behavioral care, there are 9 behavioral professions (psychiatry, psychology, social work, marriage and family therapy, counseling, nursing, nurse practice, behavioral analysis, addictions). In many states, the boards don’t even talk to one another, so coordination on issues as far-reaching as licensure portability are not likely. In fact, even in the PSYPACT states, non-psychology boards have not yet made this type of progress with their legislators. Besides, our professions have a history of “turf wars,” that is, going out of their way to harm each other’s attempts at progress. Integrated care is a possible antidote to these problems, but it is still in its infancy.

      STATES: Licensing boards are little fiefdoms – they run independently from one another even when they are in the same state. If you look across states, you see that the challenge is even larger than can be tackled with one legal change. Counselors, social workers, nurses, nurse practitioners, MFTs, speech therapists, occupational therapists etc. then, have boards that are not in alignment with psychology’s, or with each other’s in many cases.

      What You Can Do

      Boards have limited budgets and time. If you are in a non-psychology profession, write to your board website, tell them what you need with regard to interjurisdictional practice and why. Become the pebble in their shoe. Don’t call. Ask for an answer in writing.

  3. This is wonderful. As a PhD student at a university with a Telehealth clinic, I have seen the good telehealth does. Imagine all the people we could reach (esp in areas with a shortage of mental health professionals) with this system implemented nationally. Where I am, the wait lists to see a psychologist are long- there just aren’t enough in the area. Eight states is a great start, and I look forward to
    being another pebble to push more states to get on board so we can continue expanding access to care.

  4. How is this looked at from a theorerical perspective? Meaning as a psychologist, if I sign up for psypact licensure I am allowed to provide teletherapy but not in-person therapy to the same patient? So the state is essentially saying that I am qualified to provide teletherapy but not in-person therapy – how does that make sense?

    • Dr. A,

      Thank you for your question. States who sign the PSYPACT into law are saying that if you are fully licensed and pass their identified criteria for telepsychology, you can then deliver services to clients/patients in other states who have also signed the PsyPact into their state law. You have to be fully licensed first.

      Marlene

      • PSYPACT provides for “….temporary in-person, face-to-face practice of psychology by psychologists across state boundaries for 30 days within a calendar year in the performance of their psychological practice as assigned by an appropriate authority”

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