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Telemental Health Interjurisdictional Licensure Update

In spite of much confusion over the years, most clinicians and their employers now understand that interjurisdictional licensure does not yet exist in the United States. While providers can legally and ethically offer services across state and national borders, they typically are required to be licensed in the state and/or country of the patient at the time of the contact. This general principle is true of all behavioral healthcare disciplines, whether the clinician is a counselor, marriage and family therapist, social worker, physician or psychologist.

Interjurisdictional Licensure Reform

However, interjurisdictional (cross-border) practice benefited from movement on two fronts in 2015. The first involved an attempt by the Federation of State Medical Board (FSMB) to propose a “model act” to streamline and simplify physician licensing across state lines. Called the “Physician Licensure Compact.” Under the Compact, participating state medical boards would retain their licensing and disciplinary authority, but would agree to share information and processes essential to the licensing and regulation of physicians who practice across state borders. The Compact is an agreement for states to share documents, but not licensure. That is, unlike laws regulating driver’s licenses across state lines, the FSMB’s model only facilitates the transfer of documents from one state to another, but each physician regulated by such states will be subject to fees, processing and reporting to each state involved. It has been approved by 26 states to date.

Psychology has evolved its own “model act,” conceived and advanced by the Association of State and Provincial Psychology Boards (ASPPB). Approved in February 2015, the Psychology Interjurisdictional Compact (PSYPACT) was created to facilitate both telepsychology and the temporary in-person, face-to-face practice of psychology across jurisdictional boundaries. Once ratified by at least seven states, this model will be a true “reciprocity” agreement, whereby psychologists in one state of the PsyPact will be allowed to practice in any other state that has ratified the agreement. PSYPACT then is an agreement between states to enact legislation. Licensed psychologists will be able to apply for and use the ASPPB E.Passport to practice telepsychology. Just approved by the American Psychological Association in August, the PsyPact has already enjoyed widespread support, and official ratification has been achieved by at least one state.

With these two model programs in place, it is expected that the 2016 legislative year will bring significant movement with interjurisdictional licensure across behavioral disciplines.

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