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) Licensees may use technology-assisted services only after receiving appropriate education, training, and/or supervised experience in using relevant technology. A therapist who uses technology-assisted services must maintain documentation of academic preparation and supervision in the use of technology-assisted services as part of the therapist’s academic program or the substantial equivalent provided through at least 15 hours of continuing education and 2 hours every subsequent renewal period. Licensees must comply with this subsection by January 1, 2018.
The Texas Board also provided a detailed list of requirements that their licensees need to be able to demonstrate if investigated. The complete ruling can be seen in this attached document. 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 practitioenrs seeking to not only adapt to marketplace forces by using technology, but also to be allowed to reasonably practice interjurisdictionally, 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.