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For Mental Health and Medical Professionals: State-by-state guide to the rules/laws about telehealth/telemedicine services across state lines

Context:

Since the COVID-19 outbreak, mental health professionals of all disciplines have been struggling with keeping up with the changing rules/laws in each state related to providing mental health services via telehealth/telemedicine across state lines. This is particularly true for mental health and medical professionals who work with college and university students, as many students are away from campus and might be in different states from where the university is located.

Penn State University and the University of Texas at Austin teamed up to create a central resource with up-to-date information on the status of these rules/laws in each of the 50 states plus the District of Columbia. Our first version included marriage and family therapists, physicians, professional counselors, psychologists, and social workers. We have now added an additional tab to the spreadsheet that provides the same information for advanced practice nurses, physician assistants, and physical therapists. A list of rules/laws for physicians created by the Federation of State Medical Boards can be found here.

The information contained in this spreadsheet is intended to be a living document that will be updated as different states update their rules/laws. Please check back regularly so that you are using the most recent information. If you have information about a state that is not included in this spreadsheet, if you can help us fill in any information that is designated as unknown, unclear, or that is blank, or if you are aware of inaccuracies in this spreadsheet, please reach out to spitasky@utexas.edu so that we may correct it.

In addition to an awareness of the permissibility of practicing telehealth/telemedicine across state lines, it is also important for you to be aware of the variation in other laws impacting the provision of mental health or medical services in the state that you are practicing in. Two of the areas of law that have variability between states is the duty to warn (mandatory vs. permissive vs. no guidance vs. permutations of the above) and child abuse reporting mandates. In a separate tab of this spreadsheet, we have included two resources which can help provide state-by state-guidance about these laws.

Guide:

State-by-state guide to rules/laws about telehealth services across state lines.

Disclaimers:

The information provided in this spreadsheet was not compiled by individuals with any special knowledge about the rules or laws of any state and it is only meant to be used as a starting place in your independent determination about whether to proceed working with an existing or future client/patient in another state. We recognize that each situation is unique, and no single resource, such as this spreadsheet, can provide definitive guidance. This spreadsheet should not be construed as giving any advice, granting permission, or encouraging the taking of any such action based on the information contained in this spreadsheet. Please consider consultation with your legal counsel to ensure that you are following the appropriate rules/laws of the state where your client/patient resides. Some information in this spreadsheet could be outdated, inaccurate, and/or incomplete. We are not responsible for any decisions made based on the information that we provide, as this is only intended to be a repository of information. All decisions and judgements you make should be independently verified, and we are not responsible for any adverse outcomes based on your use of this information. This document does not and cannot waive the university’s sovereign immunity.

State guidance varies on informed consent and documentation expectations for telehealth/telemedicine. The American Psychological Association has provided guidance related to informed consent for telehealth services. Consider documenting why telehealth/telemedicine was warranted in this case, that you informed your client/patient of your current location, and informed consent for telehealth/telemedicine services. The Federation of State Medical Boards also suggests utilizing the DEA’s guidelines on providing telemedicine.



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