Current through Register Vol. 28, No. 3, September 1, 2024
11.1 "Telehealth Services" means the practice of Mental Health Counseling, Chemical Dependency Counseling, or Marriage and Family Therapy (hereinafter referred to as Behavioral Health Practice) by distance communication technology such as but not necessarily limited to telephone, email, Internet-based communications, and videoconferencing.
11.2 In order to deliver Telehealth Services one must hold a current, valid license issued by the Board.
11.3 Licensees understand that this rule does not provide licensees with authority to deliver Telehealth Services to clients domiciled in any jurisdiction other than Delaware, and licensees bear responsibility for complying with laws, rules, and/or policies for the delivery of Telehealth Services set forth by other jurisdictional regulatory boards.
11.4 Licensees delivering Telehealth Services shall comply with all of the rules of professional conduct and state and federal statutes relevant to Behavioral Health Practice.
11.5 Licensees must establish and maintain current competence in the professional practice of Telehealth Services through continuing education, consultation, or other procedures, in conformance with prevailing standards of scientific and professional knowledge. Licensees must establish and maintain competence in the appropriate use of the information technologies utilized in the practice of Telehealth Services.
11.6 Licensees must recognize that Telehealth Services are not appropriate for all Behavioral Health Practice and clients, and decisions regarding the appropriate use of Telehealth Services are made on a case-by-case basis. Licensees delivering Telehealth Services are aware of additional risks incurred when engaging in Behavioral Health Practice through the use of distance communication technologies and take special care to conduct their professional practice in a manner that protects the welfare of the client and ensures that the client's welfare is paramount. Licensees delivering Telehealth Services shall:
11.6.1 Conduct a risk-benefit analysis and document findings specific to:
11.6.1.1 Whether the client's presenting problems and apparent condition are consistent with the use of Telehealth Services to the client's benefit; and
11.6.1.2 Whether the client has sufficient knowledge and skills in the use of the technology involved in rendering the service or can use a personal aid or assistive device to benefit from the service.
11.6.2 Not provide Telehealth Services to any person or persons when the outcome of the analysis required in subsections 11.6.1.1 and 11.6.1.2 of this rule is inconsistent with the delivery of Telehealth Services, whether related to clinical or technological issues.
11.6.3 Upon initial and subsequent contacts with the client, make reasonable efforts to verify the identity of the client;
11.6.4 Obtain alternative means of contacting the client;
11.6.5 Provide to the client alternative means of contacting the licensee;
11.6.6 Establish a written agreement relative to the client's access to face-to-face emergency services in the client's geographical area, in instances such as, but not necessarily limited to, the client experiencing a suicidal or homicidal crisis;
11.6.7 Whenever feasible, use secure communications with clients, such as encrypted text messages via email or secure websites and obtain and document consent for the use of non-secure communications;
11.6.8 Prior to providing Telehealth Services, obtain the written informed consent of the client, in language that is likely to be understood and consistent with accepted professional and legal requirements, relative to:
11.6.8.1 The limitations and innovative nature of using distance technology in the provision of Behavioral Health Services;
11.6.8.2 Potential risks to confidentiality of information due to the use of distance technology;
11.6.8.3 Potential risks of sudden and unpredictable disruption of Telehealth Services and how an alternative means of re-establishing electronic or other connection will be used under such circumstances;
11.6.8.4 When and how the licensee will respond to routine electronic messages;
11.6.8.5 Under what circumstances the licensee and service recipient will use alternative means of communications under emergency circumstances;
11.6.8.6 Who else may have access to communications between the client and the licensee;
11.6.8.7 Specific methods for ensuring that a client's electronic communications are directed only to the licensee or supervisee;
11.6.8.8 How the licensee stores electronic communications exchanged with the client;
11.6.9 Ensure that confidential communications stored electronically cannot be recovered and/or accessed by unauthorized persons when the licensee disposes of electronic equipment and data.
11.7 If in the context of a face-to-face professional relationship the following are exempt from this rule:
11.7.1 Electronic communication used specific for appointment scheduling, billing, and/or the establishment of benefits and eligibility for services; and
11.7.2 Telephone or other electronic communications made for the purpose of ensuring client welfare in accord with reasonable professional judgment.
