Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
335.300,
335.305,
335.310,
335.320,
335.325,
335.332,
335.380,
335.399
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
335.320(9) requires the
Board of Li-censure for Marriage and Family Therapists to promulgate
administrative regulations to implement the purpose and scope of
KRS
335.300 to
335.399.
KRS
335.380 requires the board to promulgate
administrative regulations to govern telehealth services in the provision of
marriage and family therapy services. This administrative regulation
establishes procedures for the use of telehealth by licensees and
associates.
Section 1. Definitions.
(1) "Asynchronous" means a communication that
does not occur simultaneously in real time.
(2) "Electronic communication" means the use
of Web sites, cell phones, email, texting, online social networking, video, or
other digital methods and technology used to send and receive messages or post
information.
(3) "Encryption" means
a mathematical process that converts text, video, or audio streams into a
scrambled, unreadable format when transmitted electronically.
(4) "Fee-splitting" means offering or
accepting payment for referrals other than in an employer-employee or
contractor-contractee relationship.
(5) "HIPAA" means the Health Insurance
Portability and Accountability Act of 1996, Pub L. No. 104-191, 110 Stat. 1936
(1996).
(6) "HITECH" means the
Health Information Technology for Economic and Clinical Health Act of 2009,
42
U.S.C. 17901-17953.
(7) "Social media" means a Web-based
communication tool that enables people to interact with each other by both
sharing and consuming information.
(8) "Synchronous" means a communication that
occurs simultaneously in real time.
(9) "Telehealth" is defined by
KRS
335.380(3).
Section 2. Licensure, Standard of
Practice, and Competency.
(1) License or
permit required. Each licensed marriage and family therapist, or permitted
marriage and family therapy associate practicing telehealth in this state shall
be licensed by the board, or hold a permit issued by the board, and comply with
all statutes, administrative regulations, and ethics guidelines applicable to
the practice of marriage and family therapy.
(2) Standard of appropriate practice. A
licensed marriage and family therapist, or permitted marriage and family
therapy associate providing telehealth services in this state shall be held to
the same standards of practice as those applicable for in-person therapy
settings.
(3) Competency. A
licensed marriage and family therapist, or permitted marriage and family
therapy associate shall only provide telehealth services in this state in those
instances in which the licensed marriage and family therapist, or permitted
marriage and family therapy associate has successfully completed all
requirements set forth in Section 3(1) of this administrative
regulation.
(4) Continued
competency. A licensed marriage and family therapist, or permitted marriage and
family therapy associate providing telehealth services in this state shall have
an ongoing obligation to assess his or her technical and clinical competency to
render these services by successfully completing all requirements set forth in
Section 3(2) of this administrative regulation.
(5) Fee splitting. A licensed marriage and
family therapist, or permitted marriage and family therapy associate providing
telehealth services shall not split fees.
Section 3. Education and Continuing Education
Requirements.
(1) Initial educational
requirements. Effective January 1, 2020, a licensed marriage and family
therapist, or a permitted marriage and family therapy associate providing
telehealth services in this state, and a licensed marriage and family therapist
who is supervising a marriage and family therapy associate providing telehealth
services in this state shall have completed fifteen (15) hours of
board-approved training in the practice of telehealth as provided in
201 KAR
32:060, Section 2(2), which shall include three (3)
hours of ethics in the practice of tele-health. Each approved course shall be
live or online. Areas to be covered in the training shall include:
(a) Appropriateness of teletherapy;
(b) Teletherapy theory and
practice;
(c) Modes of
delivery;
(d) Legal and ethical
issues;
(e) Handling online
emergencies; and
(f) Best practices
and informed consent.
(2) Continuing education requirements. A
licensed marriage and family therapist, or permitted marriage and family
therapy associate who has completed the initial training in the practice of
telehealth shall complete at least two (2) credit hours of continuing education
approved by the board, in accordance with
201 KAR
32:060, in the practice of telehealth during each
subsequent renewal period.
(3)
Credit hours earned to comply with subsections (1) and (2) of this Section may
be applied to continuing education requirements set forth in
201 KAR
32:060.
Section 4. Verification of the Client. Prior
to providing initial telehealth services in this state a licensed marriage and
family therapist, or permitted marriage and family therapy associate shall
require the client to produce a valid photo identification. If the client is a
minor, prior to providing telehealth services in this state a licensed marriage
and family therapist, or permitted marriage and family therapy associate shall
verify the identity of the parent, guardian, or other person consenting to the
minor's treatment.
Section 5.
Client Assessment.
(1) Initial assessment.
Prior to providing telehealth services in this state a licensed marriage and
family therapist, or permitted marriage and family therapy associate shall
conduct an initial assessment of the client to determine if telehealth is an
appropriate delivery of treatment considering the professional, intellectual,
or emotional needs of the client.
(2) Ongoing assessment. Throughout the
duration of providing telehealth services in this state, a licensed marriage
and family therapist, or permitted marriage and family therapy associate shall
engage in a continual assessment of the appropriateness of providing these
services to the client.
(3)
Telehealth may not be appropriate if the client:
(a) Recurrently experiences, or is likely to
experience, crises or emergencies;
(b) Is a suicide risk, or likely to become a
suicide risk;
(c) Is violent, or
likely to become violent; or
(d)
Otherwise poses a risk to themselves or to others.
Section 6. Informed Consent.
(1) Generally. Prior to providing telehealth
services in this state, the licensed marriage and family therapist, or
permitted marriage and family therapy associate providing these services shall
obtain the informed consent of the client, which shall include:
(a) Disclosure of specific information
regarding the licensed marriage and family therapist's, or permitted marriage
and family therapy associate's:
1. Training
and credentials;
2. License or
permit number;
3. Physical location
and contact information;
4. Social
media policy;
5. Encryption policy;
and
6. Collection, documentation,
tracking, and storage of client information;
(b) Client confidentiality and the limits to
confidentiality in electronic communication;
(c) Information on reporting complaints to
the board and other appropriate licensing bodies;
(d) The specific services to be
provided;
(e) The risks and
benefits of engaging in telehealth in the clinical setting;
(f) The possibility of technology failure and
alternate methods of service delivery;
(g) Time zone differences, if any;
(h) Cultural or language differences that may
affect the delivery of services;
(i) The possible denial of insurance
benefits;
(j) The pertinent legal
rights and limitations governing practice across state lines or international
boundaries, if applicable; and
(k)
Whether delivery of service will be asynchronous or synchronous.
(2) Minors. Except as allowed by
KRS
214.185, if the client is a minor, prior to
providing telehealth services in this state the licensed marriage and family
therapist, or permitted marriage and family therapy associate shall, pursuant
to Section 4 of this administrative regulation, verify the identity of the
parent, guardian, or other person consenting to the minor's treatment and
obtain from that person the informed consent required by this
section.
Section 7.
Emergency Procedures, Coordination of Care and Referrals. Prior to providing
telehealth services in this state, the licensed marriage and family therapist,
or permitted marriage and family therapy associate shall establish with the
client:
(1) Acceptable ways to contact the
licensed marriage and family therapist, or permitted marriage and family
therapy associate in an emergency;
(2) Emergency procedures to include emergency
services at the client's location;
(3) Coordination of care with other
professionals; and
(4) Conditions
under which telehealth services may be terminated and a referral made to
in-person care.
Section
8. Compliance with Privacy Laws, Documentation, and Recordkeeping.
A licensed marriage and family therapist, or permitted marriage and family
therapy associate performing telehealth services in this state shall:
(1) Comply with all privacy laws and
regulations relating to the transmission and protection of protected health
information, including HIPAA and HITECH; and
(2) Comply with all state and federal laws
and regulations relating to the practice of tele-health, documentation of
services delivered, and related recordkeeping.
STATUTORY AUTHORITY:
KRS
335.320(9),
335.380
