Practicing Teletherapy/Telehealth in Colorado
Telehealth practice (the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration) is subject to the same standards as traditional practice. The social worker must comply with guidelines for the locations of the social worker and the client, including compliance with all licensing and practice regulations with the state(s) in which both the client and social worker reside (there ARE exceptions to this during the COVID-19 Pandemic- check NASW COVID-19 Web Resources ). The social worker must accurately represent themselves and practice within their competencies. Informed consent must be expanded to address additional risks of using technology. When considering providing teletherapy as a licensee in Colorado, social workers must practice in accordance with the Colorado Department of Regulatory Agencies (DORA) . Refer to this NASW weblink for getting licensed to practice in Colorado and for the temporary (20 day max) practice in Colorado as a licensee from another state: https://naswco.socialworkers.org/Professional-Development/Licensure/LSW-LCSW-Information
Insurance Coverage for Telehealth Services- Insurance coverage for teletherapy services is impacted by federal and state laws, as well as individual insurance company policies. Providers should check with their liability insurance and their patient’s insurance plan regarding how telehealth services are covered. Note that according to Colorado law, telehealth reimbursed by health benefit plans and Medicaid must be delivered via HIPAA compliant platforms, unless there is an Emergency Order exemption. Since 2017, Colorado law (CRS-10-16-123) has ensured health benefit plan coverage for telehealth services, with the same reimbursement, coverage and benefits as for in-person services. NASW-CO advocated for SB20-212, which will become law in summer of 2020 and further protects clients’ ability to receive care via telehealth, requiring that Colorado health insurance carriers, including Medicaid across setting types, cover telehealth visits. This legislation waives the requirement that patients have a pre-existing relationship with a provider in order to receive telehealth, and it bars insurers from imposing additional certification or licensure requirements on telehealth providers.
Telemental Health Informed Sample Consent Form
DORA Teletherapy Policy- see 30-1 on Page 10; comply with mandatory disclosure requirements (see above NASW sample informed consent form) and address all expectations and include documentation in clinical notes: https://drive.google.com/file/d/0B-K5DhxXxJZbM0tZMEVmNjg1SHM/view
(Full Social work licensing/MH Practice Act DORA laws, rules and policies https://dpo.colorado.gov/SocialWork/Laws)
NASW Code of Ethics with 2017 highlighted revisions regarding the use of technology in the provision of professional services: https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Highlighted-Revisions-to-the-Code-of-Ethics
NASW’s Standards for Technology in Social Work Practice: https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf
Risk Management: Treading Through Teletherapy Treatment Topics: https://naswassurance.org/malpractice/malpractice-tips/treading-through-teletherapy-treatment-topics/
Technology in Social Work Practice: Standards of Practice - free for Members https://naswinstitute.inreachce.com/Details/Information/b55057c2-cc1a-4809-94b8-939cf3f5bbcf
Best Practices Teletherapy Webinar from NASW Online CE Institute: https://naswinstitute.inreachce.com/Details/Information/ff8e16c7-c783-4038-ab56-26023754a89d
ASWB resource for electronic practice for social workers is: State-Specific Social Work Electronic Practice.
More on best practices in telehealth: HealthIT.gov guide
Resource app. for following telemental health laws developed by Epstein, Becker, and Green. Here’s that link: telemental health law app.
What Telehealth Platform to Use?
NASW-CO does not endorse any telehealth platform but (generally) you must use a HIPAA- compliant platform. These are rarely the communication mediums you use on a daily basis in your personal life. HIPAA compliance has been mirroring technological change. Ensuring that your platform is HIPAA compliant is critical so as to reduce your risk and to maintain patient privacy.