5 Worst Myths: GA Telemental Health

The 5 Worst Myths About
Georgia Telemental Health

Here they are. In no particular order...

Myth #1: Telemental health training is required every 5 years.

At present, the Georgia Composite Board of LPC SW and MFT requires telemental health continuing education once. If you have met the telemental health and telemental health supervision training requirements, rule Chapter 135-12, you are done. The hours do not need to be repeated. So strictly speaking they are training requirements- not continuing education. Chap 135-12 is a new rule chapter and separate from 135-9, "Continuing Education". It was created to accommodate telemental health definitions and requirements. Georgia social worker, professional counselor and marriage and family continuing education is required every two years.

You may have other credentials (for example the NBCC BC-TMH) that have different requirements. But if you have completed Georgia Board requirements you can practice telemental health in Georgia. Read Chapter 135-12 thoroughly to ensure you are in complete compliance.

Myth #2: If you have any form of telephone contact with your clients, you are engaging in telemental health. 

The board has not been enforcing scheduling and other business phone calls as practicing telemental health.

Read Chapter 135-12 again: Telemental health is a mode of providing counseling and psychotherapy. It is not defined by specific activities. In contrast, 'Hi John: since you live in Augusta Georgia and I am in Atlanta, let's do your therapy via video.'...that is telemental health under Georgia rules.

Myth #3: Georgia has a telemental health law.

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False. Many if not most states do not have telemental health law. Some states' counseling boards such as Florida are piggybacking off their telemedicine/telehealth law to allow for out-of-state practice of psychotherapy. This process has required those states to first determine whether their telehealth laws can legally be extended to psychotherapy. In Georgia, provisions for counselor telemental health exist only in board rules.

Interestingly, GA SB118 was enacted/signed into law on 5/6/2019. The title of the law has been changed from "Georgia Telemedicine Act" to "Georgia Telehealth Act" and also addresses provisions for practice across state lines. However, this law has not yet been fully explored to allow for legal practice of psychology or psychotherapy across state lines. 

Myth #4: Georgia's Composite Board has reciprocity with some states. 

No reciprocity. Georgia's Composite Board has a process of endorsement for Licensed Professional Counselors and Marriage and Family Therapists. The endorsement application process includes evaluating whether the home state has substantially similar licensing requirements.

Some states have reciprocal agreements, but there are very specific conditions written into those states' reciprocity rules and they are written joint agreements. Georgia has no such arrangement with another state. Reciprocity, endorsement and portability are constantly evolving and I work hard to keep up with interstate practice of psychotherapy.

Myth #5: If I follow HIPAA law, I am safely delivering telemental health to my patients.

Following HIPAA means you are in compliance with federal law. There are many other factors in safe electronic therapy. In terms of threats to your practice license there are other serious problems inherent in distance communication. --All of that HIPAA communication is still on a third party server. If it is a third party provider of telemental health that you have contracted with, they in effect own that information. To the extent they have access to the databases and servers, they have captured in video/audio every intervention you did --or did not and were supposed to do. Consider whether you want any third party having access to such detailed information--it can be taken out of context. 

The greatest hazard to your license lies in the fact that you are delivering the services in an environment you don't control. The patient controls the environment. It doesn't matter how many informed consents and other agreements you have them sign. Doesn't matter how HIPAA compliant. These problems may be reconcilable in your case. Carefully consider the type of psychotherapy activities and interventions you intend to provide.

Telemental health is here to stay. How it can be done safely involves problems that still need to be worked out.