The counseling profession has struggled with barriers to delivering mental health services to clients across state lines since the conception of licensure law. Most states require counselors to be licensed in the state where the client resides. This means clients have to find a new counselor if they move out of state. It also limits telehealth options for many clients.

To address this dilemma the American Counseling Association (ACA) – in collaboration with the National Center for Interstate Compacts (NCIC) – has been working on an interstate licensure compact. This compact would create licensure portability for professional counselors – creating a way for counselors to practice in multiple states.

To explore what the interstate compact would mean for counselors, Raymond Barrett, CEO of the Telehealth Certification Institute (TCI), interviewed Dr. Lynn Linde, chief knowledge and learning officer at ACA.

The jurisdictional structure of the counseling profession has hampered counselors and their clients for decades. Differing state licensure requirements associated with educational coursework, supervision hours, and professional examinations have fragmented the profession since the founding of the American Counseling Association (ACA) in 1952 and continue to impact counselors. An easy, straightforward answer to this dilemma has eluded industry decision-makers for years, but a professional reformation is underway—set in motion by a three-year investigative study, true portability for counselors is possible.

As the COVID-19 pandemic hit, telehealth became a necessity for many communities across the United States as a means of mitigating the risk of virus transmission and accessing healthcare in a timely manner. Telehealth has expanded access to healthcare in many communities across the country which previously lacked access to such healthcare, including Native communities. On April 8, 2020, the Indian Health Service (IHS) announced an expansion of telehealth across all facilities.

The healthcare industry is taking a simple and effective step in protecting its nurse workforce: listening to and allying with their needs. Groups like the National Council of State Boards of Nursing (NCSBN) have put pieces in place to enhance the work-life balance of advanced practice registered nurses (APRN). The APRN compact, influenced by a big legislative push from the NCSBN, is restructuring how patients are treated across the U.S. The compact has opened a new channel for multi-state practice for nurses licensed in a state that has signed the agreement.

In early 2019, the Georgia Senate passed two bills addressing telehealth and telemedicine. Both bills address comprehensive healthcare reform in order to reduce costs, increase access, and enhance quality care for Georgia residents. Since 2006, the state of Georgia has addressed telehealth parity law, and continued to address the need and coordination of telehealth care. The most recent bills (Senate Bill 115 and Senate Bill 118) continue to demonstrate how Georgia legislature has updated and revised existing laws.

The Florida legislature has passed Chapter 2019-137, Laws of Florida. Signed into law by the governor and effective July 1, 2019, Chapter 2019-137 clarifies the definitions for health care providers who use or plan on using telehealth services in Florida, as well as the steps needed to provide ethical, legal and competent services within the state. The full text of Chapter 2019-137 can be downloaded on the home page http://www.flhealthsource.gov/telehealth/.

It is now mandatory for practitioners who are licensed out-of-state and do NOT hold an additional Florida license to be registered with the state in order to perform telehealth services for patients located in Florida. (Licensed Florida providers are already allowed to practice telehealth with patients they would be able to see face-to-face.)

Technological improvements nationwide have meant an increase in telehealth services since patients and providers can communicate in a variety of two-way, real-time methods that provide remote consultation, home monitoring, and counseling, to name just a few.

However, specialized treatment is often elusive in rural areas. In order for states to adequately handle the rapid expansion of telehealth services, significant development of remote connections is necessary when providing access to a variety of specialists in both telemedicine and telemental health.

Telehealth services and their availability are expanding rapidly and the state of New York is prepared. Numerous avenues exist for those seeking services and providers are in place as well.

Telehealth is a constantly evolving mode of healthcare and there are numerous aspects of the field in need of clarification so that statutes, policies and practices follow the same guidelines. Telehealth is not a type of health care, rather it is the manner in which care is given. And as the standards for that care become more defined and the use of this mode more prevalent, so will the need for caregivers who are adequately trained and licensed to deliver telehealth.

In 2016, the State of Florida created the Telehealth Advisory Council in order to survey, research and recommend changes to telehealth in order to better serve those living in the state.  The increase in both access and use of telehealth will also require an increase in health care practitioners offering telehealth services.

Georgia is using telemental health for assessments, treatment, supervision, coordination of care, school-based services, and in many other facilities. The Partnership Georgia Partnership for Telehealth has had 240,000 telehealth patient visits in 2014, and it currently includes over 600 locations with over 200 specialists and healthcare partners. Georgia has had a telehealth parity law since 2006. Georgia has been requiring counselors, social workers, and MFTs to receive 6 hours of CE training in telemental health. Georgia’s Office of Telehealth & Telemedicine is establishing a new sophisticated telemedicine network.

If you are wanting to begin offering telebehavioral health services in Georgia, I highly recommend earning a certification. A certification in telebehavioral health will not only teach you important best practices but will inform referral sources of your credibility.

Read about Georgia's CE requirement for telemental health.