Risk Management Series 2- Treating the College Student: Risk Considerations for Behavioral Health Professionals

Tip #2: Treating via Telebehavioral Health

Last week we discussed some risk considerations when treating the college student. There are additional questions that may arise:

  • What if the patient and his/her family want you to continue treating the patient from afar using telebehavioral health methods?
  • Are there special considerations if the patient is located at a distance, and you intend to use telebehavioral health methods?

There are special considerations when engaging in telebehavioral health with patients who are away at college. Here are a few considerations to keep in mind:

  • Consider if you are licensed to provide the treatment. The patient may be located in another state or another country, and there are licensure considerations in each scenario.
    • The patient is located out of state. If the patient is located in another state, you may not have appropriate licensure to continue to see him/her via telebehavioral means. It is important that you are aware of the rules in the state where the patient is located as well as your own. Although his/her “home base” may be located in your state, if the patient is attending an out-of-state college, you are bound by the laws where he/she is located. If you do not adhere to the regulations and laws in that particular state, you could face negative licensure consequences and liability, especially if an adverse issue occurs.
    • The patient is located out of the country. The patient may engage in a semester abroad but wants to continue engaging in sessions during this time. It is important to determine if there are regulations preventing you from engaging in telebehavioral health in his/her location. Be aware if the country requires licensure. Similar with state licensure issues, you could face licensure implications, especially if an adverse issue occurs, and you are required, but not licensed, to practice in that particular country. Again, it is important to be aware of access to emergency services. Know whether the country has a method to access emergency services should an issue arise. In addition, it is important to know how to direct the patient to seek care in that country should he/she need it.
    • You may not be able to bill insurance if the patient is located out of state or in another country. If you are billing the patient through insurance, services may be denied. In addition to checking with the licensing board, when applicable, you should also check with the patient’s insurer to determine if there will be reimbursement for services.
  • Determine whether ongoing treatment is appropriate via telebehavioral health (or phone). Not every patient is a candidate for distance treatment, particularly if he/she has periods of instability and diagnoses that are not effectively treated via technology. We discuss these issues more in depth in our resource: “Telebehavioral Health: Considerations in the Changing Practice Landscape,” which can be found in the Article tab.
  • Ensure the patient is aware of how to access emergency services should he/she need it. Discuss when to seek emergency care and how to do so. It may be important to determine the patient’s location at the outset of each session. It may be critical to be aware of the patient’s location, particularly if he/she decompensates, and emergency services are warranted. When providing distance treatment, it is your responsibility to be aware of how the patient can access emergency services when providing distance treatment.
  • When in doubt, seek advice. There are a number of resources available should you consider engaging in telebehavioral health with a patient who is away at college. For example, “Telebehavioral Health: Considerations in the Changing Practice Landscape,” has references which may provide additional information. Further, check your state licensing board website for additional state specific resources. Keep in mind that each case is different. Seek advice from an attorney should you have questions.
 

Kristen Lambert, JD, MSW, LICSW, CPHRM, FASHRM
Healthcare Practice and Risk Management Innovation Officer
Trust Risk Management Services, Inc.
email: contact@trustrms.com

 

NOTE: This information is provided as a risk management resource and is not legal advice or an individualized personal consultation.  At the time this resource was prepared, all information was as current and accurate as possible; however, regulations, laws, or prevailing professional practice standards may have changed since the posting or recording of this resource. Accordingly, it is your responsibility to confirm whether regulatory or legal issues that are relevant to you have since been updated and/or to consult with your professional advisors or legal counsel for timely guidance specific to your situation. As with all professional use of material, please explicitly cite The Trust as the source if you reproduce or distribute any portion of these resources.  Reproduction or distribution of this resource without the express written permission of The Trust Companies is strictly prohibited.