Wyoming Mental Health Professions Licensing Board Rules and Regulations have been adopted by the Board and filed with the Secretary of State's Office effective December 16, 2020. AMERICAN COUNSELING ASSOCIATION CODE OF ETHICS Section H Distance Counseling, Technology, and Social Media "Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions. Counselors actively attempt to understand the evolving nature of the profession with regard to distance counseling, technology, and social media and how such resources may be used to better serve their clients. Counselors strive to become knowledgeable about these resources. Counselors understand the additional concerns related to the use of distance counseling, technology, and social media and make every attempt to protect confidentiality and meet any legal and ethical requirements for the use of such resources. H.1. Knowledge and Legal Considerations H.1.a. Knowledge and Competency Counselors who engage in the use of distance counseling, technology, and/ or social media develop knowledge and skills regarding related technical, ethical, and legal considerations (e.g., special certifications, additional course work). H.1.b. Laws and Statutes Counselors who engage in the use of distance counseling, technology, and social media within their counseling practice understand that they may be subject to laws and regulations of both the counselor’s practicing location and the client’s place of residence. Counselors ensure that their clients are aware of pertinent legal rights and limitations governing the practice of counseling across state lines or international boundaries. H.2. Informed Consent and Security H.2.a. Informed Consent and Disclosure Clients have the freedom to choose whether to use distance counseling, social media, and/or technology within the counseling process. In addition to the usual and customary protocol of informed consent between counselor and client for face-to-face counseling, the following issues, unique to the use of distance counseling, technology, and/ or social media, are addressed in the informed consent process: H.2.b. Confidentiality Maintained by the Counselor Counselors acknowledge the limitations of maintaining the confidentiality of electronic records and transmissions. They inform clients that individuals might have authorized or unauthorized access to such records or transmissions (e.g., colleagues, supervisors, employees, information technologists). H.2.c. Acknowledgment of Limitations Counselors inform clients about the inherent limits of confidentiality when using technology. Counselors urge clients to be aware of authorized and/or unauthorized access to information disclosed using this medium in the counseling process. H.2.d. Security Counselors use current encryption standards within their websites and/or technology-based communications that meet applicable legal requirements. Counselors take reasonable precautions to ensure the confidentiality of information transmitted through any electronic means. H.3. Client Verification Counselors who engage in the use of distance counseling, technology, and/or social media to interact with clients take steps to verify the client’s identity at the beginning and throughout the therapeutic process. Verification can include, but is not limited to, using code words, numbers, graphics, or other nondescript identifiers. H.4. Distance Counseling Relationship H.4.a. Benefits and Limitations Counselors inform clients of the benefits and limitations of using technology applications in the provision of counseling services. Such technologies include, but are not limited to, computer hardware and/or software, telephones and applications, social media and Internet-based applications and other audio and/or video communication, or data storage devices or media. H.4.b. Professional Boundaries in Distance Counseling Counselors understand the necessity of maintaining a professional relationship with their clients. Counselors discuss and establish professional boundaries with clients regarding the appropriate use and/or application of technology and the limitations of its use within the counseling relationship (e.g., lack of confidentiality, times when not appropriate to use). H.4.c. Technology-Assisted Services When providing technology-assisted services, counselors make reasonable efforts to determine that clients are intellectually, emotionally, physically, linguistically, and functionally capable of using the application and that the application is appropriate for the needs of the client. Counselors verify that clients understand the purpose and operation of technology applications and follow up with clients to correct possible misconceptions, discover appropriate use, and assess subsequent steps. H.4.d. Effectiveness of Services When distance counseling services are deemed ineffective by the counselor or client, counselors consider delivering services face-to-face. If the counselor is not able to provide face-to-face services (e.g., lives in another state), the counselor assists the client in identifying appropriate services." Wyoming Mental Health Professions Licensing Board Rules and Regulations have been adopted by the Board and filed with the Secretary of State's Office effective December 16, 2020 NATIONAL ASSOCIATION OF SOCIAL WORKERS CODE OF ETHICS 1. Social Workers' Ethical Responsibilities to Clients 1.03 Informed Consent "(e) Social workers should discuss with clients the social workers’ policies concerning the use of technology in the provision of professional services. (f) Social workers who use technology to provide social work services should obtain informed consent from the individuals using these services during the initial screening or interview and prior to initiating services. Social workers should assess clients’ capacity to provide informed consent and, when using technology to communicate, verify the identity and location of clients. (g) Social workers who use technology to provide social work services should assess the clients’ suitability and capacity for electronic and remote services. Social workers should consider the clients’ intellectual, emotional, and physical ability to use technology to receive services and the clients’ ability to understand the potential benefits, risks, and limitations of such services. If clients do not wish to use services provided through technology, social workers should help them identify alternate methods of service. (h) Social workers should obtain clients’ informed consent before making audio or video recordings of clients or permitting observation of service provision by a third party. (i) Social workers should obtain client consent before conducting an electronic search on the client. Exceptions may arise when the search is for purposes of protecting the client or other people from serious, foreseeable, and imminent harm, or for other compelling professional reasons." Wyoming Mental Health Professions Licensing Board Rules and Regulations have been adopted by the Board and filed with the Secretary of State's Office effective December 16, 2020 AMERICAN ASSOCIATION FOR MARRIAGE AND FAMILY THERAPY CODE OF ETHICS Wyoming Mental Health Professions Licensing Board Rules and Regulations have been adopted by the Board and filed with the Secretary of State's Office effective December 16, 2020 STANDARD VI TECHNOLOGY-ASSISTED PROFESSIONAL SERVICES "6.1 Technology Assisted Services. Prior to commencing therapy or supervision services through electronic means (including but not limited to phone and Internet), marriage and family therapists ensure that they are compliant with all relevant laws for the delivery of such services. Additionally, marriage and family therapists must: (a) determine that technologically- assisted services or supervision are appropriate for clients or supervisees, considering professional, intellectual, emotional, and physical needs; (b) inform clients or supervisees of the potential risks and benefits associated with technologically-assisted services; (c) ensure the security of their communication medium; and (d) only commence electronic therapy or supervision after appropriate education, training, or supervised experience using the relevant technology. 6.2 Consent to Treat or Supervise. Clients and supervisees, whether contracting for services as individuals, dyads, families, or groups, must be made aware of the risks and responsibilities associated with technology-assisted services. Therapists are to advise clients and supervisees in writing of these risks, and of both the therapist’s and clients’/supervisees’ responsibilities for minimizing such risks. 6.3 Confidentiality and Professional Responsibilities. It is the therapist’s or supervisor’s responsibility to choose technological platforms that adhere to standards of best practices related to confidentiality and quality of services, and that meet applicable laws. Clients and supervisees are to be made aware in writing of the limitations and protections offered by the therapist’s or supervisor’s technology. 6.4 Technology and Documentation. Therapists and supervisors are to ensure that all documentation containing identifying or otherwise sensitive information which is electronically stored and/or transferred is done using technology that adhere to standards of best practices related to confidentiality and quality of services, and that meet applicable laws. Clients and supervisees are to be made aware in writing of the limitations and protections offered by the therapist’s or supervisor’s technology. 6.5 Location of Services and Practice. Therapists and supervisors follow all applicable laws regarding location of practice and services, and do not use technologically-assisted means for practicing outside of their allowed jurisdictions. 6.6 Training and Use of Current Technology. Marriage and family therapists ensure that they are well trained and competent in the use of all chosen technology-assisted professional services. Careful choices of audio, video, and other options are made in order to optimize quality and security of services, and to adhere to standards of best practices for technology-assisted services. Furthermore, such choices of technology are to be suitably advanced and current so as to best serve the professional needs of clients and supervisees." We are not aware of any specific rules and regulations of the practice of telemental health services for Psychologists. We are not aware of any specific rules and regulations of the practice of telemental health services for Psychiatrists. No References found. “As a party state to the Nurse Licensure Compact (NLC), Wyoming issues multistate licenses to nurses and applicants who reside in the state and recognizes multistate licenses issued by other party states, for practice in Wyoming. A nurse holding a multistate license is entitled to practice in any NLC party state, but must comply at all times with the laws of the state where he or she is currently practicing.” “It should be noted that not every state in the US is an NLC party state; a map of participating states, as well as further resources related to the NLC, are available on the Nurse Licensure Compact website.” Refer to the source provided for all requirements and limitations. No References found. Source: WY Dept. of Public Health Insurance, Medicaid, CMS 1500 ICD-10, p. 111-110 (July. 1 2019) "Each site will be able to bill for their own services as long as they are an enrolled Medicaid provider (this includes out-of-state Medicaid providers). Providers shall not bill for both the spoke and hub site. Any telehealth provider such as Community Mental Health Centers and Substance Abuse Treatment Centers can bill telehealth services where the provider is at one location and the client is at a different location even though the pay to provider is the same. A single pay to provider can bill both the originating site (spoke site) and the distant site provider (hub site) when applicable." Approved Originating Sites includes: Client’s Home (Telehealth consent form must be completed and kept in the client’s medical records) Refer to the source provided for all requirements and limitations. We are not aware of any explicit payment parity. *Clinicians who have had an experience with telehealth reimbursement in this state are invited to share their experiences in the comments section below: a) type of service provided; b) insurance provider; c) payment parity, payment issues, or insurance requirements. We are not aware of any permission that allows for services delivered by out-of-state providers.Counselors
Social Workers
Marriage and Family Therapists
Psychologists
Psychiatrists
Wyoming Professional Regulation/Health & Safety Online Prescribing
Nurses
Wyoming Professional Regulation/Health & Safety Online Prescribing
Medicaid Telehealth Parity Law
Payment Parity
Permission for the Temporary Practice of Clinicians Licensed Outside the State
Wyoming
Note: As this is a free resource and Rules and Regulations regarding Telehealth are always changing, we appreciate any updates or corrections. They can be emailed to us at [email protected] with a link to the source or a citation of the rule or regulation.
Telemental health is not a separate service from mental health services. All state licensing boards require that licensed clinicians follow all the regulations for practicing under their license no matter what medium of communication is used. All licensing boards also require that clinicians only practice within the boundaries of their competence. This usually requires education, continuing education, and/or supervision in telemental health. Complete our telehealth training program to cover all the essential competencies of providing telemental health services and earn the THTC (Telemental Health Training Certificate).