R.I.’s legislative focus includes telehealth services

The Rhode Island Psychological Association 2017 legislative agenda will include a focus on telehealth services as well as the goal of improving the ability of the Board of Psychology to investigate and adjudicate disciplinary complaints faster.

Peter M. Oppenheimer, Ph.D., chair of the RIPA Legislative Committee, said for the second consecutive year, RIPA will introduce the Psychology Interjurisdictional Compact (PSYPACT), which enables interstate telepsychology practice for psychologists in participating states.

PSYPACT, approved in 2015 by the Association of State and Provincial Psychology Boards, becomes operational once seven states enact it. In 2016, Arizona became the first state to enact PSYPACT and Rhode Island is among states proposing it for 2017 legislative sessions.

Once enacted, licensed psychologists in participating states will obtain a credential called the “E.Passport” that would allow them to provide telehealth services to clients in other participating states and would also be able to practice up to 30 days on the ground in those states, Oppenheimer said.

“We’re trying to adapt and be able to provide people with quality, effective services in ways that work for them,” Oppenheimer said. “People are becoming more mobile and telepsych is showing itself in research to be appropriate and effective in certain situations.”

Oppenheimer said telepsych isn’t meant to be a replacement for in-office treatment, noting, “Face-to-face work is always going to be important. This is just an extension that I think is part of providing up-to-date service.”

“I’ve had multiple people who were home following hospital care, who physically can’t come in for treatment or can’t be out due to immune suppression issues,” Oppenheimer said.

In addition to patients battling illness, other instances where telepsychology services could come into play include college students who go to school out of state for the school year and people who travel frequently.

Additionally, “We could work out an arrangement with an institution that could help us provide services in rural areas” and parts of the country where there is a shortage of psychologists, Oppenheimer said.

“Medicine is doing it, nursing is doing it,” he said of telehealth services. “It’s just developing the way that healthcare is done.”

Currently, telepsychology isn’t a billable insurance service in Rhode Island, but that will change in January 2018 because of the 2016 passage in Rhode Island of The Telemedicine Coverage Act, which requires health insurers to reimburse for medically appropriate telemedicine services in the same manner as for health care services provided through in-person treatment.

Oppenheimer said RIPA will monitor the implementation of that legislation, to help ensure parity in both treatment and reimbursements, for telepsychology vs. face-to-face services.

Also in 2017, RIPA will introduce an update to the state’s Rules and Regulations for Licensing Psychologists that seeks to increase the size of the Board of Psychology within the R.I. Department of Health from five to seven members. The board currently allows for four psychologists and one public member, but if passed, the update would add two psychologists to the board.

Under Department of Health rules, when conducting an investigation of a complaint, the Board must establish an investigative committee that does not include all board members, “So that if there’s a hearing, the other board members become a hearing board, untainted by doing the investigation,” Oppenheimer explained.

“These cases are very complicated and it really takes a team of three to do the job right,” he said. If the board expands to seven, it would allow for three members to conduct the investigation and three others to sit on the hearing board. “Having two teams would help us process complaints more quickly,” he said.

Oppenheimer said RIPA would also introduce a change to the state’s Open Meetings law that he believes would help professional health care licensing boards work more efficiently.

Currently, investigations can only be discussed in formal meetings, Oppenheimer said. The change that would be introduced would enable boards to meet in executive sessions without necessarily having to hold them during those formal meetings. “Many boards, including Psychology, have few face-to-face meetings each year,” he said. “Decisions on disciplinary cases can only be made within those meetings. We want to enable boards to resolve cases promptly when they are able to do so.”

Currently, a complaint might not be heard for several months until the next formal meeting, which Oppenheimer said isn’t fair to the person who filed the complaint or to the psychologist whom the complaint is against.

The revision would allow for departments to post an executive session separate from their regular meetings to have a resolution much more quickly. “We want to preserve all the rules for the open part of meetings – just find a way to enable us to work practically and efficiently in service of protecting the public and respecting the interest of the party.”