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    Maryland Register

    Issue Date:  January 18, 2019

    Volume 46 • Issue 2 • Page 69-71

    Title 10 


    10.36.10 Telepsychology

    Authority: Health Occupations Article, §§1–901—1–903, Annotated Code of Maryland

    Notice of Proposed Action


    The Secretary of Health proposes to adopt new Regulations .01—.06 under a new chapter, COMAR 10.36.10 Telepsychology.

    At this time, the Secretary is also withdrawing new Regulations .01—.04 under a new chapter, COMAR 10.36.10 Telepsychology, as proposed in 45:2 Md. R. 114—115 (January 19, 2018).

    This action was considered by the Board of Psychologists at a public meeting held on November 2, 2018, notice of which was given by publication on the Board’s website at https://health.maryland.gov/psych/Pages/home.aspx pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

    Statement of Purpose

    The purpose of this action is to:

    (1) Define the term telepsychology;

    (2) Require that an individual be licensed with the Board as a psychologist or registered with the Board as a psychology associate in order to engage in the practice of psychology using telepsychology in Maryland if either the client or the psychologist or psychology associate is physically located in Maryland; and

    (3) Establish standards of practice for telepsychology for licensed psychologists and registered psychology associates.

    Comparison to Federal Standards

    There is no corresponding federal standard to this proposed action.

    Estimate of Economic Impact

    The proposed action has no economic impact.

    Economic Impact on Small Businesses

    The proposed action has minimal or no economic impact on small businesses.

    Impact on Individuals with Disabilities

    The proposed action has no impact on individuals with disabilities.

    Opportunity for Public Comment

    Comments may be sent to Jake Whitaker, Acting Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through February 19, 2019. A public hearing has not been scheduled.

    .01 Scope.

    This chapter applies to all psychologists and psychology associates in Maryland who engage in the practice of psychology using telepsychology.

    .02 Definitions.

    A. In this chapter, the following terms have the meanings indicated.

    B. Terms Defined.

    (1) “Board” means the Maryland Board of Examiners of Psychologists.

    (2) “Client” means the individual, couple, family, group, business, agency, school, organization, or association that the psychologist or psychology associate provides, or has provided, with professional services.

    (3) “Psychologist” means an individual who is licensed by the Board to practice psychology.

    (4) “Psychology associate” means an individual who is registered by the Board to practice psychology under the supervision of a licensed psychologist.

    (5) Telepsychology.

    (a) “Telepsychology” means the use of interactive audio, video, or other telecommunications or electronic media by a psychologist or psychology associate who engages in the practice of psychology at a location other than the location of the client.

    (b) “Telepsychology” does not include:

    (i) An audio-only telephone conversation between a psychologist or psychology associate and a client;

    (ii) An electronic mail message between a psychologist or psychology associate and a client;

    (iii) A facsimile transmission between a psychologist or psychology associate and a client; or

    (iv) A text message or other type of message sent between a psychologist or psychology associate and a client by a short message service or multimedia messaging service.

    .03 Licensure.

    An individual shall be licensed with the Board as a psychologist or registered with the Board as a psychology associate in order to engage in the practice of psychology using telepsychology in Maryland if one or both of the following occurs:

    A. The individual practicing telepsychology is physically located in Maryland: or

    B. The client is in Maryland.

    .04 Standards of Practice for Telepsychology.

    A. Before providing telepsychology services, a psychologist or psychology associate shall develop and follow a procedure to:

    (1) Verify the identification of the client receiving telepsychology services;

    (2) Obtain written informed consent specific to telepsychology services using appropriate language understandable to the client;

    (3) Prevent access to data by unauthorized persons through encryption, or other means;

    (4) Notify clients in the event of a data breach;

    (5) Ensure that the telepsychology practitioner provides a secure and private telepsychology connection and complies with federal and state privacy laws;

    (6) Establish safety protocols to be used in the case of an emergency, including contact information for emergency services at the client’s location; and

    (7) Ensure that any psychological testing instruments used are designed, validated, or appropriate for use via telepsychology.

    B. A psychologist or psychology associate shall:

    (1) Obtain or confirm an alternative method of contacting the client in case of a technological failure;

    (2) Determine whether the client is in Maryland and identify the client’s specific location;

    (3) For an initial telepsychology interaction only, disclose the psychologist’s or psychology associate’s name, location, license number, and contact information;

    (4) Identify all individuals present at each location and confirm they are permitted to hear the client’s health information; and

    (5) Be held to the same standards of practice and documentation as those applicable for in-person sessions.

    C. A psychologist or psychology associate may not treat a client based solely on an online questionnaire.

    .05 Evaluation for Telepsychology Services.

    A. Before engaging in the practice of psychology using telepsychology, a psychologist or psychology associate shall evaluate the client to determine that delivery of telepsychology is appropriate considering at least the following factors:

    (1) The client’s:

    (a) Diagnosis;

    (b) Symptoms;

    (c) Medical and psychological history; and

    (d) Preference for receiving services via telepsychology; and

    (2) The nature of the services to be provided, including anticipated:

    (a) Benefits;

    (b) Risks; and

    (c) Constraints resulting from their delivery via telepsychology.

    B. The client evaluation set forth in §A of this regulation shall take place at an initial in-person session, unless the psychologist or psychology associate documents in the record the reason for not meeting in person.

    .06 Discipline.

    A. The Board shall use the same standards in evaluating and investigating a complaint and disciplining a psychologist or psychology associate who practices telepsychology as it would use for a psychologist or psychology associate who does not use telepsychology technology in the licensee’s practice.

    B. The failure of a psychologist or psychology associate to comply with this chapter shall constitute unprofessional conduct and may be subject to disciplinary action by the Board.

    Secretary of Health