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Coronavirus (COVID-19)

We have created this webpage as a resource for LPCs, LMFTs, registered associates, and applicants in response to the coronavirus.  We will continue to add information as we learn of new developments and in response to stakeholder concerns.  Please remember that agency staff is unable to respond to requests for legal or clinical advice.  The Board cannot advise or make comment on the Governor’s orders, insurance reimbursements, federal regulations such as HIPAA, or the happenings of outside organizations such as CACREP.  You will need to contact those associated entities with questions related to their programs.

Important!  Notwithstanding updated masking guidance, whether vaccinated or not, all licensees, registered associates and other behavioral health providers are reminded that as designated healthcare providers, we fall under the most recent OHA Guidelines for healthcare settings and both clinicians and clients are currently required to wear face coverings.  OHA and OSHA are reviewing the mask mandate and will notify OBLPCT if that status changes; until then, the mask mandate remains in effect.

Statement on Distance Counseling

Given the current health crisis, the need for mental health services is expected to dramatically increase, and distance counseling may be appropriate in a greater number of cases.  If you choose to provide counseling by electronic means, please review the section in the ACA Code of Ethics pertaining to distance counseling.  Although the ethics rules do not expressly require training in distance counseling, the rules do require knowledge and competency, and so training is highly recommended.

Questions and Answers

The following FAQs are broken down by subject area. 

Telehealth

1.    Are there any guidance materials on tele-therapy?
Please see below, under “Resources.”  There is no additional certification required for Oregon LPCs and LMFTs (or registered associates) to practice teletherapy in Oregon.

2.    Is there any exception that allows me to practice in other states or countries?
We cannot answer this question for other jurisdictions, but understand that many are reviewing their laws and making changes to allow such practice, so please check with the individual jurisdiction.

3.    Is there any exception that allows licensees from other states to practice in Oregon?
No.  Oregon law requires a license or registration with the Board in order to practice professional counseling or marriage and family therapy in Oregon, with some limited exemptions.   The Apply for a License webpage contains the necessary forms and instructions.
 
4.    Will insurance coverage for telehealth continue?  
On June 1, 2021, House Bill 2508 was signed into law.  This stipulates that in Oregon, telemedicine shall be reimbursed at the same rate as in-person services.  We recommend you contact insurance companies directly to determine the appropriate billing codes.

5.    Isn’t it unethical and unsafe for you to not continue to see your out-of-state clients via telehealth?  
Check with the Board of the state where your client is located at the time of your provision of services.  Prepare your client for the possibility that licensure requirements might require them to see a practitioner who is licensed in their state.

6.    Do you need to substitute virtual for physical sessions if you are unable to engage in physical distancing in your office (i.e., very small office space which will not allow for 6 feet distancing at all times)?
Yes.  LPCs, LMFTs, and registered associates are considered health care providers. Please reference the most current OHA guidelines for clinics. Masks and distancing are currently required and will be until the Governor’s Executive Orders are lifted and the OHA and CDC declares that masks and social distancing are no longer necessary.  When determining whether or not to see clients in person, consider your client’s safety and carefully document your rationale for choosing to see clients in person as well as what actions you took to ensure their safety. 

7.    What changes in documentation should be considered when providing telehealth services during the pandemic?
When providing telehealth services, you should consider documenting in your clinical files that the session was conducted over telehealth, if an alternate platform was used and why (e.g., power outage necessitated a telephone call instead of video), where the client was at the time of the session, and how confidentiality was protected (e.g., did you ask if there were others in the house/room). 

Seeing Clients In-Person

8.    What issues should be considered when deciding whether to see clients in person?
These factors should be considered when making your decision [not in any particular order].  This is not intended as an exhaustive list. 
1. Compliance with the Governor’s Executive Orders, Oregon Health Authority guidance and rules, and Board rules regarding COVID-19,
2. Notifying clients about your COVID-19 mitigation and risk reduction requirements, 
3. Notifying co-workers, office partners, and landlords of resumption of in-office work, 
4. Ensuring sufficient procedures and supplies for PPE and office sanitation [see links below],
5. Evaluating risk factors for yourself, and for all of those with whom you share office space, and their respective family members, 
6. Having a policy in place if your clients are unable or unwilling to wear a mask, or get the vaccine, 
7. Sufficient air filtration systems [HEPA filters in a building’s HVAC system, or HEPA filters in rooms where patients will be seen],
8. An informed consent form regarding COVID-19,
9. A waiver of liability form regarding COVID-19, 
10. Vaccine availability for yourself and patients, and staff. 

9.    If both my client and I have been fully vaccinated for COVID-19, may we resume meeting for therapy in person in my office?
Some therapists are now seeing clients in person.  Licensees should consider what is in their clients’ best interest in determining whether or not to meet in person; they should guard against taking action that meets their needs rather than their clients’ needs.  Transitioning back to in-person visits should be limited to those individuals for whom the benefits outweigh the risks, including the therapist's.  Optimally, the therapist will consider the individual needs of the client (e.g., health vulnerabilities, access to technology, age, nature of the clinical or assessment requirements, etc.), of themselves, and the emerging research on COVID-19.  Therapists should seek information from the Oregon Health Authority, the CDC, and from other workplace health advisories to inform their decision making.  Best practices at this time should include, at a minimum, informed consent, continued distancing and masking, consideration of patient traffic and ability of your facility to maintain sanitary conditions, and attention to air exchange and filtration.  Therapists should document their rationale for seeing clients in person as well as their safety practices.

10.    Is informed consent required to see patients in-person now?   
It is the therapist’s ethical responsibility to obtain informed consent regarding any potential risk related to participating in therapy services, including the ongoing risk of contagion during the current pandemic.  You may also want to consider asking your in-person client to sign a waiver of liability if they contract COVID-19 while in your office. 

11.    How should I document when a new client arrives at my office without a vaccination card, as instructed by my informed consent document?  
While documentation may be more complete with a filed copy of the vaccination card, you may wish to write, “Client stated that she was fully vaccinated and now beyond the 14-day waiting period”, with an explanation of when she will add a copy of her vaccination card, or the reason why you will choose to do otherwise.

12.    What cleaning protocols and rules regarding masks does the Board recommend? 
The Board does not recommend specific safety practices.  You are referred to the public health entities that address this (CDC, OHA, other).  However the Board is responsible for addressing any violation of the Governor’s order.  Please consider recommendations from CDC, OHA, and other relevant health authorities when considering a return to in-person practice.

13.    What are proper screening procedures according to the CDC?
Please see the Centers for Disease Control and Prevention's CDC Facilities COVID-19 Screening.

14.    When does the mask requirement apply?
The June 30, 2021 OHA mask requirement applies to all providers regardless of vaccination status wherever they are providing behavioral health care services.  Starting August 13, 2021, all clients are also required by the current Governor’s order to wear masks in all indoor public places, including their appointments with therapists. 

15.    May I inquire about a person’s vaccination before returning to in-person treatment?  Can we require clients to show proof of vaccines?  
Offering in-person appointments only to full-vaccinated people is not discriminatory.  Clients are free to decline sharing their vaccination status and can then be offered remote sessions.  Regardless of vaccination status, in-person sessions require masks at all times, social distancing, sanitation measures and documentation as described below in “Resources”.

If a complaint is submitted to the Board regarding this question, the Board will consider whether the practitioner is acting in an ethical manner and is in compliance with the Governor’s orders and OHA requirements.  Health information about the spread of coronavirus is frequently updated, and the most recent OHA recommendations, along with the therapist's own health issues, should be key considerations as well.

16.    What if a client does not want to comply with your safety practices (such as wearing a mask, hand washing, social distancing)?   
In a manner that respects Oregon law and ACA Ethical Principles (including, for example, weighing the directives regarding nonmaleficence and non-abandonment), you may offer telehealth or refer to another provider.

17.    Can I see a client in my office without wearing masks if they are not concerned about the risk of COVID-19?
The Oregon Health Authority has established masking requirements that apply in healthcare settings (OAR 833-019-1011).  The requirement applies to both providers and patients/visitors in healthcare settings, with exceptions delineated in the rule.  Please refer to OHA’s Health Care Setting Masking Requirements FAQ, which explains that settings where behavioral health services are offered (including private practice) are considered healthcare settings subject to the masking requirement.  Practitioners should carefully document thought processes and actions regarding masking.

18.    What changes in documentation should therapists consider when providing services in-person during the pandemic/quarantine?
Therapists should document the clinical reasons when the services were provided in-person, and if so, how OHA/CDC requirements were met (e.g. if masks were worn, social distancing precautions implemented, or other safety precautions provided such as increased ventilation, air filtration devices, etc.)

19.    What are the guidelines regarding having therapy sessions at an ADU or private outdoor garden at our place of residence?  
Therapists are responsible for conducting their practices in a professional manner, and for ensuring a setting that allows for confidential communications.

20.    What if my office partner continues to see in-person clients during the pandemic?
Some therapists are now seeing clients in-person.  Licensees who work in an independently owned clinic or who practice in a shared office space setting with staff are encouraged to adopt policies around COVID-19 that takes into consideration safety, ethics, and professional conduct as they relate to OAR 833-110-0041, the Governor’s Executive Orders, and guidelines put out by the Oregon Health Authority in order to minimize risk and disease exposure and to limit the spread of the virus.

Other Board-Related, Ethical, and Legal Considerations

21.    Is the Board canceling meetings?
Not at this time.  If a previously noticed public meeting is canceled, it will be noted on the Board Meetings webpage.

22. Is the Agency office still open?

We have not changed our normal operating hours; however, to minimize the unnecessary added risk of exposure to our staff and others in our building, we strongly encourage electronic communications to our office only.  The Building was closed to the general public beginning March 23, 2020.  Then as of May 2, 2022, the office has reopened by pre-arranged appointment only and on an as-needed basis.

23.    Has the Board issued any official statement or advice regarding COVID-19?
Nothing has been issued specific to the Board besides the information on this webpage.  Please see below for other resources.

24. Is the Board amending any of the educational or experience requirements for licensure?

No, the Board is not considering amending the education requirements in OAR 833-030-0011 and OAR 833-040-011 at the present time.

25. Is the Board making changes to the continuing education requirements?

Effective 6/8/20, the Board has adopted an extension to the Continuing Education (CE) requirements. CE reporting and auditing for the year 2020 has ceased.  All licensees, even those who already reported CE in 2020, will report 80 clock hours of CE in the year 2022, instead of reporting 40 hours in 2020 and 40 hours in 2022.  All CE documentation must be saved for reporting in the year 2022.  Please see our CE Webpage for more details and helpful charts.  Note: All licensees will continue to renew their licenses annually as usual. There are no waivers of the renewal or fee requirements.  Please note that under current OAR 833-080-0041, all continuing education hours may be obtained via home study (distance learning).

26. Can an registered associate or licensee under disciplinary supervision receive individual supervision from their supervisor by electronic means?

Yes.  Under prior OAR 833-050-0081, at least 25% of registered associate supervision was required to be conducted in-person.  However, in response to the pandemic, the Board has filed a Temporary Rule Amendment, effective March 18 - September 13, 2020, that allowed for 100% electronic delivery of supervision for registered associates and those under disciplinary supervision. Subsequently, on October 2, 2020, the Board filed a Permanent Rule Amendment that now permanently allows 100% of supervision hours to be conducted through live, synchronous confidential electronic communications.

27. Are there any changes being made for application-related forms that must be sent by paper mail? 
Yes. Please see our Temporary Changes to Application Form Procedures in Response to COVID-19.

28. How can I keep my application/registration active when I cannot take the national exam due to exam site closures? 
Applicants, including registered associates, need to remember that there are timelines to take the exam.  If you are nearing expiration, the Board will grant all extension requests under the current emergency circumstances.  But you will need to send your written request for an extension to the deadline prior to the exam deadline that you face.  Please request the extension through the Exams page. 

29.   Can a licensee or registered associate be sanctioned by the Board if they do not comply with the Governor's Executive Orders related to COVID-19?
Yes.  OAR 833-110-0041 (effective 10/2/20) is a permanent rule which sets forth that failure to comply with any applicable provision of a Governor’s Executive Order, including failure to comply with Oregon Health Authority (OHA) guidance, constitutes gross negligence.  Violations are subject to Board sanction and include, but are not limited to: engaging in the practice of a profession required by an Executive Order to be closed; failing to screen clients in accordance with OHA guidance prior to providing services; failing to limit the number of individuals inside the premises or implement other protocols necessary to maintain physical distancing of six (6) feet; failing to implement OHA guidance on mask and face coverings; and failing to clean and disinfect in accordance with OHA guidance.  This applies to current and future Executive Orders that might be issued during a Governor declared emergency.  Please refer to the OHA guidance below, under Resources.

30.    What do we do if we become aware of colleagues or clients violating the Governor’s Executive Orders?
Violations of the Governor’s Executive Orders by licensees and registered associates constitute gross negligence.  Licensees and registered associates have a duty to report such violations to the health professional regulatory board responsible for the licensee or registrant (per ORS 676.150).  The Board may impose sanctions for violations of the Governor’s Executive Orders or Oregon law (in accordance with ORS 675.745).  In a related question regarding violations of OAR 333-019-1010, which stipulates that all health care providers and staff in healthcare settings are required to be fully vaccinated or request an exemption by October 18, 2021, employers of healthcare providers or healthcare staff, or other responsible parties are subject to civil penalties by the Oregon Health Authority of $500 per day per violation.  (See also OAR 333-019-1030 for teachers and school staff)

Other ethical principles prevail if we become aware of clients violating the Governor’s Executive Orders. In short, therapists are bound by the limits of confidentiality (ORS 40.230).

31.    What possible sanctions or penalties might I incur if I, as a licensee, fail to comply with the Governor's Executive Order during an emergency?
OAR 833-110-0041 was adopted by the Board at the direction of the Governor’s office. This rule gives the Board the authority to enforce the Governor’s Executive Orders that have been put in place during the COVID-19 declared emergency, and are necessary to keep Oregonians healthy and safe. Failure of a registered associate, LPC, or LMFT to comply with the Governor’s Executive Order is considered gross negligence, and the Board may impose sanctions for violations of this rule in accordance with ORS 675.745 up to and including revocation and civil penalties not to exceed $2,500 for each occurrence.

32.    Are we mandated to report a client exposed to or who has contracted COVID-19 to contact tracers from the health department?
The OHA regulation does not require LPCs, LMFTs, or registered associates to report to contact tracers, and it would be a violation of confidentiality if you reported without written consent.

33.    I heard that there is a new exception to confidentiality that requires Oregon health professional licensees to report potential infections.  Is this true?
No, this is not true.  The Board will communicate with all licensees, applicants, and registered associates, if we learn of any changes to the confidentiality requirements or other laws applicable to licensed health professionals. Recently enacted House Bill 3057 specifies that “The Oregon Health Authority may disclose individually identifiable information related to COVID-19 that is reportable under ORS 433.004 and rules adopted by the authority if the authority determines that the disclosure is necessary for the evaluation, treatment or care coordination of individuals who have been tested for COVID-19 or individuals who have had a substantial exposure to COVID-19, or is necessary for the state’s COVID-19 response and recovery efforts, to:  …A health care provider…” (among others). However, any such disclosure would come from the OHA, not the provider.

34.    Do LPCs and LMFTs have a duty to warn if we become aware that clients are knowingly interacting with others without social distancing/wearing masks thereby putting others at risk?  
Licensees in Oregon do not have a duty to warn and must adhere to client privilege.

35.    Is it unlawful for health systems/clinics to mandate return to in-person services?
The Board recommends that you check with your human resources representative, your labor union, or professional association regarding your options.

36.    Are licensees mandated to get the COVID-19 vaccine?
Yes.  Under OAR 333-019-1010 all Oregon health care providers and health care staff must be fully vaccinated against COVID-19 or request an exemption by October 18, 2021.  A violation of any part of this regulation will result in a penalty of $500 from OHA for each day of non-compliance.  Please also see OHA's Healthcare Provider and Healthcare Staff Vaccine Rule FAQs.

37.    Should I send my request for vaccination exemption to the Board?
No.  The Board is not authorized to grant variances to public health rules established by the Oregon Health Authority, and therefore has no process to accept exemption requests. Please refer to OHA’s Exemptions Instructions.

38.    Who should I contact if I have questions or don’t agree with OHA guidelines or rules?
LPCs, LMFTs, and registered associates (along with all other designated health care providers) are required to comply with OHA rules and guidance regarding COVID-19, prior to and while providing services.  Our inclusion as health care providers allowed us to receive COVID-19 vaccines ahead of other groups when vaccines were first available, and it requires us to continue to comply with OHA guidance regarding COVID-19 mitigation until the state of emergency is lifted.  Licensees may contact OHA with their questions, objections or concerns regarding OHA guidelines at https://www.oregon.gov/oha. You may also submit public comments to OHA regarding COVID-19 related proposed rules.

39.  Now that I'm working from home, is it OK for me to use a PO Box as my public address, and on my professional disclosure statement (PDS)?

The Board has always allowed licensees and registered associates to use a PO Box for their business address.

40.    How can I help during the pandemic or other emergencies?
Counselors, therapists, and other healthcare providers may register for the SERV-OR roster of volunteers in response to local, state, and/or federal emergencies, to support fellow health professionals and communities in times of crisis.  The American Red Cross also needs disaster mental health volunteers.

Resources

Distance Counseling:

State and federal response to COVID-19: