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Coronavirus (COVID-19)

We have created this webpage as a resource for psychologists, residents, and applicants in response to the coronavirus.  We will continue to add information and resources 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 reimbursement, federal regulations such as HIPAA, or the happenings of outside organizations such as APA.  You will need to contact those associated entities with questions related to their programs.

COVID-19 Workgroup

Decisions made by a psychologist about their pandemic practices should reflect a careful and thoughtful process. At a minimum, the psychologist should consider the welfare and safety of the client and family members, specifics of relevant public health orders and workplace safety advisories (e.g., personal distancing options and ventilation), and legal and ethical standards for psychologists. Included at the end of this list of FAQs are guidance documents from professional organizations such as the American Psychological Association, The Trust, the Association of State and Provincial Psychology Boards, and the Centers for Disease Control that may also help to highlight the many health and safety factors under consideration. Sample forms are also included as an example of one approach to pandemic psychological policies.

Telehealth may be the safest practice option during periods of pandemic viral danger. However, a psychologist may encounter clients in need of ongoing clinical attention but who cannot safely or practically utilize video or a telephone format (e.g., an older adult with hearing loss, or a quasi-homeless client without phone or internet access). In addition, clinical assessment, (e.g., neuropsychology) may require in-person administration and or observation in order to maintain reliability and validity of the assessment procedures. The Board expects that psychologists who decide to see clients in person do so only after a careful and balanced evaluation of both the safety risks (for clients, supporting staff, and the psychologist) and the legal requirements of State Executive Orders.

As a general principle, the Board will weigh individual complaints regarding practice management during COVID-19 against guidance which is frequently updated by the Oregon Health Authority, in addition to the APA Ethical Code and relevant state statutes. Since each instance will present unique characteristics, it is not possible to provide specific predictions of the sanctions that may be involved in addressing a complaint. However, psychologists should be aware that the Board is required to enforce the Governor’s Executive Order, in compliance with an Oregon Temporary Rule in effect from 11-20-2- through 5-18-21. This new rule sets forth that failure to comply with any applicable provision of a Governor’s Executive Order, including failure to comply with Oregon Health Authority guidance, constitutes unprofessional conduct. Violations are subject to Board sanction in accordance with ORS 675.070.

Many of the FAQs below were assembled by the OBOP Covid-19 Workgroup.  The Oregon Board of Psychology would like to thank the members who have graciously volunteered their time and expertise to this project.  Our team consisted of a non-psychologist public Board member (Janice Schermer), two member psychologists (Deborah Wise, Ph.D., and Michael Fulop, Psy.D.), and three OBOP Board members (Elisabeth Goy, Ph.D., Patricia Bjorkquist, Ph.D., and Linda Nishi-Strattner, Ph.D., chair).  We would like to add that this FAQ list, like most factors of COVID-19, are constantly evolving, so please stay tuned for updates and course corrections.

COVID-19 Survey

The Board recognizes that there are some unknowns and many questions about the best way for practitioners to protect the public in the practice of psychology, particularly as we approach the possible transition from telehealth to in-person visits. The Board is working on making guidance available for best practices, and we will provide this in our newsletter and on our website and as needed, in stand-alone emails as quickly as possible. Be watching for this information in the next few weeks. 

The Board invites members of the public and licensees to please use the following survey link to submit your questions and concerns about creating safe clinical practices during COVID. Your input will help us create a most relevant "Frequently Asked Questions" reference tool.

 
Please be aware, as new knowledge is acquired about virus transmission and tested safety protocols, we may need to update or in some circumstances reverse information to reflect new evidence.  The Board cannot provide medical or insurance advice, and does not provide interpretation of the Governor’s Executive Orders or Oregon Health Authority’s guidelines.

FAQs

The following FAQs are broken down by subject area.  Last updated: February 26, 2021.

Telehealth

1. Are there any guidance materials on tele-therapy?
Please see below, under “Resources.”  There is no additional certification required for Oregon psychologists 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?
Effective only March 31, 2020 - September 26, 2020, in response to the COVID-19 emergency, the Board has filed a Temporary Rule Amendment (only valid up to 180 days) that created an Emergency Visitor's Permit. It temporarily allowed psychologists licensed in good standing in other states to provide mental health care services in Oregon through confidential electronic communications.  Applications are no longer processed for this permit type.

4.    Will insurance coverage for telehealth continue?  
OPA and APA are your best resources for advocacy with insurance companies for continued coverage of telehealth services after the pandemic subsides.  

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 psychologist who is licensed in their state, after the temporary licensure provisions are lifted.

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. Both 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.

Seeing Patients In-Person

7.    What issues other than the Governor’s current emergency orders, should a psychologist consider 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 orders 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. 

Read more about it: Factors to Consider in Re-Opening In-Person Psychological services during the COVID-19 crisis, May 7, 2020 (The Trust).

8.    If both my patient and I have been fully vaccinated for COVID-19, may we resume meeting for psychotherapy in person in my office?
Transitioning back to in-person visits should be limited to those individuals for whom the benefits outweigh the risks.  Optimally, the clinician will consider the individual needs of the patient (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.  Psychologists 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.

9.    Is informed consent required to see patients in-person now?   
It is the psychologist’s ethical responsibility to obtain informed consent regarding any potential risk related to participating in psychological 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. 

10.    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.


12.   May I inquire about a person’s vaccination before returning to in-person treatment?  Can we require clients to show proof of vaccines?  
If a complaint is submitted to the Board regarding this question, the Board will consider whether the psychologist is acting in an ethical manner and is in compliance with the Governor’s orders.  Asking a patient about their health status has become a routinized part of every health-related encounter, and may help to inform you about whether to offer in-person services.  However, community spread remains an issue with the covid-19 vaccine, and that, along with the psychologist’s own health issues, should be key considerations as well.

13.    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 Psychologists’ Ethical Principles (including, for example, weighing the directives regarding nonmaleficence and non-abandonment), you may offer telehealth or refer to another provider.

14. Can I see a client in my office without wearing masks if they are not concerned about the risk of COVID-19?
We would consider the well-being of the client, the client’s community, your health risk, your community’s health risk, and OAR 858-020-0115. Also we as professionals would want to model rule-abiding behavior in our best practices, and would encourage clients to do the same. We would weigh these risks with the concern about providing the best care for our clients, and ask ourselves if the risk of not providing face-to-face service outweighs the risk of covid-19. We would want to model OHA and CDC guidelines while considering APA ethics principals.

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

16. What if my office partner continues to see in-person clients during the pandemic?
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 that takes into consideration safety, ethics, and professional conduct as they relate to OAR 858-020-0115, the Governor’s Executive Orders and guidelines put out by the Oregon Health Authority in order to minimize risk and exposure to COVID and to limit the spread of the virus.

Other Board-Related, Ethical, and Legal Considerations

17. 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.

18. 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.  Our office doors remain closed and locked, and beginning on Monday, March 23, 2020, members of the public will be allowed entry only if they have a pre-arranged appointment with staff.  Beginning on Tuesday, March 24, 2020, members of the public will not be allowed entry.

19. Has the Board issued any official statement or advice regarding COVID-19?
Nothing has been issued specific to the Board besides these FAQs.  Please see below for other resources.

20. Will the Board be extending the Emergency Visitor's Permit past September 26, 2020?
No.  The temporary rule creating this permit was put into place on March 29, 2020 to address the immediate needs of clients who were being displaced to Oregon due to the pandemic.  The Board is not extending this permit type.  The expectation is that during this six-month period, providers and their clients would determine whether ongoing services are needed, and if so, whether it is most appropriate to transition the client to another provider, or for the provider to seek full licensure in Oregon to continue providing services to the client.  Providers who wish to continue to practice in Oregon should start the licensing process several months in advance to avoid any gaps in their ability to serve their clients.  The Applying for Licensure webpage contains the necessary forms and instructions. 

21. Is the Board amending any of the continuing education requirements?
Yes.  The Board filed a Temporary Rule Amendment that suspended the 20 hour limit on home study (online) CE for licensees whose renewals are due between March 31, 2020 and August 31, 2020.  Subsequently, the Board filed a Permanent Rule Amendment that extends this to renewals that are due on July 31, 2021. This removes requirements for in-person CE for renewals due between March 31, 2020 and July 31, 2021.  The Board will continue to monitor the situation to determine if further action is needed.

22. Can a resident receive individual supervision from their supervisor by electronic means?
Usually, weekly individual supervision must occur face-to-face between resident and supervisor.  However, OAR 858-010-0036(2)(e)(D) allows for non-routine individual supervision by electronic means when an emergency prohibits a face-to-face meeting.  On March 8, 2020 the Governor declared a state of emergency in Oregon due to the coronavirus.  So, if face-to-face meetings are prohibited due to the coronavirus emergency, then supervision may occur via electronically.  Also, OAR 858-010-0036(2)(e)(C) allows individual supervision to be delayed for up to 14 days to accommodate illness.

23. Is the Board amending any of the residency experience requirements for licensure?
No, not at this time.

24. Is the Board amending any of the continuing education requirements?
Yes.  The Board filed a Temporary Rule Amendment that suspended the 20 hour limit on home study (online) CE for licensees whose renewals are due between March 31, 2020 and August 31, 2020.  Subsequently, the Board filed a Permanent Rule Amendment that extends this to renewals that are due on July 31, 2021. This removes requirements for in-person CE for renewals due between March 31, 2020 and July 31, 2021.  The Board will continue to monitor the situation to determine if further action is needed.

25. Are there changes to the Oregon Jurisprudence Exam (OJE)?
The exam has moved from in-person to an online format pursuant to a Permanent Rule Amendment filed January 14, 2021. 

26. Are there changes for application-related forms that must be sent by paper mail?

27.   Is the Board considering relief for licensees, such as fee and CE deferrals?
We are actively monitoring developments in the Oregon Legislature and the Governor's Office, and we will explore options in light of those developments. Please check the updates on this webpage for changes that occur.

28.   Can a licensee be sanctioned by the Board if they do not comply with the Governor's Executive Orders related to COVID-19?
Yes.  The Board filed a Temporary Rule Adoption on November 20, 2020 (effective through May 18, 2021) that 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 unprofessional conduct.  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.  Please refer to the OHA guidance below, under Resources.

29. Does OAR 858-020-0115 apply only during the 4 weeks of lockdown in Oregon?
No, this level of compliance with the Governor’s Executive Orders continues throughout the Governor’s declaration of emergency, and it also applies to any Governor’s Executive Orders that might be issued during this pandemic emergency. OAR 858-020-0115 is a temporary order implemented by the Board of Psychology, and is in effect from 11-2-2020 through 5-18-2020. However, the Board may vote to make this a permanent rule amendment before the temporary rule expires. Please visit our Administrative Rulemaking Webpage for current information.

30. What do we do if we become aware of colleagues violating OAR 858-020-0115 (which involves resolving ethical issues) or patients violating these rules (which involves confidentiality)?
There is a duty to report unprofessional conduct, per ORS 676.150. The Board has a new rule that adopts the Governor’s Executive Order and states that violations of this constitute unprofessional conduct. Therefore, there is a duty to report a violation, and OAR 858-020-0115 provides the authority for the Board to enforce the Governor’s Executive Orders.

31. What possible sanctions or penalties might I incur if I, as a psychologist, fail to comply with the governor's executive order during an emergency?
OAR 858-020-0115 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 declared emergency, and are necessary to keep Oregonians healthy and safe during a declared emergency. Failure of a licensed Psychologist, Psychologist Associate or resident to comply with the Governor’s Executive Order is considered unprofessional conduct, and the Board may impose sanctions for violations of this rule in accordance with ORS 675.070 up to and including revocation and civil penalties not to exceed $10,000 for each occurrence.

32. Are you mandated to report a patient exposed to or who has contracted COVID-19 to contact tracers from the health department?
The OHA regulation does not require psychologists 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.  We will communicate if we learn of any changes to the confidentiality requirements or other laws applicable to licensed health professionals.

34.   Do psychologists 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?  
Psychologists 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 OPA regarding your options.

36. Is the Board mandating that licensees get the COVID-19 vaccine?
No. For vaccine information, please visit the OHA COVID-19 Vaccine Webpage.

Resources

Telepsychology:

State and federal response to COVID-19:



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