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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.

Important!  Notwithstanding updated masking guidance, whether vaccinated or not, all licensed psychologists, psychologist 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 OBOP if that status changes; until then, the mask mandate remains in effect.

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, young children, 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. Given the needs of these clients, some psychologists are seeing clients in person.  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.  Psychologists who determine that benefits outweigh the risks of seeing clients in person should document both their rationale for providing in person services and their safety practices.

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 (OHA), 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 (OAR 858-020-0115), and OHA rules related to COVID-19 (OAR 858-020-0116). The rules set forth that failure to comply with any applicable provision of a Governor’s Executive Order, including failure to comply with Oregon Health Authority guidance, or failure to comply with OHA COVID-19 related rule, 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 consists 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., Workgroup Chair).  We would like to add that this FAQ list, like most factors of COVID-19, is constantly evolving, so please stay tuned for updates and course corrections.

COVID-19 Survey: Ask your Questions of the COVID-19 Workgroup Here

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 during the COVID-19 emergency, particularly as we respond to changing federal and state mandates. The Board is making guidance available for best practices, and we will provide updates on this webpage as needed. 

The Board invites members of the public and licensees to please use the following ongoing survey link to submit your questions and concerns about creating safe clinical practices during COVID. Your input will help us regularly update these "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: September 1, 2022.

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?
The Board offers a Limited Permit (Visitor's) to out-of-state psychologists who are licensed in good standing in other jurisdictions.  This allows the psychologist to practice through confidential electronic communication in Oregon for a limited purpose. 

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.  Psychologists are advised to 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 psychologist who is licensed in their state.

REVISED 9/1/22!   6.    What if my client cannot wear a mask due to a medical condition?
Psychologists must develop and follow a policy that if a patient cannot tolerate any form of face covering due to a medical condition, strict physical distancing of at least six feet be observed from other non-health care personnel to the greatest extent possible. 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 psychologists consider when providing telehealth services during the pandemic?
When providing telehealth services, psychologists should consider documenting in their 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 patient 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 Patients In-Person

8.    What ethical issues should I consider when weighing whether or not to meet with clients in person?
Psychologists should consider the ethical principle of beneficence and nonmaleficence in which they strive to benefit those with whom they work and take care to do no harm.  In this instance, psychologists should consider whose interest is met by shifting to in person meetings and guard against having their own needs supersede their client’s needs as they consider making this transition. According to guidance published by the American Psychological Association, “keep in mind that psychologists can refuse to see patients face-to-face, especially if they are older or have health conditions, or live with family members who have heightened risk factors. Do not unnecessarily jeopardize your health, or the health of your family, your staff or your patients.”

In Summary: Carefully document your thought processes and your actions.* 

*One recent reasonable decision-making framework addressing whether to see patients in-person vs telehealth, masked vs not masked, administering psychological measures or doing therapy can be found at this link: https://pubmed.ncbi.nlm.nih.gov/32997103/ and an earlier version in the Resources section below: Sample COVID Policy & Procedure Documents pages 11-13.

9.    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).

10.    If both my patient and I have been fully vaccinated for COVID-19, may we resume meeting for psychotherapy in person in my office?
Some psychologists are now seeing clients in person.  Psychologists 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 psychologist's.  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.  Psychologists should document their rationale for seeing clients in person as well as their safety practices.

11.    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. 

12.    How should I document when a new patient 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, “Patient 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.

REVISED 9/1/22!    13.    If a patient does not provide a vaccination card, can I still see them in person, how should I document this, and what policies should I follow?
This is at the discretion of the psychologist/clinic.  Psychologists are responsible for maintaining documentation of informed consent, including a reasoned evaluative process that accounts for potential risks and benefits for all stakeholders.  If you do decide to see patients in your office, be prepared to document the precautions and preventative measures that you and your staff have undertaken to insure patient and staff’s health and safety.  Please refer to the most recent materials form the CDC, OHA, and the OBOP website for procedures to mitigate risk from COVID-19.

14.    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 or OHA guidance or rule related to COVID-19.  Please consider recommendations from CDC, OHA, and other relevant health authorities when considering a return to in-person practice.

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

16.    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 psychologists. 

17.    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”.  [Adapted from comments by Paul Cooney, Atty., in email exchange of 9/16/21 on the OPA ListServ]

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 and OHA requirements.  Health information about the spread of coronavirus is frequently updated, and the most recent OHA recommendations, along with the psychologist’s own health issues, should be key considerations as well.

18.    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.

19.    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 to both providers and patients/visitors in healthcare settings, with exceptions delineated in the rule (OAR 833-019-1011).  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.

20.    What changes in documentation should psychologists consider when providing psychological services in person during the pandemic/quarantine?
Psychologists 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.)

21.    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.

22.    What if my office partner continues to see in-person clients during the pandemic?
Some psychologists 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 take 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, OAR 858-020-0116, in order to minimize risk and disease exposure and to limit the spread of the virus.

Other Board-Related, Ethical, and Legal Considerations

23.    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.

24.    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.

25.    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.

REVISED 9/1/22!    26. Did the Board amend any of the continuing education requirements?
The Board did create an temporary accommodation for renewals due between March 31, 2020 and July 31, 2022 that waived the home-study limitation, but this has now expired.   The Board will continue to monitor the situation to determine if further action is needed.  Please remember that an online presentation that you attend in real time which is interactive- meaning you can communicate with the presenter and other attendees as if you were physically present at a presentation- is not considered "home study," and therefore not subject to any limitation.

27. Can a resident receive individual supervision from their supervisor by electronic means?
Up until January 19, 2022, OAR 858-010-0036(2)(e)(D) allowed for non-routine individual supervision by electronic means when an emergency (in this case, the Governor declared coronavirus emergency) prohibited a face-to-face meeting.  Now, as of January 19, 2022, the Board filed a permanent rule amendment (that does not expire) that removed the requirement for in-person supervision, and allows all individual and group supervision to occur via live, synchronous confidential electronic communications. Supervisors and residents may still opt to utilize in-person supervision if this fits their needs.

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

29. 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. 

30. Are there changes 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. These changes are in effect until further notice.

31.   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.

32.   Can a licensee be sanctioned by the Board if they do not comply with the Governor's Executive Orders related to COVID-19?
Yes.  OAR 858-020-0115 (effective 11/20/20) is a permanent rule (that does not expire) 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 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.  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.

33.  Can a licensee be sanctioned by the Board for violating Oregon Health Authority rules related to COVID-19?
A new rule adopted on 3/14/22, OAR 858-020-0116,  sets forth that failure to comply with any applicable provision of an Oregon Health Authority COVID-19-related rule constitutes unprofessional conduct.  Violations will be subject to Board sanction.

Please also visit our Administrative Rulemaking Webpage for other rule information.

34.    What do we do if we become aware of colleagues or clients violating the Governor’s Executive Orders or OHA's rules related to COVID-19?
Violations of the Governor’s Executive Orders or OHA rules related to COVID-19 by licensees and residents constitute unprofessional conduct.  Therefore, licensees and residents 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 has authority to enforce the Governor’s Executive Orders (OAR 858-020-0115) and the Oregon Health Authority's (OHA) COVID-19 requirements (OAR 858-020-0116).  The Board may impose sanctions for violations of the Governor’s Executive Orders or Oregon law (in accordance with ORS 675.070).  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, we are bound by the limits of confidentiality (ORS 40.230).

35.    What possible sanctions or penalties might I incur if I, as a psychologist, fail to comply with the Governor's Executive Order or OHA COVID-19 rule during an emergency?
OAR 858-020-0115 and OAR 858-020-0116 were 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. 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.

36.    Are psychologists mandated to report a patient exposed to or who has contracted COVID-19 to contact tracers from the health department?
The Oregon Health Authority (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.  Some health care providers and facilities are mandated by law to report diagnoses of COVID-19 to the Oregon Health Authority, but this requirement does not apply to behavioral healthcare providers (psychologists) who are not diagnosing the disease.  Psychologists are encouraged to direct patients who believe they have been exposed to seek COVID testing and to follow current quarantine guidelines.  Patients with questions about these topics can reach out to their primary care providers or local county health department.  Note that HIPAA does not prohibit providers from reporting protected health information to public health authorities for the purpose of preventing or controlling diseases, including public health surveillance and investigations (45 CFR 164.512(b)(1)(i)).

37.    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 Oregon Board of Psychologists will communicate with all licensees, applicants, and residents, 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.

38.    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.

39.    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.

40.    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.

41.    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.

42.    Who should I contact if I have questions or don’t agree with OHA guidelines or rules?
Licensees and residents (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 psychologists to receive COVID-19 vaccines ahead of other groups when vaccines were first available, and it requires us to continue to comply with OHA rules and guidance regarding COVID-19 mitigation until the state of emergency is lifted.  Psychologists 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.

43.    How can I help during the pandemic or other emergencies?
Psychologists 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

Telepsychology:

State and federal response to COVID-19: