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Notice to California Consumers Regarding the Practice of Psychology on the Internet

The Board of Psychology would like to make the following recommendations to California consumers who choose to seek psychological services over the Internet.

Individuals who provide psychotherapy or counseling, either in person, by telephone, or over the Internet, are required by law to be licensed. Licensing requirements vary by state. Individuals who provide psychotherapy or counseling to persons in California are required to be licensed in California. Such licensure permits the consumer to pursue recourse against the licensee should the consumer believe that the licensee engaged in unprofessional conduct.

Be a cautious consumer when seeking psychological services over the Internet, or by any other means, by doing the following:

Verify that the practitioner has a current and valid license in the State of California.
Be sure you understand the fee that you will be charged for the services to be rendered and that you fully understand how and to whom the fee is to be paid.
Be sure you are satisfied with the methods used to ensure your communications with and by the therapist will be confidential.
Be sure you are aware of the risks and benefits of receiving therapy over the Internet so that you can make an informed choice about the therapy to be provided.
According to Business and Professions Code Section 2290.5, prior to the delivery of health care via telemedicine, the health care practitioner who has ultimate authority over the care or primary diagnosis of the patient shall obtain verbal and written informed consent from the patient or the patient's legal representative. The informed consent procedure shall ensure that at least all of the following information is given to the patient or the patient's legal representative verbally and in writing:

(1) The patient or the patient's legal representative retains the option to withhold or withdraw consent at any time without affecting the right to future care or treatment nor risking the loss or withdrawal of any program benefits to which the patient or the patient's legal representative would otherwise be entitled.
(2) A description of the potential risks, consequences, and benefits of telemedicine.
(3) All existing confidentiality protections apply.
(4) All existing laws regarding patient access to medical information and copies of medical records apply.
(5) Dissemination of any patient identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without the consent of the patient.

This law requires that the patient or the patient representative signs a written statement prior to the delivery of health care via telemedicine, indicating that the patient or the patient's legal representative understands the written information provided in 1 through 5 above and that this information has been discussed with the health care practitioner or his/her designee.

Legislation passed in 2003 (AB 116 - Nakano) added section 2904.5 to the Psychology Licensing Law. This section affirms that a psychologist is indeed a health care practitioner subject to the provisions of section 2290.5 of the Medical Practice Act.

Business and Professions Code Section 2290.5 - Telemedicine; informed consent procedures; written consent statement; compliance; application of section

(a) For purposes of this division, the following definitions shall apply:

(1) "Asynchronous store and forward" means the transmission of a patientís medical information from an originating site to the health care provider at a distant site without the presence of the patient.
(2) "Distant site" means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.
(3) "Health care provider" means a person who is licensed under this division.
(4) "Originating site" means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.
(5) "Synchronous interaction" means a real-time interaction between a patient and a health care provider located at a distant site.
(6) "Telehealth" means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patientís health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.

(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented.
(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.
(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.
(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.
(f) All laws regarding the confidentiality of health care information and a patientís rights to his or her medical information shall apply to telehealth interactions.
(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.
(h)

(1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.
(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).
(3) For the purposes of this subdivision, "telehealth" shall include "telemedicine" as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.

If you believe you have been treated unprofessionally by a Board licensee, either through treatment over the Internet or by any other means, review our information on filing complaints.