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January 24, 2019

Broad Expansion of "Telemental" Services Proposed

On January 23, 2019, the NYS Office of Mental Health (OMH) proposed a broad expansion to the delivery of mental health services via telehealth equipment to enable patients to access mental health services from home or other locations. The intent of the sweeping changes is to make mental health services available to individuals who may not "be able to access on-site services or are delayed in receiving such services because of distance, location, time of day, or availability of resources." In addition to allowing patients to receive services in their homes, the proposed regulation permits NYS-licensed professionals to provide services from locations other than OMH-licensed facilities, including their homes. Lastly, the proposed rule expands the types of eligible practitioners from psychiatrists and nurse practitioners to also include psychologists, social workers, and mental health counselors.

Currently referred to as "telepsychiatry," the expanded services are now described as "telemental" under the proposed rule. Telemental health practitioners must be authorized in writing by the OMH to provide services via two-way interactive audio and visual equipment. Among other requirements, practitioners must submit a plan to the OMH that describes their procedures for assessing patients and handling emergencies and contingencies when the delivery of telemental services is interrupted or deemed inadequate. Requests for approvals must be submitted by the originating site where the patient is assessed to the OMH field office in the region where the site is located. OMH officials may make on-site visits to the originating site and distant site.

Patients must be assessed in person and approved to receive telemental services. Thereafter, the patient may receive "visits" from the practitioner within or outside the state. The practitioner must utilize telemental-health technology—an interactive audio and video system—as specified in the proposed rule. Services may not be provided by telephone, email, text, or facsimile. In addition, telemental services delivered in a Personalized Recovery-Oriented Services (PROS) setting and by an Assertive Community Treatment (ACT) team can only be delivered by psychiatrists and psychiatric nurse practitioners subject to certain specified conditions.

The proposed regulation offers the promise of timely and accessible mental health services for residents of New York State who have been subject to an acute shortage of professionals and unavailability of services. The short public comment period suggests the OMH's recognition of the gravity of the situation—the public has until March 10, 2019, to provide comments on the proposed regulation. Thereafter, the OMH will issue its final regulation as well as guidance for patients and professionals to implement the regulation.

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