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Understanding Compliance: A Basic Guide for Independent Teletherapy Contractors

This month we spoke with Kristin Martinez, M.A., CCC-SLP, a clinical quality manager with PresenceLearning, to discuss what to expect, how to prepare, and how to navigate compliance issues for SLPs, OTs, and MHPs who might be considering a move to teletherapy.

Let’s start at the beginning. What does a provider need to consider initially when preparing to practice in a new state via teletherapy?

Of course the first consideration is adherence to any state licensure requirements. Depending on the state, this might include a state-issued license from each discipline’s governing body, but might also include a Department of Education license if you are providing teletherapy services in school-based settings. State license applications commonly require additional background checks in addition to letters of verification from the licensing bodies in any other states where you already hold a license. Also be aware that some states require a business registry/license if you are practicing as a telepractioner.

What guidelines would you advise providers to research first?

Educate yourself on your discipline’s national association best practice guidelines related to teletherapy (e.g., ASHA, AOTA, APA), and then start researching state regulations for any states where you have or are considering cross-licensure. In addition, it is essential to be aware of FERPA guidelines as you are given access to and interact with student-identifying information.

Once Iicensed and working, what will providers need to consider next?

If you have only provided speech-language, OT, or behavior and mental health services in one state or even in only one school district in your career, it might be eye-opening to see how special education guidelines, timelines, and procedures can vary state-to-state. It is your responsibility to seek out not only applicable state and district regulations and guidelines, but also any details related to site processes: Who schedules IEP meetings? Does the district require team meetings to discuss areas to be tested before requesting parental consent? It is not our role as teletherapists to impose our expectations or past experiences on a district in which we are providing services; rather, we are a guest in each new district we serve and therefore need to learn from our new colleagues!

Who’s responsible for staying up-to-date on regulatory guidelines and federal and state statutes?

You are! As an independent contractor, it is your responsibility to stay abreast of any new and/or updated guidelines and statutes specific to your discipline and to the states where you are licensed. As a company, PresenceLearning provides support in terms of identifying and sharing resources where such information might be found, however it is ultimately up to each provider to ensure he/she stays informed.

How does licensing work when providers travel?

Teletherapy gives providers the potential to work from varying locations, and this can be very appealing for those of us who like to travel! However, it is best practice that treating clinicians be licensed in all of the following: 1) state where clinician permanently resides; 2) state where clinician is sitting; 3) state where student is enrolled; 4) state where student is sitting (some students attending online schools also travel with their families). As such, this can limit the ability to continue therapy with a student if the clinician is traveling throughout the school year. Some clinicians who tend to travel between two states (e.g., visiting family) will attain licensure in both states so that they can continue to provide therapy for their students throughout the school year without interruption.

Can you offer some tips on relationship management when things are out of compliance with a provider’s school or schools?

Whether you are providing therapy in-person or virtually, joining a school district that is dealing with significant compliance issues is a challenge. However, try to avoid judgment (“How can so many IEPs be past due?”) and instead, step into whatever role is most needed. Remember that school districts are required to continue provision of services as outlined in each student’s IEP, even if that IEP has expired. So, it’s possible that you will be asked to plan and deliver therapy based upon some expired IEPs…don’t panic! The priority is to get services to children who have been found eligible, and then IEP meetings can be held in order to return to a state of compliance.

What kind of support does PresenceLearning offer in these situations?

PresenceLearning offers extensive support to independent contractors in the form of a searchable help center, a clinician community platform, as well as dedicated provider success managers, lead clinicians, and clinical quality managers who support all providers and clinical services. As outlined here, there is much to consider when starting as a teletherapist, and PresenceLearning understands and values the importance of support for new and veteran providers. We base our services on best practice guidelines, so supporting providers in their efforts to become appropriately licensed and to provide high-quality services is a top priority.

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