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.
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. The mask mandate for healthcare settings has been lifted as of April 3, 2023. However, individual health care providers and health care settings may still choose to require face masks at their locations.
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. The Board expects that psychologists who decide to see clients during a pandemic or public health emergency in person, if allowed, 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 a public health emergency 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 any 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 in response to the first world-wide global pandemic from 2020 to 2023. 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, member psychologists, and OBOP Board members (Janice Schermer, Deborah Wise, Ph.D., Michael Fulop, Psy.D., Elizabeth 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.
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 a pandemic or 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. At the beginning of the first global pandemic, the Board conducted a survey of all licensees who were encouraged to submit questions and concerns about creating safe clinical practices during COVID. In the event of another pandemic or public health emergency, the Board will again invite members of the public and all licensees to submit queries.
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: April 3, 2023.
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. 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.
6. 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
7. What ethical issues should I consider when weighing whether or not to meet with patients 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.*
8. What if my patient does not want to wear a mask and my office policy requires masking?
Psychologists may opt for teletherapy or provide referrals to clients as needed.
9. Are psychologists still required to be vaccinated against COVID-19?
Yes: does this mean that psychologists who move into the state must be vaccinated?
- NIH recommends that all its employees be up to date with COVID-19 vaccines.
- APA recommended that psychologists help our communities to be vaccinated.
- CMS requires all providers who provide services to patients within Medicare and Medicaid facilities to be up to date with the primary vaccination series for COVID-19, as of 10-26-22.
- OHA requires the primary vaccination series for COVID-19 of all healthcare providers who see clients in person as of 10-22-21.
10. When does the mask requirement apply?
OHA
announced that the mask mandate for healthcare settings will be lifted on April 3, 2023. OHA recommends that licensees and patients may still consider wearing masks in health care or any settings to better protect themselves and those most vulnerable around them. Some health care settings may continue to require masks even after the requirement is lifted.
11. May I inquire about a person’s vaccination before returning to in-person treatment? Can we require patients to show proof of vaccines?
Offering in-person appointments only to full-vaccinated people is not discriminatory. Patients are free to decline sharing their vaccination status and can then be offered remote sessions. 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.
12. What if a patient 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.
13. Can I see a patient in my office without wearing masks if they are not concerned about the risk of COVID-19?
Some health care settings may continue to require masks even now that the requirement is lifted. Practitioners should carefully document thought processes and actions regarding masking.
Other Board-Related, Ethical, and Legal Considerations
14. Did the Board amend any of the continuing education requirements during COVID-19?
The Board created a 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.
15. 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 prohibited a face-to-face meeting. On 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.
16. Were there changes to the Oregon Jurisprudence Exam (OJE)?
17. Are there changes for application-related forms that must be sent by paper mail?
18. 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. 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.
19. Can a licensee be sanctioned by the Board for violating Oregon Health Authority rules related to COVID-19?
20. Are psychologists mandated to report a patient exposed to or who has contracted COVID-19 to contact tracers from the health department?
No. 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)).
21. 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 Board 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.
22. Do psychologists have a duty to warn if we become aware that patients are knowingly not complying with recommendations from the CDC or OHA, thereby putting others at risk?
No. Psychologists in Oregon do not have a duty to warn and must adhere to client privilege.
23. 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. Practitioners 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.
24. 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
State and federal response to COVID-19:Information on mental health issues related to COVID-19: