Law, rules and regulations, not guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.
Engaging in Telepractice in the Speech-Language Pathology & Audiology Professions
"Telepractice" is providing service that is not “in person” and is delivered through the use of technology. Such technology may include, but is not limited to: telephone, telefax, email, internet, or videoconference. It is considered a mode of practice and the same standards that apply to all forms of practice in the speech-language pathology and audiology professions would apply to telepractice. With reference to speech-language pathology and audiology, telepractice is the use of technology for the application of speech language pathology and audiology services over a distance by connecting a qualified and licensed clinician to a client or one clinician to another for assessment, treatment, and/or consultation. Telepractice is a permitted modality in New York State, subject to certain restrictions and conditions and when used as a form of speech-language pathology or audiology practice, is subject to the following:
- All the current standards of care;
- All the laws, rules and regulations, governing speech-language pathology and/or audiology practice in New York State; and
- All the practice and ethical considerations
Message for Consumers: If you are a New York State resident receiving speech-language pathology or audiology services in New York State, your Speech Language Pathologist or Audiologist must be licensed in New York State.
Message for New York State licensed Speech-Language Pathologists and Audiologists: If you intend to provide telepractice services to clients residing outside of New York State, you must comply with the professional statutory and regulatory requirements of your client’s state or country of residence.
Message for Out-of-State Speech-Language Pathologists and Audiologists: If you intend to provide telepractice services to a resident of New York State, you must hold a New York State license and be in compliance with the relevant law, rules and regulations.
New York State law permits a person from another state to perform speech-language pathology or audiology services in this State, as long as such services are performed for no more than thirty (30) days in any calendar year and provided that such services are performed in conjunction with and/or under the supervision of Speech-Language Pathologist or Audiologist licensed under Article 159 of the New York State Education Law.
PROFESSIONAL ROLES AND RESPONSIBILITIES:
Although telepractice is a permitted modality in New York State, you should consider the particular impact of telepractice on the provision of speech-pathology or audiology services, including, but, not limited to:
- selecting clients who are appropriate for assessment and intervention services via telepractice;
- selecting and using assessments and interventions that are appropriate to the technology being used and that take into consideration the client and disorder variables;
- maintaining appropriate documentation, including informed consent (risks and benefits) for use of telepractice which includes a client agreement to use a private environment with a secure connection, and documentation of the telepractice encounter;
- complying with all New York State, HIPAA and FERPA requirements regarding the maintenance of patient records and the confidentiality of patient information;
- understanding and applying appropriate models of technology used to deliver services;
- understanding the appropriate specifications and operations of technology used in the delivery of services;
- calibrating and maintaining clinical instruments and telepractice/telehealth equipment;
- being sensitive to cultural and linguistic variables that affect the identification, assessment, treatment and management of individuals receiving services via telepractice;
- training and using other qualified individuals appropriately when delivering services;
- evaluating the effectiveness of services provided and measuring outcomes;
- being knowledgeable and compliant with existing rules and regulations regarding security and privacy protections, reimbursement for services, and licensure, liability and malpractice concerns;
- ensuring the confidentiality and privacy of patients and their transmissions, as well as the protection of confidential information through the transmission of information; and
- collaborating with physicians for timely referral and follow-up services, as necessary.
Although telepractice is permitted in New York State, it may not be considered appropriate for certain types of clients and/or in certain types of settings. Thus, before engaging in telepractice, a clinician should make sure that he or she is aware of any and all guidelines, policies, laws, rules and/or regulations that may prohibit or limit the use of telepractice for certain types of clients and/or in certain types of settings.
Guidelines for the use of speech-language telepractice in the delivery of related services to students with disabilities in New York State can be found at: http://www.p12.nysed.gov/specialed/publications/2015-memos/speech-language-telepractice.html
Telepractice is an emerging area in the fields of Speech-Language Pathology and Audiology. As technology advances, so do the available options for service provision. Therefore, it should be considered a matter of professional responsibility that those providing telepractice services obtain continuing education in the area of telepractice.
Below is a list of suggested resources that can be used to explore current best practices and efficacy of treatment methods. Note that the legal practice of the professions varies from state to state, so that not all national standards or guidelines may be applicable in New York State.
- The American Speech-Language-Hearing Association’s (ASHA) Professional Issues
- ASHA Special Interest Group 18 for Telepractice
- American Telemedicine Association
- Northeast Telehealth Resource Center: New York Legislative Update
- US Department of Health and Human Services: Health Resources and Service Administration
- American Academy of Audiology
- Health Information Privacy (HIPPA Act)