OLERE - Oklahoma Legal and Ethical Responsibilities Telehealth and Technology Questions and Answers 1 — Questions and Answers
Question 1: An LPC in Oklahoma is establishing a telemental health practice. According to the Oklahoma Administrative Code (OAC), which of the following must be specifically addressed in the informed consent process, in addition to the standard elements required for in-person therapy?
- A list of the counselor's approved supervisors and their contact information.
- A detailed biography of the counselor's educational and professional background.
- Protocols for technology failure and an emergency response plan appropriate to the client's physical location. (Correct answer)
- The brand and model of the computer and webcam the counselor will be using for sessions.
Correct answer: Protocols for technology failure and an emergency response plan appropriate to the client's physical location.
Oklahoma's rules for technology-assisted counseling require that the informed consent process specifically covers procedures for handling technology failures (e.g., what to do if the connection is lost) and establishes a clear emergency response plan. This plan must be relevant to the client's location, including identifying local emergency services, since the counselor cannot intervene in person.
Question 2: An Oklahoma LPC is providing telemental health services to a client. To comply with state regulations and HIPAA, which of the following technology platforms is most appropriate for conducting sessions?
- A popular social media application's video chat feature.
- A video conferencing service that is encrypted and for which the LPC has a signed Business Associate Agreement (BAA). (Correct answer)
- A personal, end-to-end encrypted messaging app on a mobile phone.
- Any platform the client prefers and is most comfortable using, regardless of its security features.
Correct answer: A video conferencing service that is encrypted and for which the LPC has a signed Business Associate Agreement (BAA).
Both Oklahoma regulations and HIPAA require that counselors use secure, encrypted communication methods to protect client confidentiality. A key part of HIPAA compliance for using a third-party platform is obtaining a signed Business Associate Agreement (BAA), which is a contract that ensures the vendor will also protect the client's health information. Platforms like social media video chats or standard messaging apps typically do not offer a BAA and are not considered compliant.
Question 3: A licensed LPC in Oklahoma has a client who is temporarily relocating to New Mexico for four months for a work assignment and wishes to continue weekly therapy via video conference. What is the LPC's primary legal and ethical obligation in this situation?
- Continue therapy as usual since the therapeutic relationship was established in Oklahoma.
- Verify and comply with New Mexico's laws and licensure requirements regarding the provision of telehealth services into that state. (Correct answer)
- Inform the Oklahoma Board of Behavioral Health of the client's temporary relocation.
- Have the client sign a waiver acknowledging they are receiving services from an out-of-state provider.
Correct answer: Verify and comply with New Mexico's laws and licensure requirements regarding the provision of telehealth services into that state.
The practice of counseling is regulated at the state level, and licensure is generally required in the state where the client is physically located at the time of service. The Oklahoma LPC must determine if providing services to a client in New Mexico constitutes practicing counseling in New Mexico and must comply with that state's specific laws, which may require licensure or a temporary permit. Simply having an established relationship in Oklahoma does not override the other state's regulations.
Question 4: When initiating technology-assisted counseling with a new client, which of the following steps is required by Oklahoma regulations to ensure client safety and proper identification?
- Asking the client to email a recent utility bill to prove their address.
- Making reasonable efforts to verify the identity of the client. (Correct answer)
- Requiring the client to answer a series of personal security questions at the start of each session.
- Obtaining the client's social media profiles to cross-reference their identity.
Correct answer: Making reasonable efforts to verify the identity of the client.
Oklahoma rules require that LPCs make reasonable efforts to verify the identity of the client at the outset of the telehealth relationship. While not prescribing a single method, this is a foundational step to ensure the counselor is treating the correct individual and to aid in safety planning. Methods could include viewing a photo ID via video, but the core requirement is the verification itself.
Question 5: Which of the following scenarios best demonstrates an LPC's adherence to the principle of technological competence in a telemental health practice?
- Using the newest, most popular video conferencing software available on the market.
- Only offering telemental health services to clients who are young and technologically proficient.
- Prior to using a new scheduling and billing platform, the LPC researches its security features, ensures it is HIPAA compliant, and learns how to operate it effectively. (Correct answer)
- Assuming that if a technology platform is widely used, it must be secure and appropriate for clinical use.
Correct answer: Prior to using a new scheduling and billing platform, the LPC researches its security features, ensures it is HIPAA compliant, and learns how to operate it effectively.
Professional competence extends to the technology used in practice. Oklahoma rules require counselors to have the necessary knowledge and skills for any technology they use. This includes understanding its functions, ensuring its appropriateness for clinical work, and verifying its security and confidentiality features before integrating it into their practice.
Question 6: An LPC is conducting a video therapy session with a client who suddenly becomes distressed and reports acute suicidal ideation. According to Oklahoma's requirements for telemental health, the LPC's ability to respond effectively in this crisis depends most critically on having done what during the intake process?
- Obtained the client's permission to record all sessions for safety review.
- Ensured the client has the newest version of the video conferencing software installed.
- Established the client's physical location and identified local emergency resources in the client's area. (Correct answer)
- Conducted a thorough assessment of the client's family history of mental illness.
Correct answer: Established the client's physical location and identified local emergency resources in the client's area.
A mandatory component of telemental health in Oklahoma is the creation of an emergency response plan during the initial informed consent process. This plan must include identifying the client's current physical location at the time of service and having contact information for local emergency services (e.g., nearest crisis unit, police department) readily available. This is crucial for the counselor to be able to dispatch help to the client's location in a crisis.
OLERE - Oklahoma Legal and Ethical Responsibilities Telehealth and Technology Questions and Answers 1
An LPC in Oklahoma is establishing a telemental health practice.
According to the Oklahoma Administrative Code (OAC), which of the following must be specifically addressed in the informed consent process, in addition to the standard elements required for in-person therapy?