Illinois Mental Health Counselors

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IDFPR Variance for Out-of-State licensees
Form for Out-of-State licensees to get a temporary Practice Permit -exp 9/30/20
See Form

IDFPR Variances
related to extended renewal deadlines for licenses expiring soon, massage therapists hands on training, exceed 10% in online ethics courses
These variances do not apply to LPC/LCPC - LSW/LCSW
There is NO change in LPC / LCPC earning no more than 15 CEs online in a renewal period.

CACREP RESPONSE

*NEW* To read about Internship Accommodations Report click here

*NEW* For FAQs about the Internship Accommodations Report click here

Student Loans

Student loan borrowers adversely affected by the coronavirus, or COVID-19, can officially get some relief on their debt if they request it, according to new details announced on Friday by the Education Department (ED).

Education Secretary Betsy DeVos directed all federal student loan servicers to grant “administrative forbearance” to any borrower with federal loans for at least two months, if they request one. Forbearance will be in effect for “at least 60 days” starting March 13. Documentation is not required.

“This will allow borrowers to temporarily stop their payments without worrying about accruing interest,” the department stated.

Furthermore, according to the department, all borrowers who have federal student loans will see their interest rates automatically drop to 0% “for a period of at least 60 days.”


We have tried to provide you appropriate links to the original documents and information. We can not redefine or interpret the language. If you need that, I suggest contacting your attorney. The Governor's orders were written in plain language to eliminate confusion. I recommend that you not attempt to read into it something it does not specifically say. I recommend that you not try to redefine the specific language to fit your needs. Please take the information at face value.

We are continuing to advocate for counselors about current rules and laws that need variances because of the current pandemic.   


Can counselors provide telehealth?
Yes, they always could. More details are listed below.

What electronic devices can be used for telehealth?
Section 1. “Telehealth Services” shall be defined to include the provision of health care, psychiatry, mental health treatment, substance use disorder treatment, and related services to a patient, regardless of their location, through electronic or telephonic methods, such as telephone (landline or cellular), video technology commonly available on smart phones and other devices such as FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, and videoconferencing, as well as any method within the meaning of “telehealth services” under Section 356z.22 of the Illinois Insurance Code, 215 ILCS 5. “Health insurance coverage” and “health insurance issuer” shall have the meanings given in Section 5 of the Illinois Health Insurance Portability and Accountability Act, 215 ILCS 97.

What technology can not be used?
Section 9. A covered health care provider and/or covered entity subject to the requirements of the Mental Health and Developmental Disabilities Confidentiality Act, 740 ILCS 110, that uses audio or video communication technology to provide Telehealth Services to mental health and developmental disability patients may use any non-public facing remote communication product in accordance with Section 1 of this Executive Order for the duration of the Gubernatorial Disaster Proclamation. This exercise of discretion applies to Telehealth Service providers or covered entities for any reason, regardless of whether the Telehealth Service concerns the diagnosis and treatment of health conditions related to COVID-19. Providers and covered entities should, to the extent feasible, notify patients that third-party applications potentially introduce privacy risks. Providers should enable all available encryption and privacy modes when using such applications. Facebook Live, Twitch, TikTok, and similar video communication applications which are public facing should not be used in the provision of telehealth by covered health care providers or covered entities.

What if the insured says I have to use a specific software/platform?
Email and explain to them the Governor orders. Ask for a supervisor.

What if my client is in the Federal BCBS, CABCBS, BCBSAZ, etc?
Many states have enacted similar waivers. Check with that government or provider.


Medicaid

Governor Pritzker has requested expanding system and providers, see link.

Are ALL Insurance providers covered under the Governor telehealth plan?
Section 2. Beginning March 19, 2020 and continuing for the duration of the Gubernatorial Disaster Proclamation, in order to protect the public’s health, to permit expedited treatment of health conditions during the COVID-19 pandemic, and to mitigate its impact upon the residents of the State of Illinois, all health insurance issuers regulated by the Department of Insurance are hereby required to cover the costs of all Telehealth Services rendered by in-network providers to deliver any clinically appropriate, medically necessary covered services and treatments to insureds, enrollees, and members under each policy, contract, or certificate of health insurance coverage. Issuers may establish reasonable requirements and parameters for Telehealth Services, including with respect to documentation and recordkeeping, to the extent consistent with this Executive Order or any company bulletin subsequently issued by the Department of Insurance under this Executive Order. An issuer’s requirements and parameters may not be more restrictive or less favorable toward providers, insureds, enrollees, or members than those contained in the emergency rulemaking undertaken by the Department of Healthcare and Family Services at 89 Ill. Adm. Code 140.403(e). Issuers shall notify providers of any instructions necessary to facilitate billing for Telehealth Services.

What about clinical face to face hours that are required under the LCPC licensure process? Does teletherapy count as face to face?
No waivers on this topic have been issued by IDFPR. We have requested waivers.



What about LCPC applicant requirement for in person 1 hour weekly supervision?


Record keeping, releases, consent to treatment and other forms.

See HIPAA section at top.
Governor order telehealth.

Section 8. Beginning March 19, 2020 and continuing for the duration of the Gubernatorial Disaster Proclamation, the following statutory limitations pursuant to Section 5 of Illinois’ Mental Health and Developmental Disabilities Confidentiality Act, 740 ILCS 110/5, are suspended for the provision of Telehealth Services to mental health and developmental disability patients in Illinois:

  1. The disclosure prohibitions as to records and communications pursuant to 740 ILCS 110/5(a).
  2. The written consent provisions pursuant to 740 ILCS 110/5(b).


Will their be support for counselors in providing telehealth services? Training?
Counselors can use their telephone to provide services. No special training or software is required.

What billing codes do we use?
The statement from ILBCBS lists codes.

Is special training required to provide telehealth?
No special training is required by law.

Did IDFPR issue a waiver to the in person CEs rules?
Not for counselors because the counselor license is not due for renewal for 12 months.

What if the provider or client tests positive for COVID-19?
ACA Code of Ethics.
B.2.c. Contagious, Life-Threatening Diseases When clients disclose that they have a disease commonly known to be both communicable and life threatening, counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease. Prior to making a disclosure, counselors assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party. Counselors adhere to relevant state laws concerning disclosure about disease status.

Counselor- Notify clients, self isolate, seek medical help.

What about those not licensed? Clinically supervised? Students?
Governor order
Section 5. Telehealth Services subject to this Executive Order’s coverage requirements may be provided by any in-network physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists, prescribing psychologists, dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, hearing instrument dispensers, other mental health providers, and other substance use disorder treatment providers, as long as they are licensed, registered, certified, or authorized to practice in the State of Illinois, regardless of whether or not the in-network provider was originally established prior to the COVID-19 pandemic in any designated telehealth network for the policy, contract, or certificate of health insurance coverage. Existing insurance law requirements regarding coverage of treatments based on licensure apply, such as the coverage requirements for treatment of autism spectrum disorders contained in Section 356z.14 of the Illinois Insurance Code, 215 ILCS 5.


How can I volunteer?

How can you help?

To donate personal protective equipment, e-mail ppe.donations@illinois.gov. If you are interested in volunteering in some capacity, visit serve.illinois.gov or e-mail dph.serveillinois@illinois.gov. The state is also asking licensed health care providers to register at www.illinoishelps.net to offer their services. You can also make a financial contribution to help those Illinoisans who have lost their jobs or been otherwise harmed financially by visiting www.ilcovidresponsefund.org. Illinois small businesses are asking for your help as part of the “IL”ove Local campaign.

Another opportunity to assist concerns blood donations. As blood drives have been cancelled, the state and the nation have faced a critical shortage of blood donations. Visit www.redcross.org to find out where and how you can help.

More information about volunteer opportunities is available here.

HIPAA?

Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency

During the COVID-19 national emergency, which also constitutes a nationwide public health emergency, covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services, through remote communications technologies.  Some of these technologies, and the manner in which they are used by HIPAA covered health care providers, may not fully comply with the requirements of the HIPAA Rules. 

OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.  This notification is effective immediately.

What about Co-pays? What is cost-sharing?
Section 4. Health insurance issuers shall not impose any cost-sharing (copayments, deductibles, or coinsurance) for Telehealth Services provided by in-network providers. However, in accordance with the standards and definitions in 26 U.S.C. 223, if an enrollee in a “high-deductible health plan” has not met the applicable deductible under the terms of their coverage, the requirements of this Section do not require an issuer to pay for a charge for Telehealth Services unless the associated health care service for that particular charge is deemed “preventive care” by the United States Treasury. The federal Internal Revenue Service recently has recognized that services for testing, treatment, and any potential vaccination for COVID-19 fall within the scope of “preventive care.”


We have received the question on co-pays in multiple formats. 
Health insurance issuers shall not impose any cost-sharing (copayments, deductibles, or coinsurance) for Telehealth Services provided by in-network providers.

What is a "high-deductible health plan"?
Follow link above for full definition.

How do I know if they are a high deductible?
Ask the insurance provider.

How do I know if they have met the high deductible?
Ask the insurance provider.

Do I not collect a deductible?
See above.

Under the Stay in Place Order can I and/or my client leave home for providing/receiving mental health treatment?
Yes.

Healthcare and Public Health Operations. For purposes of this Executive Order, individuals may leave their residence to work for or obtain services through Healthcare and Public Health Operations.
  1. Healthcare and Public Health Operations includes, but is not limited to: hospitals; clinics; dental offices; pharmacies; public health entities, including those that compile, model, analyze and communicate public health information; pharmaceutical, pharmacy, medical device and equipment, and biotechnology companies (including operations, research and development, manufacture, and supply chain); organizations collecting blood, platelets, plasma, and other necessary materials; licensed medical cannabis dispensaries and licensed cannabis cultivation centers; reproductive health care providers; eye care centers, including those that sell glasses and contact lenses; home healthcare services providers; mental health and substance use providers; other healthcare facilities and suppliers and providers of any related and/or ancillary healthcare services; and entities that transport and dispose of medical materials and remains.
    Specifically included in Healthcare and Public Health Operations are manufacturers, technicians, logistics, and warehouse operators and distributors of medical equipment, personal protective equipment (PPE), medical gases, pharmaceuticals, blood and blood products, vaccines, testing materials, laboratory supplies, cleaning, sanitizing, disinfecting or sterilization supplies, and tissue and paper towel products.
    Healthcare and Public Health Operations also includes veterinary care and all healthcare services provided to animals.
    Healthcare and Public Health Operations shall be construed broadly to avoid any impacts to the delivery of healthcare, broadly defined. Healthcare and Public Health Operations does not include fitness and exercise gyms, spas, salons, barber shops, tattoo parlors, and similar facilities.
  2. Human Services Operations. For purposes of this Executive Order, individuals may leave their residence to work for or obtain services at any Human Services Operations, including any provider funded by the Illinois Department of Human Services, Illinois Department of Children and Family Services, or Medicaid that is providing services to the public and including state-operated, institutional, or community-based settings providing human services to the public.
    Human Services Operations includes, but is not limited to: long-term care facilities; all entities licensed pursuant to the Child Care Act, 225 ILCS 10, except for day care centers, day care homes, group day care homes, and day care centers licensed as specified in Section 12(s) of this Executive Order; residential settings and shelters for adults, seniors, children, and/or people with developmental disabilities, intellectual disabilities, substance use disorders, and/or mental illness; transitional facilities; home-based settings to provide services to individuals with physical, intellectual, and/or developmental disabilities, seniors, adults, and children; field offices that provide and help to determine eligibility for basic needs including food, cash assistance, medical coverage, child care, vocational services, rehabilitation services; developmental centers; adoption agencies; businesses that provide food, shelter, and social services, and other necessities of life for economically disadvantaged individuals, individuals with physical, intellectual, and/or developmental disabilities, or otherwise needy individuals.
    Human Services Operations shall be construed broadly to avoid any impacts to the delivery of human services, broadly defined.





What if the provider is out-of-network?
Governor order
Section 6. This Executive Order does not apply to “excepted benefits” as defined by 45 C.F.R. 146.145(b) and 45 C.F.R. 148.220, but does apply to limited scope dental benefits, limited scope vision benefits, long-term care benefits, coverage only for accidents, or coverage only for specified disease or illness. This Executive Order applies to short-term, limited-duration health insurance coverage, fully insured student health insurance coverage, and fully insured association health plans except with respect to excepted benefits as provided above. Any policy, contract, or certificate of health insurance coverage that does not distinguish between in-network and out-of-network providers shall be subject to this Executive Order as though all providers were in-network.

Who is immune from Civil Liability?

Section 1. For purposes of this Executive Order, the following terms are defined as set forth below:

  1. "Health Care Facilities” means:
    1. Facilities licensed, certified, or approved by any State agency and covered by the following: 77 Ill. Admin. Section 1130.215(a)-(f); University of Illinois Hospital Act, 110 ILCS 330; Alternative Health Care Delivery Act, 210 ILCS 3/35(2)-(4); Emergency Medical Services (EMS) Systems Act, 210 ILCS 50; or Department of Veterans’ Affairs Act, 20 ILCS 2805;
    2. State-operated Developmental Centers certified by the federal Centers for Medicare and Medicaid Services and licensed State-operated Mental Health Centers created pursuant to the Mental Health and Developmental Disabilities Administrative Act, 20 ILCS 1705/4;
    3. Licensed community-integrated living arrangements as defined by the Community-Integrated Living Arrangements Licensing and Certification Act, 210 ILCS 135/2;
    4. Licensed Community Mental Health Centers as defined in the Community Services Act, 405 ILCS 30;
    5. Federally qualified health centers under the Social Security Act, 42 U.S.C. ยง 1396d(l)(2)(B); and
    6. Any government-operated site providing health care services established for the purpose of responding to the COVID-19 outbreak.
    “Health Care Professional” means all licensed or certified health care or emergency medical services workers who (i) are providing health care services at a Health Care Facility in response to the COVID-19 outbreak and are authorized to do so; or (ii) are working under the direction of the Illinois Emergency Management Agency (IEMA) or DPH in response to the Gubernatorial Disaster Proclamations.
      Section 4. Pursuant to Sections 15 and 21(b)-(c) of the IEMA Act, 20 ILCS 3305/15 and 21(b)-(c), I direct that during the pendency of the Gubernatorial Disaster Proclamations, Health Care Professionals, as defined in Section 1 of this Executive Order, shall be immune from civil liability for any injury or death alleged to have been caused by any act or omission by the Health Care Professional, which injury or death occurred at a time when a Health Care Professional was engaged in the course of rendering assistance to the State by providing health care services in response to the COVID-19 outbreak, unless it is established that such injury or death was caused by gross negligence or willful misconduct of such Health Care Professional, if 20 ILCS 3305/15 is applicable, or by willful misconduct, if 20 ILCS 3305/21 is applicable.



      The current IL regs: http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=3807

       (225 ILCS 150/10) 
          Sec. 10. Practice authority. A health care professional treating a patient located in this State through telehealth must be licensed or authorized to practice in Illinois. 
      (Source: P.A. 100-317, eff. 1-1-18.)






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