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Telehealth: Summary of Changes - Assembly Bill 809 (Logue) – Statutes of 2014

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Dear State Board of Psychology Stakeholders:

Assembly Bill 809 (Logue, Chapter 404, Statutes of 2014) was signed by the Governor and became effective September 18, 2014. The legislation amended Business & Professions Code section 2290.5, and affects the provision of services via telehealth. Illustrated below are explanations on the changes and how they may affect you.

Summary of Changes
The law requires psychologists initiating the provision of services via use of telehealth to obtain verbal or written consent from the patient for the use of telehealth. The law requires that a health care provider document the consent in the patient's medical file.

Changes for patients:

  • You have the right to be informed before any telehealth initiated and must provide verbal or written consent to the psychologist before the first instance of telehealth.

Changes for psychologists:

  • Inform the patient about the use of telehealth;
  • Obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services.
  • Document the consent in the patient’s medical record/ file; and
  • Only obtain consent prior to the first instance of telehealth. Additional consent does not need to be obtained for subsequent instances of telehealth.

New Language
The underlined language reflects the changes to the law. Section 2290.5 of the Business and Professions Code is amended to read:

(a) For purposes of this division, the following definitions shall apply:

(1) "Asynchronous store and forward" means the transmission of a patient’s medical information from an originating site to the health care provider at a distant site without the presence of the patient.

(2) "Distant site" means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.

(3) "Health care provider" means a person who is licensed under this division.

(4) "Originating site" means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.

(5) "Synchronous interaction" means a real-time interaction between a patient and a health care provider located at a distant site.

(6) "Telehealth" means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.

(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented

(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.

(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.

(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.

(f) All laws regarding the confidentiality of health care information and a patient’s rights to his or her medical information shall apply to telehealth interactions.

(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.

(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.

(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).

(3) For the purposes of this subdivision, "telehealth" shall include "telemedicine" as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.