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I need to know the rules regarding Emotional Support Animals and "teletherapy." Particularly, what are the rules regarding who can issue these letters, and do these rules change based on the state of the therapist or client.
Hello! Thank you for turning to Wonder for your request about an overview of the laws regarding "teletherapy" or telehealth, and the laws revolving around the authorization letters for registered emotional support animals (ESA).
The most useful sources I found to answer your request are The National Telehealth Policy Resource Center and LicensePortability.org. The short answer to your question is that there are no rules that outlaw inter-state authorization of ESA letters and the FSMB is working on fully enacting the IMLC to maximize the benefits of telehealth. Below, you will find a deep dive into this answer.
METHODOLOGY
I first focused my research on legislation and policies regarding inter-state authorization of ESA letters by licensed medical practitioners. I found that there is currently limited documentation of any regulations. I instead directed my research towards legislation and policies for telehealth, which is the distribution of health-related services and information via telecommunication such as through the internet or by telephone.
ESA LETTER AUTHORIZATION
According to the National Service Animal Registry, any licensed mental health professional such as a psychologist, psychiatrist or a therapist is authorized to write and send an ESA letter to legally qualified emotionally disabled patients. This applies even to patients located in different states.
TELEHEALTH
It is difficult to determine which laws overrule the other when a doctor and a patient are in different states. Once healthcare crosses borders, different state bodies are involved in order to regulate and maintain the level of care that is provided to the consumer. Currently, telehealth is complex with many grey areas when put into practice especially as it crosses borders.
According to The National Health Policy Resource Center, thanks to the innovation of telecommunication, health care can now be provided to distant regions remotely and with little physical barriers through high-speed internet connections. Although this will no doubt make it easier to provide better quality services over long distances more efficiently, licensed medical practitioners in most cases may be limited to practicing in the states where they are licensed depending on the regulations of the licensing boards of each state. Some states have adopted the Interstate Medical Licensure Compact. Other states allow the delivery of healthcare through borders freely. There are also states who still do not allow it at all.
The IMLC is an expedited option for licensed medical practitioners who wish to offer their services throughout the entire US. This is accomplished by streamlining procedures for licensure and regulations for medical practices among different states. Medical practitioners will be eligible for entry into the compact process by acquiring a full and unrestricted license in a compact member state, by being certified in a medical specialty, by having no history of being disciplined, penalized or punished by a court, by having a medical licensing agency or by receiving approval from the drug enforcement administration, and by meeting several other requirements. It is estimated that nearly 80% of all medical practitioners licensed in the US could be eligible for expedited licensure via the compact.
1.) Alabama
2.) Arizona
3.) Idaho
4.) Illinois
5.) Iowa
6.) Kansas
7.) Minnesota
8.) Mississippi
9.) Montana
10.) Nevada
11.) New Hampshire
12.) South Dakota
13.) Utah
14.) West Virginia
15.) Wisconsin
16.) Wyoming
17.) Colorado
18.) Pennsylvania
1.) Alaska
2.) Maryland
3.) Michigan
4.) Nebraska
5.) Oklahoma
6.) Rhode Island
7.) Vermont
8.) Washington
To wrap it up, there are no rules that outlaw inter-state authorization of ESA letters and the FSMB is working on fully enacting the IMLC to maximize the benefits of telehealth.
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