The interstate delivery of psychological services: Opportunities and obstacles.

Abstract

An analysis of the psychology licensing laws of the 50 states and the District of Columbia reveals that these laws pose serious obstacles to practicing outside of the state in which one is licensed. Eleven states do not allow any interstate practice. Twenty-three states allow an out-of-state psychologist to practice in that state but require some type of prior permission of the board. Only 17 states allow some interstate practice without prior approval, but several of these impose a variety of limitations. All 41 states that do allow an out-of-state psychologist to practice limit the number of days that such practice is allowed. These laws seem to be aimed more at protecting the psychologists who are licensed in that state than in protecting the potential consumers of psychological service. The need for reform of these laws is discussed, and a potential model-the interstate Mutual Recognition Compact-developed for nursing is a promising solution.

Looking to the VA for a roadmap on how to sustain tele-mental health care.

“…Medicaid reimbursement policies generally align with Medicare coverage standards, with some variation by state. A second challenge is ongoing mental health provider shortages and a lack of universal licensure reciprocity among U.S. states (Goodstein, 2012). The psychiatric workforce is projected to contract through 2024, followed by slow growth that is not certain to meet the population level of need through 2050 (Satiani et al, 2018).…”