Issue Date: January 18, 2019
Volume 46 • Issue 2 • Page 77-78
MARYLAND DEPARTMENT OF HEALTH
Subtitle 58 BOARD OF
PROFESSIONAL COUNSELORS AND THERAPISTS
Occupations Article, §§1-901—1-903, Annotated Code of Maryland; Ch. 505, Acts
Notice of Proposed
Secretary of Health proposes to repeal in their entirety existing
Regulations .01—.03 under COMAR 10.58.06 Licensure by
Waiver and adopt new Regulations .01—.06 under a new
chapter, COMAR 10.58.06 Teletherapy. This action was
considered by the Board of Professional Counselors and Therapists at a public
meeting held on October 19, 2018, notice of which was given by publication on
the Board’s website at https://health.maryland.gov/bopc/Pages/index.aspx
pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.
Statement of Purpose
The purpose of this action is to:
(1) Repeal the chapter regarding licensure by waiver because the
authority was repealed by Ch. 505, Acts of 2008; and
(2) Establish a new teletherapy chapter pursuant to Ch.
610, Acts of 2017.
Comparison to Federal
There is no corresponding federal standard to this proposed
Estimate of Economic
The proposed action has no economic impact.
Economic Impact on Small
The proposed action has minimal or no economic impact on small
Impact on Individuals
The proposed action has no impact on individuals with
Opportunity for Public
Comments may be sent to Jake Whitaker, Acting Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY
800-735-2258), or email to email@example.com, or fax to 410-767-6483.
Comments will be accepted through February 19, 2019. A public hearing has not
This chapter applies to the following who provide
behavioral health services using teletherapy in Maryland:
A. Certified associate counselor-alcohol and drug (CAC-AD);
B. Certified professional counselor (CPC);
C. Certified professional counselor-alcohol and drug (CPC-AD);
D. Certified professional counselor-marriage and family therapist
E. Certified supervised counselor-alcohol and drug (CSC-AD);
F. Licensed clinical alcohol and drug counselor (LCADC);
G. Licensed clinical marriage and family therapist (LCMFT);
H. Licensed clinical professional art therapist (LCPAT);
I. Licensed clinical professional counselor (LCPC);
J. Licensed graduate alcohol and drug counselor (LGADC);
K. Licensed graduate marriage and family therapist (LGMFT);
L. Licensed graduate professional art therapist (LGPAT); or
M. Licensed graduate professional counselor (LGPC).
A. In this chapter, the following terms have the meanings
B. Terms Defined.
(1) “Board” means the Maryland Board of Professional Counselors
(2) “Client” means the individual, couple, family, group,
business, agency, school, organization, or association that the counselor or
therapist provides, or has provided, with professional services.
(3) “Counselor or therapist” means an individual who is licensed
or certified by the Board to practice:
(a) Certified associate alcohol and drug counseling;
(b) Certified professional counseling;
(c) Certified professional alcohol and drug counseling;
(d) Certified professional marriage and family therapy;
(e) Certified supervised alcohol and drug counseling;
(f) Clinical marriage and family therapy;
(g) Clinical professional alcohol and drug counseling;
(h) Clinical professional art therapy;
(i) Clinical professional counseling;
(j) Graduate alcohol and drug counseling;
(k) Graduate marriage and family therapy;
(l) Graduate professional art therapy; or
(m) Graduate professional counseling.
(4) “Synchronous” means simultaneously or quickly enough to allow
two or more individuals to conduct a conversation.
(a) “Teletherapy” means the use of interactive audio, video, or
other telecommunications or electronic media by a counselor or therapist to
deliver counseling services:
(i) Within the scope of practice of the counselor or therapist;
(ii) At a location other than the location of the client;
(b) “Teletherapy” does not include:
(i) An audio-only telephone conversation between a counselor or
therapist and a client;
(ii) An electronic mail message between a counselor or therapist
and a client;
(iii) A facsimile transmission between a counselor or therapist
and a client; or
(iv) A text message or other type of message sent between a
counselor or therapist and a client by a short message service or multimedia
A counselor or therapist licensed or certified in Maryland may
provide counseling services using teletherapy if one or both of the
A. The individual practicing teletherapy is physically
located in Maryland; or
B. The client is in Maryland.
.04 Standards of
Practice for Teletherapy.
A. Before providing teletherapy services, a counselor or
therapist shall develop and follow a procedure to:
(1) Verify the identification of the client receiving teletherapy services;
(2) Obtain oral and written acknowledgement from the client;
(3) Prevent access to data by unauthorized persons through
encryption, or other means;
(4) Notify clients in the event of a data breach;
(5) Ensure that the teletherapy practitioner provides a
secure and private teletherapy connection and complies with federal
and state privacy laws; and
(6) Establish safety protocols to be used in the case of an
B. A counselor or therapist shall:
(1) Obtain or confirm an alternative method of contacting the
client in case of a technological failure;
(2) Determine whether the client is in Maryland and identify the
client’s practice setting;
(3) For an initial teletherapy interaction only,
disclose the counselor or therapist’s name, location, license number, and
(4) Identify all individuals present at each location and confirm
they are permitted to hear the client’s health information; and
(5) Be held to the same standards of practice and documentation as
those applicable for in-person sessions.
C. A counselor or therapist may not treat a client based solely on
an online questionnaire.
A. A counselor or therapist shall perform a client evaluation
adequate to establish diagnoses and identify underlying conditions or
contraindications to recommended treatment options before providing treatment.
B. If the evaluation is adequate to comply with §A of this
regulation, a counselor or therapist may use:
(1) Live synchronous audio-visual communication;
(2) Other methods of performing a counseling examination remotely;
(3) A counseling evaluation performed by another counselor or
therapist providing coverage.
A. The Board shall use the same standards in evaluating
and investigating a complaint and disciplining a counselor or therapist who
practices teletherapy as it would use for a counselor or therapist
who does not use teletherapy technology.
B. The failure of a counselor or therapist to comply with this chapter
shall constitute unprofessional conduct and may be subject to disciplinary
action by the Board.
ROBERT R. NEALL
Secretary of Health
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464