Needed Telehealth for Psychotherapy

Only recently did I realize the magnitude of the pending loss of Telehealth services for psychotherapy.

Medicare is being extended, but hundreds of thousands of vulnerable others across the country are at risk for losing Telehealth.

Yes, thousands of vulnerable individuals are at risk to lose Telehealth for psychotherapy in California as of February 28, 2023, as noted in the detailed letter below. Indeed, the discontinuation of Telehealth for most of the country is planned for May 2023.

It should not be a choice between risking grave illness versus psychotherapy, whether patients or therapists.

It should not be a choice between being poor and having access to psychotherapy through Telehealth.

Below is a copy of an email to those cited above:
Dear ACPA Members,

I am writing to ask how many of you are concerned about the possible discontinuation of Telehealth for psychotherapy and other psychological services?

As the virus and its variants are surely wearing us all down, it is no surprise that many of you are relaxing your Covid 19 protocols and seeing patients in person.

However, this situation still leaves those that have autoimmune disorders, are over age 65, babies, income-limited for travel and time expense (sitters, time away from work), and rural others or those who live far to drive - all are threatened with being no longer able to access their therapist.

Moreover, some of us therapists are also in the category of exposure risk, so that healthy individuals, often asymptomatic themselves. may unconsciously expose more vulnerable others. Even a self-test in the morning is limited to 70% effectiveness. Masks, distance, air cleaners, ventilation, vaccines, booster, and more have all been known as partial protections in which break-through cases have appeared.

Then there is also the risk of long Covid which is at epidemic proportions, but underreported in the news. Referred to as the “pandemic after the pandemic," long Covid is estimated to effect roughly 30% of Americans for weeks, months or even years.

I wrote ACPA’s new leader and President, Leryn, and she kindly responded as follows:

"When the order ends on February 28, 2023, it does not signify the end of the COVID-19 pandemic, but just means that the government has decided that there is no longer an "emergency" and that these mandates no longer need to be held. This creates the opportunity for
"insurance companies and medi-care/medi-cal to go BACK to making their own decisions around what they do and do not cover or reimburse for. This will be decided per insurance company in their own networks and you would need to contact the ones that you are in-network with to determine what this might mean for your own practice. From my research and communication with CPA, this could vary from requiring occasional sessions to be held in person to insurance companies or medi-care/medi-cal
no longer allowing services to be held and paid for by them, in-network, via telehealth.

"My hope is that they continue to allow services to be held remotely as it helps bridge a health care disparity for those that are immunocompromised, those who do not have reliable transportation to appointments, and for those that cannot take time away from childcare
and work obligations to attend healthcare appointments. I was hoping my message would encourage the ACPA membership to begin to look into these things and advocate the needs they feel the mandates in the emergency order has helped in the populations they serve."

I don’t know what it means to provide psychotherapy if the therapist is not “in-network,” but leaving the Telehealth decision to the insurance company seems unwise. It suggests a conflict of interest for them. I saw Governor Newsom announce this theoretical end of Covid and Biden too (although he walked it back a bit). Thus, I have written the Governor, urging him to consider exceptions that could allow therapists and patients to continue psychotherapy with Telehealth. Writing our senators and representatives seems important, as well, in order to appeal to them regarding the very real need for continuing Telehealth.

Telehealth is needed for the sake of public health, providers and patients alike.

Covid 19 protocols will be discontinued if denial of the risk remains. Telehealth is needed in order for thousands of individuals to continue or seek psychotherapy in this time of great need.

Please let me know if you, too, are facing this dilemma, what ideas you may suggest, or actions we could take for the purpose of protecting public health, ourselves and our practices.

Sincerely,
Susan