Objective

To determine if the Office of Mental Health is adequately monitoring the delivery and performance of telemental health services and ensuring that related telemental health activities are conducted in accordance with applicable laws and regulations. The audit covered the period from January 1, 2016 through February 11, 2021.

About the Program

Telemental health (TMH) is a treatment method that uses two-way, real-time interactive audio and video equipment to provide and support mental health services and psychiatric care at a distance. In July 2019, the Office of Mental Health (OMH) expanded the State’s TMH regulations to allow additional OMH-licensed care providers beyond physician and psychiatric nurse practitioners (e.g., psychologists, mental health counselors) to provide TMH services. The change also expanded where services could be delivered and received, allowing individuals to receive TMH services at their place of residence, at a temporary location, or at a site licensed by OMH.

On March 30, 2020, OMH expanded the definitions of TMH and TMH practitioners and outlined programs and/or services eligible to use TMH for the duration of the COVID-19 disaster emergency. In addition, OMH issued a blanket attestation for providers to complete who wished to use TMH during the disaster emergency. In July 2020, OMH streamlined its approval process for providers to incorporate TMH as an optional service.

Key Findings

OMH has opportunities to improve TMH access and oversight, as follows:

• As of December 23, 2020, there were 448 OMH-licensed, -designated, and/or -funded mental health care providers operating 1,677 programs eligible to offer TMH; however, 307 of those 448 providers operating 1,050 programs were not approved to use TMH beyond the declared disaster emergency. As a result, some patients may no longer be able to access TMH services once the disaster emergency period ends.
• Oversight of a provider’s use of TMH is focused on the initial approval, and OMH does not have defined processes after this approval to continually oversee or monitor TMH. Additionally, OMH does not have a unit solely responsible for TMH oversight and has not developed standardized procedures or forms to incorporate reviews of TMH into its oversight processes. As a result, there is a higher likelihood for oversight issues to occur regarding the delivery of TMH services and a lack of assurance that services will be available to patients who would benefit from this method.

Key Recommendations

• Work with providers to increase their ability to offer TMH as a service to clients when it is deemed an appropriate method of treatment.
• Develop defined processes and procedures related to overseeing TMH beyond the initial approval process.