Utilizing Telehealth Services During the COVID-19 Outbreak: A Letter to the Illinois Governor
The following was sent by NASW-Illinois Chapter Executive Director Joel L. Rubin and Chapter President Grisel Rodríguez-Morales to Illinois governor J. B. Pritzker.
Dear Governor Pritzker:
On behalf over the over 6,000 members of the National Association of Social Workers, Illinois Chapter (NASW-IL) and the over 20,000 licensed social workers that make up the entire social work community statewide, we would like to thank for your decisive leadership and rapid response to the COVID-19 outbreak.
Mental health therapy and counseling is both vital during this crisis and may create a health risk due to increased exposure. There are many stressors that impact a broad spectrum of people across Illinois and may cause a heightened state of anxiety and depression. Between those stressors, increased social isolation due to social distancing, and financial implications of the crisis, more people will be seeking out mental health supports. There are also many vulnerable Illinois residents that, due to age, health history, and other factors, make in-person therapy a risk, whereas therapy provided through telehealth would be the safer and more accessible option.
The Centers for Disease Control and Prevention (CDC) specifically cites the need to continue existing counseling or treatment: “People with preexisting mental health conditions should continue with their treatment plans during an emergency.” Illinois residents with pre-existing mental health conditions, if left without adequate support, may experience exacerbation of conditions that would send them to an already overburdened emergency room. Others may be going back to therapy, choosing to engage in it for the first time, or utilize it as a part of their own well-being process.
Because of this, we are asking you to review the current status and require that all state-run health plans, those regulated by the Illinois Department of Insurance, as well as policies serving state employees and retirees, commercial insurance, Employee Assistance Programs (EAP), and any other group plans (that currently does not allow telehealth mental health) to allow all providers to deliver mental health counseling to members via telehealth. Telehealth is “the use of electronic information and telecommunications technologies to support long-distance clinical health care,” but does not include telephone therapy. Because of this gap, we also request that therapy via telephone be added to the list of covered modalities on an emergency basis. Many areas of Illinois do not have adequate service to utilize video modalities, and low-income residents of Illinois often cannot afford the service or equipment. In urban areas, many people are working at home, overloading broadband systems. We believe providing therapy through telehealth, as well as telephone therapy, should be available to all during this crisis.
Furthermore, we ask that no provider or insurance carrier impose any specific requirements for additional certification or training; or on the technologies used to deliver telehealth services, including any limitations on audio-only or live video technologies. We also ask that you look at current Medicaid telehealth requirements that require dual locations for services. Asking clients to go to a separate facility, rather than allowing them to receive services at home, seems counterproductive to the intent of social distancing. Lastly, we are recommending that rates of payment to providers for services delivered via telehealth should not be lower than the rates of payment established for services delivered via traditional in-person methods. Insurers should notify providers of any instructions necessary to facilitate billing for such telehealth.
Again, your leadership, as well as the leadership of the state public health apparatus has been exemplary. The social work community, the largest provider of mental health services in the state, is willing and able to assist in any efforts. Please do not hesitate to contact us with any questions or assistance.
Thank you for your consideration in this most urgent matter.
Grisel Rodríguez-Morales, LCSW
Joel L. Rubin, MSW, ACSW, CAE