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Operations in Response to COVID-19 Outbreak

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March 26, 2020

In response to the directive from Governor Roy Cooper that State agencies implement teleworking in response to the COVID-19 outbreak, the North Carolina Board of Licensed Clinical Mental Health Counselors has implemented teleworking arrangements for Board staff members. As of December 14, 2020, the Board office is closed to the public due to COVID-19. Due to this change, please limit phone calls and forward all questions and concerns to LCMHCinfo@ncblcmhc.org. If you still decide to call, please leave a voicemail, providing your name, email address, phone number, and a detailed description of your inquiry. However, for the quickest response, please use email. The expectation is that the teleworking will allow for the seamless continuation of the Board’s functions while limiting any impact to licensees, applicants and the public. However, if you do experience a delay in receiving a response from a Board staff member during this fluid and unprecedented situation, your understanding and patience will be appreciated. As the Board office is closed to visitors at this time, you should send and/or email, and not hand deliver, all documents to the Board office. The Board will continue to update you via the website as we continue to learn of the new developments that affect our profession. Thank you for your patience and for being a valued member of our community. (Last updated: December 11, 2020)

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Frequently Asked Questions Regarding Clinical Practice and COVID-19

(Last Revised August 4, 2020)

Yes. The practice of counseling may be provided in North Carolina by clinical mental health counselors licensed by this Board or by those exempt from licensure in North Carolina (i.e. school counselor certified by the State Board of Education, qualified counselor interns, who are providing services that constitute a part of the supervised course of study, etc. Please see North Carolina General Statute § 90-332.1 “Exemptions from licensure” for more specifics.) through electronic means such as telehealth. Please find the Board’s Distance Counseling Policy, "Provision of Services via Electronic, Distance Professional Counseling Services, and Supervision," here. Also, please refer to the US DHHS Statement on telehealth and HIPPA compliance during COVID-19 public health emergency, here.

The Introduction to Section H, entitled "Distance Counseling, Technology, and Social Media" states that:

Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions. Counselors actively attempt to understand the evolving nature of the profession with regard to distance counseling, technology, and social media and how such resources may be used to better serve their clients. Counselors strive to become knowledgeable about these resources. Counselors understand the additional concerns related to the use of distance counseling, technology, and social media and make every attempt to protect confidentiality and meet any legal and ethical requirements for the use of such resources. (2014 ACA Code of Ethics, p. 17 )

Please refer to the entire Section H of the ACA Code of Ethics here.

The Board considers the practice of counseling to occur both where the counseling who is providing clinical mental health services is located and where the individual (patient/client) who is receiving the services is located. Therefore, if you are licensed in North Carolina (or exempt from licensure), you can practice clinical mental health counseling through electronic means to someone located in another state; however, you would need to first contact the state licensing board in the state where your client is located to determine if licensure is required to provide counseling services through telehealth to someone located in that state. According to the Board’s Distance Counseling Policy, “if an individual licensed in North Carolina renders services electronically to an out-of-state client, it is the responsibility of the counselor to ensure that the counselor is complying with the laws and rules in the other state."

If you are licensed to practice counseling in North Carolina, you can provide counseling services to someone located in North Carolina; however, you would need to contact the state where you reside to determine if licensure is required to provide counseling services from the state where you reside into another state such as North Carolina.

Pursuant to North Carolina Governor Roy Cooper’s Executive Order No. 130, Section 3, effective April 8, 2020, which will remain in effect until April 5, 2022 (extended by Executive Order 236 and 245), unless rescinded or replaced, the Board has voted to temporary waive the licensure requirements for clinical mental health counselors who are licensed in another state, territory, or the District of Columbia to provide counseling services within North Carolina. Any counselor licensed in another state, territory, or the District of Columbia who intends to provide counseling services (either through telehealth or in person) to someone located in North Carolina must notify the North Carolina Board of Licensed Clinical Mental Health Counselors at LCMHCinfo@ncblcmhc.org of their intent to provide counseling services to someone located in North Carolina, must identify their license number and the state(s) in which the counselor is licensed, and provide their contact information. This notification must be done either prior to or, in case of an emergency, as soon as practicable, but no later than 2 business days, after providing counseling services to someone located in North Carolina. Again, the licensure waiver is temporary and is currently effective only until April 5, 2022, unless rescinded or replaced.

In the Administrative Rule 21 NCAC 53 .0212, "Face-to-face" clinical supervision means supervision that is live, interactive, and visual. Video supervision is permitted as long as the session is synchronous and involves verbal and visual interaction during the supervision. All supervision, whether live or audio and video recordings, shall be done in a confidential manner in accordance with the ACA Code of Ethics and the Board’s Administrative Rule. The Board also refers you to the Board’s Distance Counseling Policy, “Provision of Services via Electronic, Distance Professional Counseling Services, and Supervision,” available here.

Please note that the following requirements must be met when engaging in a supervised practice as defined at the Board’s Administrative Rule 21 NCAC 53 .0208. A Clinical Mental Health Counselor Associate must comply with the Board’s Administrative Rule 21 NCAC 53.0702 before and while engaging in supervised practice. A Clinical Mental Health Counselor Supervisor must comply with the requirements of the Board’s Administrative Rule 21 NCAC 53.0801 prior to and while engaging in supervised practice.

The Board encourages you to explore the following devices which may be utilized for such purposes: transcription, 3-way conversation with a supervisor, or other HIPPA compliant digital platforms offering confidential services.