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. 2018 Dec 11;10(2):3–54. doi: 10.5195/ijt.2018.6269
Kentucky
Occupational Therapy Physical Therapy
Telehealth/Telemedicine/Telecommunications Definition
Telehealth means the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic media for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education.
Source:Ky. Rev. Stat. Ann. § 26:319A.300
Telehealth occupational therapy means the therapeutic use of purposeful and meaningful occupations (goal-directed activities) to evaluate and treat individuals who have a disease or disorder, impairment, activity limitation, or participation restriction that interferes with their ability to function independently in daily life roles, and to promote health and wellness practiced between the occupational therapist or occupational therapist assistant and the patient that is provided using:

  1. An electronic communication technology; or

  2. Two (2) way, interactive, simultaneous audio and video.

Source:201 Ky. Admin. Regs. 28:235 		Telehealth means the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic
media for diagnosis, consultation, treatment, transfer of health or medical data, and
continuing education.
Source:Ky. Rev. Stat. Ann. § 26:327.200
Telephysical therapy means physical therapy between the credential holder and the patient who are not at the same physical location using interactive, secure, synchronous audio, and synchronous videoconferencing technology.
Source:201 Ky. Admin. Regs. 22:001
Modality
Occupational therapists may use live video and audio.
Source:Ky. Rev. Stat. Ann. § 319A.300&201 Ky. Admin. Regs. 28:235 		Physical therapists may use live video and audio.
Source:Ky. Rev. Stat. Ann. § 26:327.200&201 Ky. Admin. Regs. 22:001
Location- Type of site/Geography
No reference found. No reference found.
Type of Service
Occupational therapists must limit the practice of telehealth occupational therapy to the area of competence in which proficiency has been gained through education, training, and experience.
Source:201 Ky. Admin. Regs. 28:235 		Telehealth may be used for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education.
Source:Ky. Rev. Stat. Ann. § 26:327.200
Supervision
No reference found. No reference found.
Informed Consent
The treating occupational therapist must ensure in writing that:

  1. Informed consent of the patient, or another appropriate person with authority to make the health care treatment decision for the patient, is obtained before services are provided through telehealth; and

  2. That the confidentiality of the patient’s medical information is maintained as required by Kentucky law. At a minimum, confidentiality shall be maintained through appropriate processes, practices, and technology as designated by the board and that conform to applicable federal law.

Source:Ky. Rev. Stat. Ann. § 319A.300
A credential holder using telehealth to deliver occupational therapy services shall, upon initial contact with the client:

  1. Make attempts to verify the identity of the client;

  2. Obtain alternative means of contacting the client other than electronically such as by the use of a telephone number or mailing address;

  3. Provide to the client alternative means of contacting the credential holder other than electronically such as by the use of a telephone number or mailing address;

  4. Provide contact methods of alternative communication the credential holder shall use for emergency purposes such as an emergency on call telephone number;

  5. Document if the client has the necessary knowledge and skills to benefit from the type of telehealth provided by the credential holder;

  6. Use secure communications with clients, including encrypted text messages via e-mail or secure Web sites, and not use personal identifying information in non-secure communications and;

  7. Inform the client in writing about:

    1. The limitations of using technology in the provision of telehealth occupational therapy services;

    2. Potential risks to confidentiality of information, or inadvertent access of protected health information, due to technology in the provision of telehealth occupational therapy services;

    3. Potential risks of disruption in the use of telehealth occupational therapy services;

    4. When and how the credential holder will respond to routine electronic messages;

    5. In what circumstances the credential holder will use alternative communications for emergency purposes;

    6. Who else may have access to client communications with the credential holder;

    7. How communications can be directed to a specific credential holder;

    8. How the credential holder stores electronic communications from the client; and

    9. How the credential holder may elect to discontinue the provision of services through telehealth.

Source:201 Ky. Admin. Regs. 28:235 		The treating physical therapist must ensure that:

  1. Informed consent of the patient, or another appropriate person with authority to make the health care treatment decision for the patient, is obtained before services are provided through telehealth; and

  2. That the confidentiality of the patient’s medical information is maintained as required by Kentucky law. At a minimum, confidentiality shall be maintained through appropriate processes, practices, and technology as designated by the board and that conform to applicable federal law.

A credential holder using telehealth to deliver physical therapy services or who practices telephysical therapy shall, upon an initial contact with the patient:

  1. Verify the identity of the patient;

  2. Obtain alternative means of contacting the patient;

  3. Provide to the patient alternative means of contacting the credential holder;

  4. Provide contact methods of alternative communication the credential holder shall use for emergency purposes;

  5. Not use personal identifying information in non-secure communications; an

  6. Inform the patient and document acknowledgement of the risk and limitations of:

    1. The use of electronic communications in the provision of physical therapy;

    2. The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of physical therapy; and

    3. The potential disruption of electronic communication in the use of telephysical therapy.

Source:201 Ky. Admin. Regs. 28:235
Patient-Provider-Relationship/In-Person Exam Required
No reference found. No reference found.
Licensing
Occupational therapists must be licensed in the location where the patient is domiciled. If the occupational therapist is located outside of Kentucky, must submit to the Kentucky Board of Occupational Therapy the following:

  • The name, permanent address, address in Kentucky, email address, and telephone number where the therapist can be reached;

  • The name, business address, and telephone number of the licensed occupational therapist with whom the therapist is associated;

  • The dates on which the therapist intends to practice in Kentucky; and

  • A copy of the current license from the state in which the therapist is licensed along with a statement from the licensing authority that the individual is in good standing.

Or

  • A letter of verification issued by the NBCOT stating that the therapist meets the current requirements for certification as a registered occupational therapist or a certified occupational therapy assistant and is in good standing.

Source:201 Ky. Admin. Regs. 28:235&201 Ky. Admin. Regs. 28:030 		Kentucky is part of the Physical Therapy Licensure Compact. Physical therapists licensed through the compact in other compact states may provide services in Kentucky.
Source:Ky. Rev. Stat. Ann. § 327.300
Other
A credential holder using telehealth to deliver occupational therapy services or who practices telehealth occupational therapy shall:

  • Limit the practice of telehealth occupational therapy to the area of competence in which proficiency has been gained through education, training, and experience;

  • Maintain current competency in the practice of telehealth occupational therapy through continuing education, consultation, or other procedures, in conformance with current standards of scientific and professional knowledge.

  • Document the client’s presenting problem, purpose, or diagnosis;

  • Follow the record keeping requirements; and

  • Ensure the confidential communications obtained and stored electronically shall not be recovered and accessed by unauthorized persons when the credential holder disposes of electronic equipment and data.

Source:201 Ky. Admin. Regs. 28:235 		A credential holder using electronic communication to deliver physical therapy services or who practices telephysical therapy shall:

  • Be responsible for determining and documenting that telehealth is appropriate in the provision of physical therapy;

  • Limit the practice of telephysical therapy to the area of competence in which proficiency has been gained through education, training, and experience;

  • Document which physical therapy services were provided by telephysical therapy;

  • Follow the Standards for Documentation; and

  • Ensure that confidential communications obtained and stored electronically shall not be recovered and accessed by unauthorized persons when the credential holder disposes of electronic equipment and data.

Source:201 Ky. Admin. Regs. 28:235