This page will be frequently revised as more information becomes available. Updated March 28, 2020, evening.
To all of my clients:
The coronavirus pandemic is suddenly upon us. It is so new that the U.S. Centers for Disease Control and Prevention (CDC) is still studying how it is transmitted and how to contain the spread. To ensure safety and provide needed support, I am currently offering only telepsychology and phone sessions. Third party payers have significantly loosened telepsychology restrictions and will pay for these sessions. I have moved to telepsychology for now because this is an evolving situation, and we need to keep safe. People throughout the world and in our state are taking extraordinary measures to limit the spread of the virus, including telecommuting, physical distancing, avoiding large gatherings, washing hands and frequently used surfaces, etc. The point of all of this is to save lives and avoid overwhelming the capacity of our health care system to care for patients who are severely ill. The only common sense thing to do is to provide psychotherapy via audiovisual and/or telephone communication. This is not a permanent situation. We need to work together to reduce the impact and to ride it out.
As of earlier this week, I picked up this quote from the CDC’s information page about its transmission that describes the current state of knowledge:
“COVID-19 is a new disease and we are still learning how it spreads, the severity of illness it causes, and to what extent it may spread in the United States.”
We do not yet know how contagious it is, or how dangerous. We know that older people and those with underlying health conditions are more vulnerable. But so are health care workers who have had high exposure to the sickest patients. We will know more when people are widely tested, which hasn’t happened yet, except with the sickest patients in medical settings. Dr. Anthony Fauci, a top health official, has said this disease is 10 times more lethal than seasonal flu. Does it appear that dangerous because too few people have been tested, especially those with minimal or no symptoms? Let’s stay safe until we know more.
While we are still learning about the covid-19 disease, I will offer support to established clients while taking measures to keep us all safe.
For this next couple of weeks or longer, as needed, I am offering telepsychology sessions through a secure telepsychology service, either doxy.me. If unable to connect through that platform, regulations have been loosened to allow video sessions via Skype, Google Hangouts, FaceTime, and WhatsApp. These platforms offer live video calls that work with many computers, smartphones and tablets. The device must have a camera and microphone and a fast enough internet connection. With a secure video call session, we are very much able to see and hear each other. If you have difficulty making the connection, I will do my best to guide you through setting up the video call capability and will initiate the session by sending an email or phone link just before we start.
Insurance coverage and Medicare
Many major health insurers have fast-tracked support of telepsychology. United Health Care and its Optum and UMR and Regence Blue Cross/Blue Shield of Oregon reimburse video calls. If you are in need of support and cannot make a video connection, I will support you with a phone call and may/may not be able to get it reimbursed later. I will list information about other payers that cover my services when it becomes available.
Medicare will pay for telepsychology sessions delivered as early as March 6. Regular visits require a video call, but providers can use video resources that are not outward-facing, such as FaceTime, to provide these sessions. Medicare is also allowing brief phone check-ins by clients, initiated by them. As we figure out the best means to connect remotely, I can explain benefits and limitations of the platform we’re using. Washington State is also requesting that Medicaid provide more flexibility in provider settings, funding and eligibility.
Keeping us safe
For now, I will offer telepsychology visits only, unless there is a very compelling reason for an office visit. I am erring on the side of caution to keep you, me and our community safe and avoid overwhelming our local healthcare system, with its dedicated workers and limited availability of life-saving equipment.
These are stressful times that also have the potential to unite us in helping each other. If you are an established client and are feeling overwhelmed, please try to contact me at (415) 271-2350. I want to help, but this is not a 24 hour/7 day crisis line. If you can’t reach me in a timely manner, contact the Clark County Crisis Hotline at 800.626.8137. For life-threatening emergencies or situations requiring an immediate on-scene response, please dial 911.
For established clients only, please feel free to call with any questions at (415) 271-2350. If I don’t get back to you by late in the day, please call back. You can also text me at this number, or email me at email@example.com for routine logistical communications that don’t reveal your protected health information. Be aware that personal information sent this way may not be secure. I also offer encrypted email at firstname.lastname@example.org. But that is not the most efficient way to reach me. Please call or text my phone, and I can call you back.
Here, again, is the link to the CDC’s information website. It answers most of your questions, including how to keep yourself and others from getting infected. I am available to support you through the many challenges this will put us through. May this pandemic be the wake-up call that brings us together to address the most urgent situations facing our country and our world.