Serving Students in Other States and Countries Through Telepractice

Many school-based members are serving students through telepractice due to the COVID-19 pandemic. ASHA developed Telepractice Resources During COVID-19 to provide guidance on service delivery. As the pandemic continues, questions have arisen regarding interstate and international practice requirements. ASHA addresses these topics below.

Providing Services to Students Who Temporarily Reside in Another State Where You Do Not Hold Credentials

Many states have emergency/temporary provisions in their statutes or regulations that allow members to practice across state lines for a defined period of time. ASHA’s COVID-19: Tracking of State Laws and Regulations for Telepractice and Licensure Policy [PDF] provides a summary of provisions and policy changes for each state. If a state does not have emergency provisions, ASHA suggests contacting the state licensure board where the student is residing to determine if the board will allow services to be provided within their state. Members are encouraged to indicate that the client/student is a permanent resident of the state where you are credentialed and that there is an existing student/provider relationship. In many cases, the board may indicate that services can be provided because the student is not a permanent resident of the state.

During the pandemic, about half of state governors have issued executive orders allowing for practice across state lines. In one-third of those states, members may provide services to temporary residents but must also notify the licensure board. In the remaining states, members may provide services without notifying the board.

ASHA’s State-by-State page includes contact information for each state’s licensure board.

Providing Services to Students in Your Home State When You Are Temporarily Residing in Another State

If you are temporarily living in a state where you are not licensed but are planning to deliver services to students that reside in a state where you are licensed, ASHA suggests that you notify the licensure board in the state where you are temporarily residing of your intention to serve students who are permanent residents of the state where you hold an active license.

Teaching Credential Without a Professional License

Members who hold a teaching credential or teaching license in the state where they reside or where services are delivered should check with the licensure board of that state to be sure that the state does not require a professional license in order to deliver services via telepractice.

In some cases, both teacher certification and state licensure may be required to deliver services across state lines. Although state licensure boards may only be concerned about protecting permanent residents of their state, ASHA recommends to check with the board for its interpretation and guidance.

Delivering Services to Students Internationally

If you have a student who is temporarily living in another country, ASHA suggests contacting the professional society or regulatory body in the country where you wish to practice for guidance. ASHA maintains a list of Audiology and Speech-Language Pathology Associations Outside of the United States, which includes contact information. If there isn’t an association in that country, or for additional information, ASHA suggests contacting the U.S. Embassy in that country or the Ministry of Health or Ministry of Education. When providing services outside of the U.S., ASHA-certified audiologists and SLPs must adhere to:

ASHA’s Code of Ethics (ASHA, 2016a) as well as the Codes of Ethics in the country the student resides ( if available)
Scope of Practice in Audiology (ASHA, 2018)
Scope of Practice in Speech-Language Pathology (ASHA, 2016b)

ASHA Advocates for Telepractice Flexibility in States

ASHA supports the use of telepractice and welcomes the flexibility states are providing during the COVID-19 pandemic to promote safety for both providers and students. Ongoing advocacy for flexibility to deliver services via telepractice beyond the pandemic will continue as well and efforts for Medicaid and private insurers to cover telepractice services for students permanently.

Through collaboration with the Council of State Governments, ASHA is advocating for states to adopt legislation for the Audiology & Speech-Language Pathology Interstate Compact, which would allow audiologists and speech-language pathologists to obtain a privilege to provide telepractice across state lines in participating states. ASHA has also developed model language for state associations and state licensure boards to work with state legislators to advocate for extended flexibility for interstate practice Model Language for Interstate Telepractice [PDF].