Regarding State Law

Introduction

This correspondence is in response to a concern raised by the Kentucky Psychological Association that managed care companies and insurers may inappropriately discriminate against some licensed doctoral-level psychologists by determining that only individuals with a specialty area in Clinical Psychology are eligible for reimbursement or inclusion on managed care panels for the provision of psychological services. Other duly licensed doctoral-level practitioners, including Counseling Psychologists and School Psychologists, have had claims for psychological services rendered rejected or have been rejected for inclusion on managed care panels, based solely on their licensure specialty designation by the State Board of Psychology. KPA seeks clarification regarding the intent of licensure specialty designations by the State Board of Psychology.

The Board has authorized this correspondence as an Opinion and Declaratory Ruling pursuant to KRS 13A.130(3) and KRS 13A.010(2)b as the agency with jurisdiction to interpret the statutes and regulations governing the practice of psychology in the Commonwealth of Kentucky.

1. The Board has described a broad scope of psychological practice for each practitioner regulated by the Board. This scope of practice includes the ability to diagnose and treat mental and nervous disorders and to provide diagnostic, assessment, preventive and therapeutic services directly to individuals and groups.
2. The Board hereby declares that licensure as a psychologist in Kentucky is generic. In this context, the designation of specialty occurs at the doctoral level, and is intended to indicate that different types of psychologists have different areas of expertise and competence, based on their specific education, training, and supervised experiences. Individual practitioners must practice only within areas in which they are competent, based on their specific education, training, and supervised experiences.
3. To enable the public (including third-party payors) to reach determinations about whether an individual doctoral-level psychologist is qualified to provide psychological services, the Board has created a more appropriate designation called Health Service Provider. All doctoral-level clinical, counseling, and school psychologists are endorsed as Health Service Providers by the State Board of Psychology.
4. Three major areas of specialty for doctoral-level psychologists currently designated by the Board (and codified in statute and regulation) are clinical, counseling, and school psychology. Each of these specialty areas overlaps with one another to an extensive degree, and all include the provision of psychological services such as diagnostic assessment and therapeutic interventions.
5. Within each of these psychological specialties, practitioners hold a doctoral degree in psychology and are licensed to practice independently to furnish diagnostic, assessment, preventive and therapeutic services directly to individuals. All furnish "clinical" services in the broader meaning of this term.
6. Determinations about eligibility to provide psychological services for doctoral-level licensed psychologists should be based on their holding the Health Service Provider endorsement from this Board, not on their specialty designation.

As the agency authorized by the Kentucky General Assembly to regulate the practice of psychology in this state, the Board is empowered to interpret its statutes and regulations. In summary, the Board declares that specialty designation is not the most appropriate means to determine whether an individual doctoral-level provider is eligible to be reimbursed for providing psychological services or to be included on a panel to provide psychological services. Rather, for doctoral-level psychologists, endorsement as a Health Service Provider is deemed to be a more accurate reflection of such eligibility. Licensure for independent practice at the doctoral level is interpreted to be generic, with specialty designations provided to suggest broad scope of practice considerations. Individual practitioners must practice only within areas for which they are competent.

This the 2nd day of October, 1998.

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Chair, State Board of Psychology