Purpose: The purpose of this article was to gather descriptive data on the professional use of social media in public rehabilitation settings and to analyze existing social media policies in those agencies through content analysis. Methods: The authors sent a survey to all state administrators or directors of these agencies (N = 50) in the United States, requesting frequency and other descriptive information, plus a copy of their social media policies (if available). The available policies were reviewed using content analysis procedures. Results: The results showed that although the frequency of social media use was high, training and inclusion of ethics was low. Regarding policy, approximately 42% reported a lack of an existing policy, and 38% were unsure about having a policy guide. The analysis of the available policies yielded 11 themes around which these policies were organized. Discussion: The authors offer a discussion of these results and its implications for policy and practice as well as future research. These include the need for more comprehensive social media policy creation in agencies and the role of clinical supervisors in ensuring ethical practice.