Telehealth Guidelines for Service Providers

Telehealth Guidelines for Service Providers

One of Ohio's top priorities is to support the mental health and well-being of all Ohios students. Ohio Department of Education licensed providers deliver mental and behavioral health services to both students with disabilities and general education students. Additionally, schools may partner with healthcare providers and community organizations to deliver these services to students.

Another priority is to ensure students with disabilities identified under the Individuals with Disabilities Education Improvement Act (IDEA) not only receive the educational services specified in their individualized education programs (IEPs), but also appropriate related services. Related services include, but are not necessarily limited to, those provided by a speech-language pathologist, occupational therapist, physical therapist, educational audiologist, school psychologist, school nurse or school social worker. These services may also be provided to students who are in a response to intervention (RTI) process or receiving interventions.

During the spring 2020 ordered school-building closure period, schools remotely supported continued learning, and many opted to provide related services and mental and behavioral health services virtually when feasible. As schools reopen, whether remote, in-person or using a hybrid approach, they must consider how to continue providing related services and mental and behavioral health services to meet students' needs, virtually or otherwise. For the purposes of this webpage, virtual related services and mental and behavioral health services will be referred to collectively as telehealth services.

On June 19, 2020, Governor DeWine signed House Bill 164 of the 133rd General Assembly. Section 5 of this new law which permits all school providers to use telehealth for the entirety of the 2020-2021 school year.

This information provided here answers commonly asked questions regarding the provision of telehealth services. It is intended to help school and district leaders and providers as they consider these options at the local level.

Telehealth Guidelines for Service Providers


Telehealth Guidelines for Service Providers

    1. If the IEP team determines that service delivery by telehealth is appropriate, must the IEP be amended to reflect this?
    If the IEP does not already state that services will be provided via telehealth, the IEP should be amended to reflect this.
    This can be accomplished through the IEP amendment process or by convening the IEP team. If the district’s overall plan is to provide education on a fully or partially remote plan, it is not necessary to amend the IEP to reflect that the services are being provided via telehealth.
     
    If telehealth services are part of the district’s overall plan to deliver services on a fully or partially remote plan, it is not necessary to amend each IEP, but the District should document that parents were informed that services will be provided via telehealth.

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    2. How can a school ensure student and family privacy is protected when using telehealth?

    In considering telehealth options, it is essential to review important resources that explain the Health Insurance and Portability and Accountability Act (HIPPA) and Family Educational Rights and Privacy Act (FERPA) laws and how they may apply to telehealth services, as well as the coronavirus (COVID-19) compliance updates to ensure student and family privacy is protected.   

    HIPAA may apply to children who receive services from health care providers (including related service providers with professional board licenses). See HIPPA and COVID-19.  

    FERPA protects the privacy of a student’s education records and applies to all public and private educational institutions who receive federal funds for programs, including the IDEA. See Protecting Student Privacy – FERPA and the Coronavirus 2019 (COVID-19).

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    3. Do telehealth services require additional parental consent?
    No. There are no federal or state requirements for additional consent to provide services via telehealth. However, some professional licensure boards require written parental consent to provide services via telehealth. For more information, providers may wish to check with the schools they work with along with their professional licensure boards.
     

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    4. Do IEP related services delivered via telehealth count as IEP minutes delivered?
    Yes. Service providers must keep accurate records of attendance participation of students and continue to document and analyze data as they would do when services are delivered at school. This documentation should include the dates of services, the number of minutes of services delivered, and a brief description of the services delivered. Progress reporting will be required just as it is when services are delivered in person.
     

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    5. Can a combination of in-person and telehealth IEP services be provided to the same student?
    If the IEP does not already state that services will be provided via telehealth, the IEP should be amended to reflect this.  If the combination of in-person and telehealth services are part of the district’s overall plan to deliver services on a fully or partially remote plan, it is not necessary to amend each IEP, but the District should document that parents were informed that services will be provided via telehealth. This can be accomplished through a prior written notice, IEP amendment, or other written correspondence.
     

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    6. Will Medicaid reimburse for health service provided via telehealth to Medicaid-enrolled students?
    Given the continued presence of COVID-19, rules regarding Medicaid reimbursement for telehealth services may continue to change. See the Ohio Department of Medicaid’s webpage for updates.
     

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    7. Does the Medicaid Schools Program reimburse telehealth related services provided to students with IEPs as well as telehealth services provided to all students?
    Yes. A new telehealth emergency rule was filed on July 16, 2020 and is effective through November 14, 2020. This emergency rule continues all Medicaid Schools Program (MSP) provisions that have been in place for telehealth services since March 2020. More information is available online here. More information will be available on the  Medicaid webpage.
     

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    8. Must HIPAA compliant platforms be used to deliver telehealth related services?
    No. To help expand the use of telehealth during the national emergency, the Office of Civil Rights (OCR) will temporarily allow the use of applications that are not fully HIPAA compliant such as Apple FaceTime, Facebook Messenger video chat, Google Hangouts and Skype. See HIPAA Telehealth.
    Nevertheless, schools should make every effort to use platforms that are HIPAA compliant. In addition, service providers should check with their professional licensure boards for any requirements to use encrypted platforms. The Department does not endorse or recommend any platform, but the following platforms represent that they are HIPAA compliant:
    • Skype for Business / Microsoft Teams
    • Updox
    • VSee
    • Zoom for Healthcare
    • Doxy.me
    • Google G Suite Hangouts Meet
    • Cisco Webex Meetings/Webex Teams
    • Amazon Chime
    • GoToMeeting
    • Spruce Health Care Messenger
    Given the continued presence of COVID-19, rules may continue to change. See the U.S. Department of Health and Human Services’ Health Information Privacy webpage for updates.
     

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    9. Does providing IEP related services via telehealth to a group of students in the same session violate FERPA confidentiality requirements since the transmission is going into homes?

    No. FERPA protects the privacy of students’ personally identifiable information in their education records and applies to all public and private educational institutions that receive federal funds for programs, including the Individuals with Disabilities Education Act (IDEA). 

    Because FERPA applies to educational records, service providers must take care not to discuss a student’s educational records or allow such records to be visible in a way that other students, parents or other persons could view them. However, providing services to students in groups via telehealth would not be a violation of FERPA, unless a student’s education records were discussed or viewed.

    Service providers must take care to provide services from a secure location that will not be interrupted by others walking into the room and maintain confidentiality using secure remote access to electronic documentation and records See FERPA and Virtual Learning Related Resources March 2020.

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    10. Must individual providers follow the rules of their respective professional licensure board concerning telehealth?

    Yes. The Ohio Department of Education requires related service providers and mental and behavioral health providers to follow the requirements of their respective Ohio board licenses.

    The Ohio Department of Education Operating Standards (administrative regulations for special education) and Ohio Administrative Code  3301-51-09(H)(2) state that related services personnel must have qualifications under the Ohio Department of Education that are “consistent with state-approved or state-recognized certification, licensing, registration,…” and that the Ohio Department of  Education must “ensure that related services personnel who deliver services in their discipline or profession meet the requirements and have not had certification or licensure requirements waived…”   

    School psychologists who are licensed by the Ohio Department of Education and not necessarily by the State Psychology Board may provide services to students using telehealth options. The consultations that Ohio Department of Education-licensed school psychologists perform are vital in maintaining the continuity of services for Ohio’s students with disabilities or those suspected of having disabilities.

    Given the continued presence of COVID-19, Ohio’s telehealth rules may continue to change. For specific questions regarding up-to-date telehealth rules, providers should reach out to their respective professional licensure boards directly.

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    11. Can occupational therapy assistants, school psychologist interns, etc. provide services via telehealth?
    Yes, subject to the allowances and requirements of the respective professional licensure boards. The Ohio Department of Education requires related service personnel and mental and behavioral health providers to follow the requirements of their respective professional licensure boards. The same requirements apply to services delivered via telehealth that would apply to services delivered in person. For specific questions regarding up-to-date telehealth rules, providers should reach out to their respective professional licensure boards directly.
     

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    12. Can mental and behavioral health services normally provided in the school be delivered via telehealth for all students, not just students identified as having a disability under IDEA?
    Yes. The Ohio Department of Mental Health and Addiction Services amended a rule to expand and enhance telehealth options. The rule relaxes regulations so more Ohioans, including students, can access mental and behavioral health services safely in their homes. The rule affects Ohio Department of Education-licensed providers and other mental and behavioral health care providers who may normally serve students in the school building or community. For more information, see Ohio Department of Mental Health and Addiction Services’ coronavirus information webpage and the interactive videoconferencing rule.
     
    Given the continued presence of COVID-19, rules regarding the provision of mental and behavioral health service via telehealth may continue to evolve. See the Ohio Department of Mental Health and Addiction Services’ coronavirus information webpage for updates.
     

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For more information regarding related services via telehealth, please contact the Office for Exceptional Children at exceptionalchildren@education.ohio.gov or (614)(466-2650).
 
For more information specific to the Medicaid School Program, please contact Mark Smith at schoolmedicaid@education.ohio.gov or (614) 752-1493.
 
For more information regarding mental and behavioral health services for students via telehealth, please contact the Office of Integrated Student Supports at wholechild@education.ohio.gov or (614) 466-2945.
 

Last Modified: 8/17/2020 8:05:39 AM