Telehealth Guidelines for Service Providers

The unprecedented closure of all Ohio’s public, community and private K-12 school buildings due to the ongoing coronavirus (COVID-19) health crisis is having a tremendous impact on the way in which Ohio’s students are educated and supported.

One of Ohio’s top priorities during this closure is to support the mental health and well-being of all Ohio’s 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 health care providers and community organizations to deliver mental and behavioral health services to students.

Another priority is to ensure, to the fullest extent practicable, students with disabilities identified under the Individual with Disabilities Education Improvement Act (IDEA) not only receive the educational services prescribed within their individualized education programs (IEPs) but also their 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 also may be provided to students who are in a response to intervention (RTI) process or receiving interventions.

As schools remotely support continued learning during Ohio’s ordered school-building closure, they should consider providing related services and mental and behavioral health services virtually, if possible. For the purposes of this document, virtual related services and mental and behavioral health services will be referred to collectively as telehealth services.

This webpage provides answers to 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 During Ohio’s Ordered School-Building Closure


Telehealth Guidelines for Service Providers During Ohio’s Ordered School-Building Closure

    1. Should schools provide related services that are written in the IEPs of students with disabilities if the schools are offering some form of instruction to all students during this ordered closure period?
    Yes. During this time of ordered school-building closure, schools are a making good faith effort to provide educational services to students. Therefore, similar efforts must be made to provide specialized services to students with disabilities during this time as well. Schools will need to consult with parents and caregivers to determine the needs of each individual student and identify the most appropriate means for meeting those needs during the closure period while continuing to maintain the health and safety of the student and service provider. For more information, see Considerations for Serving Ohio’s Students with Disabilities During Ohio’s Ordered School-Building Closure.

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    2. Are schools required to provide related services via telehealth during ordered school building closures?
    No. Schools that are providing education during school building closures are required to make a good faith effort to provide the IEP-required related services to the extent possible through remote learning opportunities, which may include, but are not limited to, delivering related services via telehealth. Telehealth may include phone calls, two-way video communications, the exchange of written electronic messages and other forms of virtual communication. The decision as to whether to provide related services via telehealth is an IEP team decision. The IEP team may determine the telehealth service delivery model is not appropriate for some students or some students may not have access to the internet.

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    3. If the IEP team determines service delivery by telehealth is appropriate, must the IEP be amended to reflect this?
    No. The IEP document does not need to be amended for a change of placement because all students are receiving education through remote learning. This is considered an alternate mode of learning, not a change of placement. However, if the IEP team changes the services, then an IEP team meeting must be convened, which may be done by telephone. Any proposed or determined changes to the services, not mode of delivery, must be documented in a Prior Written Notice (PR-01) and sent to the family along with the amended IEP.

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    4. How can my district ensure student and family privacy is protected when using telehealth?

    In considering telehealth options, it is important to review important resources that explain the Health Insurance and Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA) laws and how they may apply to telehealth services, as well as the 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). For more information, see HIPAA Compliance and COVID-19 Coronavirus and HIPAA Telehealth.

     

    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. For more information, see Protecting Student Privacy – FERPA and the Coronavirus 2019 (COVID-19).

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

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    6. Do IEP related services delivered via telehealth count as IEP minutes delivered?

    Yes. Service providers must keep accurate records of attendance or participation of students and continue to document and analyze data as they would do at school. This should include the dates of services, 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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    7. What if we cannot provide all the minutes of service required by the IEP using telehealth?
    IEP teams will need to determine if a student qualifies for compensatory services.

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    8. Will Medicaid reimburse for health services provided via telehealth to Medicaid-enrolled students?
    Yes, the Ohio Department of Medicaid promulgated an emergency rule to expand and enhance telehealth options, relaxing regulations for students with disabilities and general education students receiving Medicaid reimbursable services normally provided in the school. For more information, see the Ohio Department of Medicaid’s COVID-19 Medicaid Emergency Actions webpage and the telehealth during the state of emergency rule and its appendix.

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    9. Will the Medicaid School Program reimburse for related services provided via telehealth to students with IEPs enrolled in Medicaid?
    Yes. The Ohio Department of Medicaid’s telehealth during the state of emergency rule applies to Medicaid School Program (MSP) practitioners as described Ohio Administrative Code 5160-35. For more information, see the Ohio Department of Medicaid’s COVID-19 Medicaid Emergency Actions webpage.

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    10. Must HIPAA-compliant platforms be used to deliver telehealth related services?
    Not at this time. To help expand the use of telehealth during the national emergency, the Office of Civil Rights temporarily will allow the use of “‘non-public facing’ remote communication products” to deliver services. Non-public facing remote communication products include, for example, platforms such as Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Whatsapp video chat or Skype. Such products also include commonly used texting applications, such as Signal, Jabber, Facebook Messenger, Google Hangouts, Whatsapp or iMessage. The Ohio Department of Education does not endorse any one platform. For more information, see the U.S. Department of Health and Human Services Office for Civil Rights FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency document and HIPAA Telehealth.

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    11. 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 a student’s 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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    12. Must I follow the rules of my 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 coronavirus health crisis, telehealth rules may continue to be amended. The Ohio Department of Education will provide additional updates in the case of changing requirements.

    Governor DeWine signed an executive order to allow for the amendment of Ohio Administrative Code 4757-5-13 by the Counselor, Social Worker and Marriage and Family Therapist Board. The amendment relaxes current administrative rules regarding behavioral health providers’ abilities to render services through telehealth during the coronavirus health crisis, allowing patients to more easily access needed services.

    For specific questions regarding up-to-date telehealth rules, providers should reach out to their respective professional licensure boards directly.

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    13. 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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    14. Can mental and behavioral health services normally provided in the school be delivered via telehealth for all students, not just students identified as having disabilities under IDEA, during the ordered school-building closure?
    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.

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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: 4/23/2020 11:56:47 AM