Implementation Considerations for Telehealth Programs Serving Children
Rural program planners seeking to implement telehealth services for children in schools should be aware of
regulations that protect student health records. In traditional school-based health centers, healthcare staff
follow confidentiality guidelines for student health records established by the Family Educational Rights and
Privacy Act (FERPA). However, school-based telehealth programs that bring in outside staff and healthcare
providers typically follow confidentiality guidelines for student health records established by the Health
Insurance Portability & Accountability Act (HIPAA). The National Association of School Nurses also offers resources
to help schools understand HIPAA and FERPA privacy rules.
School-based health centers typically require parents or legal representatives to sign consent forms allowing
children to be treated via telehealth. Rural telehealth programs should also be aware of regulations that grant
minors the right to consent to medical treatment and services without parental permission. The age at
which a minor can consent to treatment may differ depending on the medical condition. For example, within
states, the age of consent for treatment for outpatient mental and behavioral health may differ from the age of
consent for treatment of sexually transmitted infections. For mHealth models, rural telehealth programs should
be aware that the terms of service in some applications may require all users to be over the age of 18, even if
state laws allow minors to consent to treatment. Rural telehealth programs may consider reaching out to the
mHealth vendor to seek an exception for their program.
The School-Based Telehealth Playbook provides
additional considerations for school-based telehealth programs, including suggested policies and procedures,
potential staffing models, and recommended training topics.
Resources to Learn More
Clinical Update: Telepsychiatry With Children and
Reviews use of pediatric telepsychiatry, in collaboration with primary care providers and clinicians as a direct
service delivering psychiatric, mental health, and care coordination to children and adolescents.
Citation: Journal of the American Academy of Child and Adolescent Psychiatry, 56(10), 875–893.
for Action: Advancing the Adoption of Telehealth in Child Care Centers and Schools to Promote Children's
Health and Well Being
Promotes the adoption of telehealth implementation policies in school and child care settings by offering
strategies for overcoming barriers, identifying opportunities supporting adoption, and providing tools for
development. Topics include: selecting partners, gathering data to assess needs, obtaining equipment, privacy
concerns, payment options, and measuring outcomes.
Organization(s): The Children's Partnership (TCP)