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 Adolescents
Document
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.
Date: 10/2017

Roadmap for Action: Advancing the Adoption of Telehealth in Child Care Centers and Schools to Promote Children's Health and Well Being
Document
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)
Date: 8/2018