Even as the Delta variant of COVID-19 continues to surge, children across the country are headed back to school. Keeping them safe is the first priority. Besides masks, temperature checks, and COVID testing, there are other things schools can do to help protect and care for students in these precarious times. Telehealth in schools has become the an integral cog in wellness and preventative medicine.
Having telehealth capabilities via effective video conferencing at schools, allows nurses to connect with clinicians to assess, triage, diagnose, or refer students virtually and remotely. A single clinician can “see” multiple children in a day, rather than having to travel to schools and see just a handful in the same amount of time. This is not just a better use of the clinician’s time, but it also brings timely care to more students, removing the barriers of access and income.
Children whose healthcare needs are being met do better in school.[1]
Proven success
Telehealth has been used in schools for years, especially schools serving more rural or low-income areas, as a way to improve access to care. The Medical University of South Carolina (MUSC) is a prime example.[2] According to an article published by MUSC, their telehealth program, which began in 2013, serves more than 70 schools across the state. “Evaluating a child at school via telehealth is a time-efficient process that removes the geographic and transportation barriers many families face when accessing health care for their children.”
The same is true for Children’s Health, located in Dallas, Texas, which has been utilizing telehealth since 2014 to bring healthcare to schools in the region. One area of impact has been asthma management; “72% of parents whose children have relied on our school-based telehealth services say the initiative helped their children avoid an emergency department visit.”[3] Once COVID hit, their incidents of urgent telehealth visits increased by 500% (from March 2020 through September 2020) over the same period in 2019.
Offering school-based health services helps “reduce health disparities by improving access to health care for disadvantaged children” and lowers Medicaid costs by reducing students’ hospitalizations and emergency room visits.[4]
Mental health care
In-school telehealth can also bring much-needed virtual mental health care services to students who might not otherwise receive care. According to the US Department of Health and Human Services (HHS), 20% of children and adolescents experience some type of mental health issue during their school years.[5] A 2019 report by SAMHSA states that “Among the 3.8 million adolescents ages 12–17 who reported a major depressive episode in the past year, nearly 60% did not receive any treatment.”[6]
Access during the COVID-19 pandemic, especially early on, became even more strained as behavioral health resources were initially shuttered. According to the National Academy for State Health Policy (NASHP), school-based behavioral healthcare delivered via telehealth greatly expanded during the pandemic.[7] “These services are particularly important for students experiencing increasing mental health needs during the pandemic and providing these services through telehealth is a recognized best practice.”
Where to begin
There are many funding resources—federal and state—available to schools for telehealth and in-school health services, but they vary year to year and from state to state. The best place to start is by contacting your state’s health department, department of education, or rural health association. They can provide guidance on available funding as well as information about billing and reimbursements in regard to Medicare, Medicaid, private pay, and Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) guidelines—some of which has changed due to the pandemic.
The next step is to assess the needs of your school district and your student population and to identify partnership opportunities through community, state, regional, and federal organizations. For example, the National Consortium of Telehealth Resource Centers (NCTRC) is a collaborative working to help rural and underserved communities implement telehealth programs.[8] With funding from HHS Health Resources and Services Administration, Telehealth Resources Centers (TRCs) focus on advancing telehealth education, technical help, and other assistance based on community need.[9]
While the pandemic has highlighted the great health inequity that has existed in our country for a very long time, it has also highlighted the great opportunity telehealth provides in expanding access to care to those who have been underserved for far too long.
The time to act is now
The virtual telehealth landscape is quickly evolving. On August 18, 2021, HHS announced that the federal government will be investing more than $19 million to “expand telehealth nationwide and improve health in rural, other underserved communities.”[10] While many schools and health systems have already come together to implement in-school telehealth programs, others haven’t had the opportunity or resources to do so. For them, the time has never been better to begin.
[1] https://healthyschoolscampaign.org/wp-content/uploads/2017/03/A-Missing-Link-in-School-Reforms-to-Close-the-Achievement-Gap.pdf
[2] https://web.musc.edu/about/news-center/2021/03/24/school-based-telehealth
[3] https://www.healthleadersmedia.com/clinical-care/school-based-healthcare-moves-virtual-during-covid-19
[4] https://www.nashp.org/wp-content/uploads/2021/05/telehealth-report.pdf
[5] https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists
[6] https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and-behavioral-health-services-and-school-psychologists
[7] https://www.nashp.org/wp-content/uploads/2021/05/telehealth-report.pdf
[8] https://telehealthresourcecenter.org
[9] https://www.hrsa.gov/rural-health/telehealth/resource-centers
[10] https://www.hhs.gov/about/news/2021/08/18/biden-harris-administration-invests-over-19-million-expand-telehealth-nationwide-improve-health-rural.html
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