Last fall, PresenceLearning presented at the National Alliance for Medicaid in Education (NAME) Conference in Bozeman, MT. In the session, titled “School Based Telehealth Services and Medicaid,” PresenceLearning’s Mark Mantel and Cameron Kilberg joined forces with Kevin Bauer, the Department Specialist at the Michigan Department of Community Health, and Mark Smith, the Agency Lead at Ohio Medicaid in Schools Program for the Ohio Department of Education, to talk about the role of telehealth and Medicaid reimbursement in schools.
Bauer pointed out that districts that only hire on-site clinicians (SLPs, OTs, and mental health professionals) may be pigeonholing themselves. There’s a nationwide shortage of qualified clinicians, and some are reluctant to apply for vacancies at hard-to-reach rural districts or at urban districts perceived as unsafe. Districts that don’t have enough on-site clinicians to balance caseloads to recommended levels can struggle to evaluate and serve all their students with special needs. Because districts are relying on on-site clinicians, Bauer said they are not meeting IEP mandates 80% of the time, which creates compliance issues.
Smith discussed the benefits districts, clinicians, and students can expect from implementing teletherapy services. Underserved districts now have a practical solution to meet urgent student needs. Districts are able to connect their students with highly qualified SLPs, OTs, and mental health professionals who can evaluate and provide therapy based on each student’s individual needs. It’s cost-effective because districts don’t have to pay clinicians for their travel time, also known as “windshield time,” and more state Medicaid programs are starting to recognize it as a reimbursable service (find out your state’s policy here). And lastly, extensive research shows that it is as effective as on-site therapy (see research for online speech-language pathology, occupational therapy, and behavioral and mental health services).
Teletherapy also supports on-site clinicians and helps to balance workloads. For example, some on-site clinicians commute between multiple school districts, consequently decreasing actual therapy time for children. With teletherapy, on-site clinicians can relinquish some of these cases to an online SLP, OT, or mental health professional to make the workload more manageable.
For the practitioner, teletherapy is beneficial for many situations, including for clinicians who:
- Are nearing retirement, but are not quite ready to stop practicing
- Need a more flexible schedule to care for family
- Want to learn new skills and stay at the forefront of the field
- Do not want to move for a new opportunity
- Move frequently due to having a spouse in the military or other profession that requires mobility
- Want to start or augment their own private practice
It’s no doubt, however, that students see the greatest benefit. They are getting consistent, personalized therapy – something which may have been impossible for them previously – and it’s leading to increased outcomes for students. Also, students are able to work with technology that they’re familiar with. “It might come as a shock, but children like to use technology,” said Smith. And, although teletherapy services are deployed via a different modality, it’s still face-to-face therapy, argued Bauer and Smith.