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State Licensure Considerations for the Adoption of Telehealth Services in Higher Education During COVID-19

  • April 13, 2020
  • Alan Dennington, M.D.

The COVID-19 pandemic has generated an unprecedented demand for telehealth services. analysts expect virtual healthcare interactions to surpass 1 billion by year’s end, according to recent reports. And healthcare resources at higher education institutions are dealing with a student population dispersed across the country because of campus closures to limit the spread of the virus. Medical and mental health providers are left to sort through the complication of state licensures for out-of-state students and the possible legal implications of non-compliance, such as loss or suspension of licensure.

Complications of state licensure for remote care

As of September 2020, the recommendation from the federal government is for all states to issue emergency licensure waivers to allow clinicians with licenses in good standing to deliver care nationwide, but it is the decision of each individual state to manage emergency licensure waivers during the COVID-19 pandemic. Unfortunately, states are not uniformly waiving licensure requirements for medical and mental health providers.

This confusion at the state level has led some higher education institutions to act upon the federal recommendation, and provide care across state lines that may not be compliant with the current state regulation. There remains great variance between states, with some waiving requirements entirely, some providing forms of emergency licensure, and others not providing any declaration.

In response to COVID-19 and to support the needs of higher education institutions, TimelyCare has introduced Campus.Health — an immediate telehealth solution that enables students to access medical and mental health services anytime, anywhere. The program offers no-cost visits for students and can be implemented within 24 hours.

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights also recently stated that it “will not impose penalties for non-compliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.” This means that providers can utilize non-encrypted video technology — like Zoom, Google Hangouts, and Apple FaceTime — during the COVID-19 emergency.

However, the removal of technology regulations does not remove the need for other compliance issues related to care, like state licensure. The HHS has also recommended using video platforms with encryption whenever possible. And the agency advises that patients should be alerted to the fact non-encrypted third-party platforms pose a privacy risk.

Considerations for college and university clinics

Providers at college and university clinics who are currently using or considering virtual care need to consider the following:

  • Where are my out-of-state students located?
  • Have the state licensure requirements in those states been altered by the COVID-19 emergency declaration?
  • What technology is best to leverage for video and voice communications with patients? Is the technology HIPAA compliant?
  • What is the digital intake process for students?
  • Does our clinic or institution’s malpractice insurance cover virtual care? Does it cover care across state lines or provide adequate coverage given each state’s differing malpractice environment/tort reform?
  • What are the state-specific telehealth standards of care?
  • What are the state-specific mandatory reporting laws?
  • Are there state-specific telehealth specific informed consent requirements? And how is consent received?
  • What are the electronic prescribing restrictions?
  • What is the safety plan for students who need to be referred locally for treatment?

Additionally, there are considerations for telehealth-specific privacy and security laws, as well as state laws regarding the emergency practice of medicine and the continuing treatment obligations of providers once a doctor-patient relationship has been established.

The need for a strategic virtual care partner

All of this adds up to a complex, evolving situation for campus clinic providers who are tirelessly working to provide medical and mental health support for students seeking care. Partnering with a telehealth service like TimelyCare can ease the burden of compliance on higher education institutions. Our TimelyCare team is experienced in providing virtual care that is compliant and takes into consideration all the complexities associated with delivering healthcare services via telehealth.

From HIPAA-compliant technology to ensuring provider credentials are accurate, TimelyCare provides a seamless integration that serves as an extension of your campus clinic, with an easy-to-use platform for students to access care.

If you have questions about telehealth and virtual care during COVID-19, contact us today.

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Alan Dennington

Dr. Alan Dennington

Strategic Advisor and Board Member

Founding Chief Medical Officer, Dr. Alan Dennington believes strongly in telemedicine’s ability to transform healthcare delivery for patients. He sets a high bar for virtual care, and is focused on building the best possible provider network for TimelyCare. A seasoned entrepreneur and emergency medicine physician, Alan has a wealth of healthcare experience from serving in the emergency department at Baylor Grapevine to owning and operating an urgent care center.

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