Maryland Lawmakers Debate Bill to Expand School-Based Telehealth

Maryland lawmakers are moving forward with emergency legislation designed to make it easier for school-based health centers to offer telehealth.

HB 34/SB 278, introduced by State Sen. Cheryl Kagan, would eliminate the requirement that school-based health centers apply to the state’s Department of Health and Department of Education to offer telehealth and mandate that those departments greenlight connected health programs without adding any extra conditions.

Kagan said the bill is needed because only 18 of the state’s 86 school-based health centers have been approved by the state to use telehealth.

“The Department of Education has not been very supportive and has not made the process easy, so this is going to be us stepping in at the request of our superintendents,” she told the Maryland Matters news site. Those superintendents have “thrown up their hands because the process is cumbersome, complicated, confusing and it doesn’t yield the outcome that they need desperately in order to provide health care.”

Kagan, who co-sponsored legislation that was passed last year to extend telehealth coverage and access throughout the state, said this bill doesn’t change how connected health programs are administered or overseen. It would just streamline the process so that more students would have access to telehealth, especially during the coronavirus pandemic.

“These are students in the midst of a public health pandemic that are not able to get the kinds of services they would be able to get if they were in school, and somehow, our pediatricians, our other our hospitals have been able to pivot quite smoothly to telehealth,” State Sen. Shelly Hettleman, noting none of her district’s 13 school-based health centers have been OK’d to use telehealth, told Maryland Matters. “I think our students and our schools deserve the same.”

Opponents say the process is good as it stands, and removing checks and balances might affect the quality of the services or allow controversial programs like abortion counseling to be offered without state consent.

Arguments like these are playing out in many states. The COVID-19 public health emergency prompted many healthcare providers to scramble to launch telehealth and mHealth services, and federal and state governments paved the way with emergency measures aimed at boosting coverage and access. But that also brought to light the often complex and confusing guidelines and laws that have long governed telehealth, and which have hindered widespread adoption.

Not everyone agrees with the move toward simplicity. In a letter to the news service, Maryland’s Department of Education defended the process in place for approving telehealth in school-based health centers.

“MSDE is dedicated to the support and maintenance of school-based health centers,” the letter, written by MSDE Spokesperson Lora Rakowski, said. “The process currently in place provides critical safeguards for students and families and MSDE has continued to work diligently alongside the Maryland Department of Health to meet the requests of all programs that have sought to provide telehealth services to students during this difficult time.”

Kagan’s bill has been approved by the Senate and is now making its way through the House.