The COVID-19 emergency has prompted school districts across the United States to rethink how they provide related services to students with disabilities, many of whom are presently receiving limited educational supports and no services at home.  According to the Individuals with Disabilities Education Act of 2004 (IDEA), related services include speech and language therapy; occupational therapy; physical therapy; and counseling services.  One way to deliver related services remotely is known as telepractice.  Under telepractice, related services are delivered remotely using a web conferencing tool, web camera, laptop, tablet, or smartphone to deliver services.

Before districts provide related services remotely, there are some immediate roll-out considerations for three distinct audiences: (1) School Districts and Related Services Providers; (2) Parents; and (3) Students.

Considerations for School Districts and Related Service Providers

1. Confirm that telepractice is permitted. In some states, vis-a-vis the state education agency, telepractice is considered an allowable means to deliver related services.  In other states, it is not.  And in some states, because of the COVID-19 crisis, it is becoming available.  Check with your Board counsel and state education agency to confirm that telepractice is allowable.

2. Physical space of the service provider. Ensure related service staff members are conducting remote services from a location in their home that is free from distractions and noises. In addition, to ensure the confidentiality of the students receiving the services, conduct the remote services in a room of the home that is completely separate from others who may be in the home.

3. Equipment. Make sure that your related service staff members have access to a computer, laptop, tablet, or smartphone with a webcam.  If your providers do not have the necessary equipment, make sure they receive it from the district in a timely manner.

4. Web conferencing delivery platform. Do your best to ensure a consistent conferencing platform is used for related service delivery.  With assistance from your Board counsel, ensure that the web conferencing tool is HIPAA compliant.  In addition, adopt the use of a web conferencing platform that is Americans with Disabilities Act (ADA) compliant for staff, parents, and/or students with disabilities. Finally, consider the security of the web delivery platform you choose to ensure that student privacy is protected.

5. Compliance. Working with Board counsel, develop best practices to ensure Health Insurance Portability and Accountability Act (HIPAA) compliance during remote service delivery.  Given this may be an entirely new service delivery platform for these services, over-communicate these needs to related services staff.

6. Agreement to service delivery and possible changes to IEP. Based on the regulations, code in your state, and guidance provided by your state education agency, consider creating an agreement between the school district and parents to memorialize the temporary provision of remotely delivered related services because of the COVID-19 emergency. If the timing of the service delivery is different than what is included in the IEP, the IEP Team will want to create an amendment that addresses the temporary provision of these services.  In addition, IEP goals connected to the related services may also need to be changed, given potential challenges with meeting the IEP goal because of the change in service setting.

7. Best practices with professional associations. With the assistance of your related service providers, seek information on best practices on delivering related services online through their respective professional associations. For example, the American Speech Language and Hearing Association (ASHA) has published best practices for speech and language pathologists on the provision of teleservices.

8. Submit claims for qualified Medicaid reimbursable services. Follow your state’s regulations and protocols to claim for school-based Medicaid reimbursement on these services when appropriate. As you consider how you are delivering services and who is performing them, be certain to examine and refine your standard operating procedures and processes for logging services and documentation retention practices so that you can maximize appropriate reimbursement for costs you incur as a district.

Considerations for Families

1. Inform families. Provide families with basic, easy to follow instructions for web conferencing in their native language.

2. Confirm equipment availability. Confirm the family has access to a laptop or tablet or provide a device to the student in order to facilitate the delivery of services. Additionally, ensure the device the family will be using has the appropriate web conferencing tool downloaded.  Consider setting up a telephone hotline for parents to call to get assistance with setting up their devices or for troubleshooting any technical issues that may arise.

3. Prepare parents on how they can help. For some students, receiving related services through web conference may be challenging. 
   
   
   1. In these cases, it will be imperative for parents to provide an environment free from auditory and visual distractions.
      
      
   2. In addition, the parent(s) may need to play the role of in-person facilitator during the services. Parents may be called to help model, prompt, and assist with repetition.  Although it may be less than ideal, especially for students with low incidence disabilities who may struggle with attending to a computer screen, receiving services remotely is better than receiving no services at all.
      
      
   3. Ahead of counseling or mental health related services, remind parents that for counseling sessions, they may need to leave the room to provide their child with a space to have a confidential session with the counselor. During these services, remind families to provide a space that is comfortable, quiet, and free from distractions.

Considerations for Students

1. Supporting students where they are. Receiving related services over a smart device or computer may create a whole host of emotions for children who miss spending time with their related service provider. For some students, they may be excited and ready to participate.  For others, especially students with low incidence disabilities, they may be apprehensive.  For some students, including students on the Autism Spectrum, consider consulting with the district behaviorist to support the implementation of services through the use of Social Stories or other behavioral intervention strategies.

How Can PCG Help?

PCG supports school districts across the country to provide solutions that matter.  Its special education subject matters are ready to remotely help your district administrators with this operational undertaking.  Time is of the essence in making sure that your district’s students with disabilities are receiving the right services at the right time.  This is especially true while students receive their educations from home during COVID-19.

About the Author

Matthew Korobkin, a Senior Advisor for Special Education Services based in Princeton, NJ, brings strategic planning expertise at the state and district levels in the areas of special education policy, compliance, operations, and instructional practice. Currently, Matthew focuses on supporting our national efforts in this field; performing special education program reviews as well as targeted reviews throughout the country; and working with other subject matter experts on thought leadership development.

Prior to joining PCG, Matthew was the Special Education Officer for Strategic Planning and Evaluation in the Office of the Secretary of Education at the Delaware Department of Education. As a direct report to the Secretary of Education, Matthew advised a legislated Special Education Oversight Group comprised of the Governor, Co-Chairs of the General Assembly’s Joint Finance Committee, and cabinet secretaries from the Department of Education, Department of Health and Social Services, and the Department of Services for Children, Youth, and their Families.