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<section article="ged" article_name="Education" number="4-143" title_number="4" title_name="Local School Administration" subtitle_number="1" subtitle_name="County Boards of Education">
  <level label="a">
    <text>In this section, “telehealth” means a mode of delivering health care services through the use of telecommunications technologies by a health care practitioner to a patient at a different physical location than the health care practitioner.</text>
  </level>
  <level label="b">
    <level label="1">
      <text>On or before December 31, 2024, the Department and the Maryland Department of Health, in consultation with the stakeholders described in paragraph (2) of this subsection, jointly shall develop State guidelines for school health services regarding the availability for student participation in telehealth appointments during the school day on the premises of public middle and high schools in the State.</text>
    </level>
    <level label="2">
      <text>The Department and the Maryland Department of Health shall consult with a broad range of stakeholders in developing the State guidelines under paragraph (1) of this subsection, including:</text>
      <level label="i">
        <text>Local school systems;</text>
      </level>
      <level label="ii">
        <text>Middle and high school principals;</text>
      </level>
      <level label="iii">
        <text>School nurses, other school–based health and behavioral health providers, and other support personnel;</text>
      </level>
      <level label="iv">
        <text>Health care providers of various practice areas;</text>
      </level>
      <level label="v">
        <text>Parents; and</text>
      </level>
      <level label="vi">
        <text>The Maryland Consortium on Coordinated Community Supports.</text>
      </level>
    </level>
    <level label="3">
      <text>In developing the State guidelines under paragraph (1) of this subsection, the Department and the Maryland Department of Health shall consider operational, legal, and financial issues, including:</text>
      <level label="i">
        <text>Equity and prioritization of access;</text>
      </level>
      <level label="ii">
        <text>Student and parental rights and responsibilities, including student privacy, informed consent, parental consent, and communications with parents;</text>
      </level>
      <level label="iii">
        <text>School system rights and responsibilities;</text>
      </level>
      <level label="iv">
        <text>The role and responsibilities of health care providers providing telehealth services, including informed consent, collection of medical history and insurance information, follow–up care, and patient communications;</text>
      </level>
      <level label="v">
        <text>The role and responsibilities of school nurses and other school–based health, behavioral health, and other support personnel;</text>
      </level>
      <level label="vi">
        <text>The role of the student health plan;</text>
      </level>
      <level label="vii">
        <text>Telehealth services related to a student’s individualized education program or Section 504 plan;</text>
      </level>
      <level label="viii">
        <text>Protocols to provide in–person support if telehealth appointments create a challenge to a student returning to the classroom, especially relating to mental health counseling or treatment;</text>
      </level>
      <level label="ix">
        <text>Protocols for missed instruction due to standing or consistently scheduled appointments;</text>
      </level>
      <level label="x">
        <text>Operational issues, including coordination of services, approval and verification of appointments, including appointments without parental knowledge or consent, school resource allocation, and the use of treatment space;</text>
      </level>
      <level label="xi">
        <text>School system, parent, and health care provider liability;</text>
      </level>
      <level label="xii">
        <text>Health insurance, including Medicaid;</text>
      </level>
      <level label="xiii">
        <text>The feasibility of designating a school building space that:</text>
        <level label="1">
          <text>Is private and safe to allow for confidential conversation between a health care provider and a student;</text>
        </level>
        <level label="2">
          <text>Has Internet access;</text>
        </level>
        <level label="3">
          <text>Includes at least one seating option with a flat surface and a nearby electrical outlet to accommodate placement of a laptop device; and</text>
        </level>
        <level label="4">
          <text>Is not a bathroom or closet; and</text>
        </level>
      </level>
      <level label="xiv">
        <text>Any other issues determined relevant by the Department, the Maryland Department of Health, or a stakeholder.</text>
      </level>
    </level>
    <level label="4">
      <text>The State Board shall adopt the State guidelines developed under paragraph (1) of this subsection.</text>
    </level>
  </level>
  <level label="c">
    <text>Before the start of the 2025–2026 school year, each county board shall adopt and implement a student telehealth policy in accordance with the State guidelines adopted under subsection (b) of this section.</text>
  </level>
  <level label="d">
    <text>Each county board shall ensure that the local school system:</text>
    <level label="1">
      <text>Publishes the student telehealth policy in the student handbook; and</text>
    </level>
    <level label="2">
      <text>Makes school personnel aware of student telehealth policy objectives and requirements.</text>
    </level>
  </level>
  <level label="e">
    <text>On request, the Department shall provide technical assistance to a county board to establish the student telehealth policy required under this section.</text>
  </level>
  <level label="f">
    <text>Nothing in this section shall be construed to:</text>
    <level label="1">
      <text>Require a school to construct an addition or a new space to a school building to provide a private space to comply with the student telehealth policy required under this section; or</text>
    </level>
    <level label="2">
      <text>Alter the responsibilities of a health care provider regarding the disclosure of medical records under Title 4, Subtitle 3 of the Health – General Article, including the authority to disclose a medical record in the case of an emergency.</text>
    </level>
  </level>
</section>
