Telehealth Toolkit: Best Practices for Providing Employment and Benefits Services to People with Disabilities

Jump to a Section

Telehealth has evolved from a pandemic necessity to an established component of modern service delivery. While virtual care usage has stabilized since the height of the COVID-19 era, it remains a vital tool for providing employment and benefits counseling services to people with disabilities—offering flexibility, accessibility, and opportunities that complement in-person services.

Research shows that telehealth continues to be particularly beneficial for individuals with disabilities, reducing transportation barriers, increasing access to specialists, and enabling services in comfortable, familiar environments. However, as we move forward, success requires intentional design: ensuring accessibility, maintaining quality therapeutic relationships, and addressing equity concerns for those with limited technology access.

This toolkit provides evidence-based best practices for employment and benefits counseling providers to deliver effective, accessible telehealth services that support people with disabilities in reaching their employment and life goals.

Set a Solid Foundation for a Telehealth Relationship

Establishing clear communication preferences and boundaries from the start creates a framework for successful remote collaboration.

Define Communication Preferences and Boundaries:

Document each person's preferred contact method (phone, email, text, video) and their available times
Clarify your communication boundaries: office hours, response times, and preferred methods for urgent vs. routine matters
Establish a regular meeting cadence or clarify an "as-needed" approach
Update voicemail and email auto-responses to reflect your current availability and response timeframes

Plan Document Handling:

Assess technology access: Does the person have a computer, printer, scanner, or smartphone for document management?
Explore alternatives: mail service (noting potential delays), email, secure file-sharing platforms, or fax
Verify electronic signature policies with relevant agencies—many now accept digital or verbal signatures
Consider accessibility: Can documents be read by screen readers? Are they in plain language?

Prepare Your Workspace:

Create a professional, distraction-free environment visible on camera
Remove confidential materials and personal items from view
Plan for managing interruptions from family members or pets
Test lighting and camera angles for optimal visibility

Professional Standards:

Review your profession's code of ethics regarding telehealth service delivery
Stay informed about state licensing requirements for remote services
Understand insurance and reimbursement policies for telehealth services

Build Individuals’ Access to and Comfort with Technology

Technology barriers remain a significant equity concern. Take time to assess and build technology capacity with each person you serve.

Assess Current Technology Status:

Internet and phone access: Inquire about data limits, broadband reliability, and phone minute restrictions
Device availability: What devices do they have access to (smartphone, tablet, computer)?
Digital literacy: What is their comfort level with technology? Have they used video calls before?
Language access: Are language barriers present? Are interpretation services needed?

Address Technology Barriers:

Identify community resources: libraries, community centers, or public spaces with free WiFi and private spaces
Explore device-lending programs through social services or disability organizations
Consider phone-only options for individuals without reliable internet or devices
Connect people to programs like Lifeline (federal program for low-cost internet and devices) or the National Deaf-Blind Equipment
Distribution Program (iCanConnect)

Build Digital Skills and Confidence:

Offer technology orientation sessions separate from service appointments
Provide written instructions with screenshots for joining meetings
Practice using features: muting/unmuting, turning camera on/off, screen sharing, chat function
Encourage questions and normalize the learning process—reassure people that discomfort with technology is common
Emphasize the benefits: video enables better communication through body language and facial expressions

Always Have a Backup Plan:

Establish what to do if technology fails (call a specific phone number, text for help, reschedule)
Have phone numbers readily available as a fallback option
Build in buffer time before and after appointments to troubleshoot

Prepare for a Telehealth Meeting

Preparation prevents many common telehealth challenges and demonstrates respect for people's time.

Before Scheduling:

Confirm the person has the technology and skills needed
Verify internet/data availability for the proposed meeting time
Send clear, step-by-step joining instructions well in advance

Send Meeting Reminders:

Send a reminder 24-48 hours before the meeting
Include: date, time, duration, how to join (with link or phone number), and backup contact information
Request that devices be charged and ready 10 minutes before the meeting
Remind them to test their connection and find a private space

Prepare Your Technology:

Test your internet connection, camera, microphone, and speakers/headphones
Close unnecessary applications to preserve bandwidth
Have all needed documents open and organized on your computer
Ensure individuals have copies of any documents you'll be discussing
Check that platform security features are enabled (passwords, waiting rooms)

Prepare Your Environment:

Position your camera at eye level for natural eye contact
Ensure good lighting (natural light from windows facing you works well)
Minimize background noise and visual distractions
Have a glass of water nearby
Display a professional, uncluttered background

HIPAA/Confidentiality Considerations

Protecting privacy in a telehealth environment requires extra vigilance, especially when working from home.

Protect Spoken Information:

Use headphones or earbuds to prevent others from overhearing conversations
Avoid using names or identifying details if others are in your workspace
Work from a private room with a closed door when possible
Use a white noise machine or fan to mask conversations if needed

Secure Written and Visual Information:

Keep physical documents in locked, secure locations when not in use
Log out of systems and lock your computer when stepping away
Keep confidential information out of camera view during video calls
Close windows containing protected health information before screen sharing

Use Secure Technology:

Choose HIPAA-compliant telehealth platforms with end-to-end encryption
Use platform security features: meeting passwords, waiting rooms, participant approval
Understand how to remove participants and end meetings if privacy is compromised
Never discuss confidential information over unsecured public WiFi

Guide Individuals on Privacy:

Confirm they are in a private location where they can speak freely
Suggest they use headphones if others are nearby
Discuss privacy concerns before diving into sensitive topics
Respect if someone is uncomfortable discussing certain topics due to their environment

Video Etiquette Tips

These practices help virtual meetings feel more natural and professional:

Technical Setup:

Use headphones or earbuds to prevent audio feedback and echo
Position your camera at eye level—avoid looking down or up at the camera
Ensure stable internet connection; consider using ethernet cable if WiFi is unstable
Join meetings 5-10 minutes early to resolve technical issues before the scheduled start
Test audio and video before the person joins

During the Meeting:

Mute your microphone when not speaking to reduce background noise
Look at the camera when speaking to simulate eye contact (not at your own image)
Speak clearly and at a moderate pace—allow extra time for audio transmission
Wait a beat after someone stops talking before responding (to account for delays)
Use visual cues: nod, smile, and show engagement through body language
Minimize multitasking—stay present and focused on the person

Professional Presence:

Dress professionally, as you would for an in-person meeting
Sit in a comfortable but alert posture
Avoid eating, smoking, or other distracting activities during the call
Silence phone notifications and close email applications
Be mindful of your facial expressions—they're more visible on video

Start Your Meeting with a Strong Foundation

The first few minutes set the tone for the entire session. Establish clear expectations and comfort.

Open with Connection and Rapport:

Greet the person warmly and check in on how they're doing
Acknowledge any awkwardness with the technology—normalize it
Ask about their comfort level with the virtual format

Address Technical Logistics:

Review what to do if connectivity issues occur (speech delays, frozen video, disconnection)
Discuss backup communication options if the call drops
Confirm they have enough phone/data minutes for the session duration
Show them how to use key features (mute, chat, screen share) if relevant

Establish Privacy and Confidentiality:

Confirm they're in a private space where they can talk freely
Explain the security measures you're using to protect their information
Discuss HIPAA protections and their rights to privacy
Address any privacy concerns they may have

Set Session Expectations:

Clarify the agenda and goals for the meeting
Confirm how long the meeting will last
Establish how you'll share and receive documents during or after the session
Invite questions before diving into the core content

Build Therapeutic Rapport

Remote services can create distance, so invest extra effort in building connection and trust.

Invest in the Relationship:

Allow more time for casual conversation and checking in at the start of each session
Show genuine interest in the person's life beyond employment goals
Be patient with longer pauses—missing in-person cues means processing time may increase
Express empathy through both words and visible body language

Communicate Clearly:

Speak naturally but slightly slower to accommodate potential audio delays
Use concrete, descriptive language since some non-verbal cues may be missed
Summarize and paraphrase regularly to confirm mutual understanding
Ask open-ended questions to encourage dialogue

Check for Understanding:

Frequently ask "Does that make sense?" or "What questions do you have?"
Invite the person to share their perspective and feelings about the process
Pay attention to facial expressions and body language for signs of confusion or discomfort
Adjust your approach based on feedback and observations

Maintain Continuity:

Reference previous conversations to show you remember and care
Follow up on action items from past sessions
Maintain consistent scheduling when possible to build routine
Send brief check-in messages between sessions when appropriate

Create a Healthy Work/Life Balance

When your workspace is your home, healthy boundaries become essential.

Create Physical Boundaries:

Designate a specific workspace, separate from living and sleeping areas if possible
Use a room with a door that can close to minimize interruptions
Establish visual signals (closed door, "in session" sign) to communicate you're unavailable
Set up and take down your workspace daily if you don't have a dedicated office

Set Time Boundaries:

Establish and communicate clear working hours
Use calendar blocking to protect lunch breaks and personal time
Turn off work notifications and close work-related applications outside work hours
Create a transition ritual to mark the end of your workday

Manage Professional Relationships:

Be clear with individuals about when you're available for non-emergency contact
Avoid the temptation to respond to work messages at all hours
Set realistic expectations about response times

Prioritize Self-Care:

Schedule regular breaks between sessions to rest and recharge
Step away from screens during breaks—move your body, go outside
Maintain boundaries with colleagues and supervisors about workload
Monitor for signs of burnout and seek support when needed

Consider Benefits of Telehealth for Individuals and Service Providers

Despite challenges, telehealth offers unique advantages that can enhance service quality and access.

Benefits for People Receiving Services:

Increased Access and Flexibility:

• Eliminates transportation barriers—especially critical for those without reliable transportation
• Reduces travel time and associated costs
• Enables service access from rural or underserved areas
• Allows for more flexible scheduling, including shorter or more frequent check-ins

Reduced Barriers and Stress:

• Receive services in comfortable, familiar home environments
• Less exposure to illness in public spaces
• Decreased anxiety associated with traveling to unfamiliar locations
• Better accommodates fluctuating health conditions or energy levels

Skill Building:

• Develops transferable employment skills: technology use, video conferencing, digital communication, professional phone etiquette
• Builds confidence with technology that's increasingly required in the workplace
• Creates opportunities to problem-solve technical challenges—valuable for employment readiness

Enhanced Privacy:

• Eliminates concerns about being seen entering a disability services office
• More control over environment and who's present during meetings
• Can participate from locations where they feel most comfortable and safe

Benefits for Service Providers:

Improved Efficiency:

• Eliminates travel time between appointments, increasing direct service hours
• Enables more flexible scheduling and ability to fill cancelled slots more easily
• Reduces geographic limitations on who you can serve
• Lower overhead costs (reduced mileage reimbursement, office space needs)

Enhanced Service Quality:

• Opportunity to observe people in their natural environment and daily routines
• Easier to include family members or support persons in sessions
• More frequent contact possible with shorter, regular check-ins
• Ability to share and collaborate on documents in real-time

Professional Development:

• Builds technology skills that benefit all areas of practice
• Develops adaptability and creative problem-solving abilities
• Creates opportunities to coach technology skills that benefit employment outcomes

Expanded Impact:

• Serve individuals in rural or underserved areas previously difficult to reach
• Continue services during inclement weather, transportation strikes, or public health concerns
• Reach people who might not seek services if in-person attendance were required

Additional Resources

Professional Resources

Reimbursement and Policy

Current Medicare telehealth coverage policies (subject to change—verify with CMS)
State-specific Medicaid telehealth policies
Private insurance telehealth coverage information

About This Toolkit

This toolkit is designed to support employment and benefits counseling service providers in delivering high-quality telehealth services to people with disabilities. It reflects current best practices and should be periodically reviewed as technology, policies, and evidence-based practices continue to evolve.

Guidance on Nondiscrimination in Telehealth | HHS.gov