MN Hospitals receive funding from FCC for telehealth

Fox9 reports

St. Paul’s Regions Hospital is receiving $1 million of federal funding for telehealth services.

The funding comes from the Federal Communications Commission’s COVID-19 Telehealth Program, Senators Amy Klobuchar and Tina Smith announced Thursday. It will be used to buy a remote patient care telehealth platform.

“The pandemic has shown us how telehealth services have been a lifeline for patients across Minnesota who may otherwise not be able to access the health care they need,” said Smith in the press release. “This funding will help Regions Hospital continue to use telehealth to make health care accessible to patients who are unable to get services in person.”

Along with the $1 million for Regions Hospital, Klobuchar and Smith secured funding for the expansion of telehealth services for these health providers in Minnesota:

  • $21,533 for Native American Community Clinic in Minneapolis
  • $498,818 for Minnesota Community Care in St. Paul
  • $234,352 for CentraCare Health System, the largest provider for rural Minnesota communities
  • $120,305 for Nett Lake Health Services in northern Minnesota
  • $981,204 for Essentia Health in Duluth

The funds will allow providers to expand patient access by purchasing more telehealth equipment like laptops and monitoring devices, as well as increase wireless broadband coverage at several clinics.

Senator Carla Nelson outlines improvements tele mental health and broadband

The Post Bulletin shares Senator Carla Nelson’s blueprint for mental health, including an update on improvements in telehealth…

We made several other key advancements this session to improve the speed and effectiveness with which Minnesota provides support to Minnesotans working to improve their mental health.

This year’s final health and human services bill contained important funding that will help us accomplish this goal:

  • We permanently expanded Telehealth access to include mental health and substance use disorders. I have long been an author of Telehealth legislation, beginning with the very first telehealth bill, and we will continue to pursue advancements so every Minnesotan has affordable access to the health services they need, when and where they need them.

  • We provided funding to prioritize the mental and behavioral health needs of Minnesota youth, and established individual treatment plans for children in outpatient services. This was part of the YOUTH Act that I authored this year to help Minnesota better support children in crisis.

  • We provided additional funding in this year’s jobs and economic growth bill to expand broadband access in underserved and unserved communities to help close gaps in access to important services like telehealth.

Nurse Licensure Compact would allow MN to ease licensure for telehealth

The Duluth New Tribune posts a column on health care and how to remove a barrier to make telehealth easier…

First, Minnesota should join the national Nurse Licensure Compact. When the pandemic hit, Minnesota needed all the qualified medical professionals it could get, but licensing proved to be an obstacle to qualified health care workers from outside the state putting their skills to use here. Gov. Tim Walz eventually signed an order allowing health care workers licensed in other states to work in our state, but a permanent solution would be for our state to join the national Nurse Licensure Compact.

The compact allows a nurse to have one license in their primary state of residence with authority to practice in person or via telehealth in other compact states, with the requirement that they follow the nurse practice act of each state. As the Minnesota Board of Nursing says, the compact “advances public protection and access to care through the mutual recognition of one state-based license that is enforced locally and recognized nationally.” At present, 34 states are members of the compact.

CentraCare Health Systems (St Cloud) gets $230,000 for telehealth

St Cloud Times reports

U.S. Senators Amy Klobuchar and Tina Smith announced Tuesday the Federal Communications Commission awarded CentraCare Health Systems more than $230,000 for telehealth services.

The funding will be used to purchase telehealth equipment and software licenses to increase access to care and services, according to a press release.

“Americans have benefited from telehealth during the pandemic and have come to rely on it for access to care, especially in rural communities,” said Klobuchar in a statement. “This funding will help CentraCare Health System expand its services and meet the needs of its patients. I’ll continue pushing for resources to ensure Minnesotans in all parts of our state are able to access affordable, quality health care.”

Duluth rural health center gets $10M grant for telehealth expansion

Minneapolis Star Tribune reports

The National Rural Health Resource Center in Duluth has received a $10 million grant from the federal Department of Health and Human Services to expand telehealth and shore up workforce shortages in the Mississippi Delta region.

The money will help the center expand its Delta Region Community Health Systems Development Program, which “provides technical assistance to rural health care organizations to improve patient outcomes, retain healthcare providers, and ensure long-term financial stability,” according to a news release.

The nonprofit center advises rural clinics, hospitals and health systems on improving care and access across the country.

Access to tele-mental-health increases during pandemic

KSTP reports on increased access to tele mental health services during the pandemic, thanks to telehealth services and relaxed regulations

One of the bigger challenges highlighted by the COVID-19 pandemic has been the need to boost access to mental health care in many areas in the state.

In less populated areas of Greater Minnesota, change is taking place due to the work of a group of mental health professionals and other stakeholders who started working on the access issue even before the pandemic began.

For the first time, licensed drug and alcohol counselors are now eligible for Minnesota’s state-run loan forgiveness program.

“These recommendations highlight the need for continued efforts to strengthen the mental health care system in Greater Minnesota,” said Minnesota Department of Health Commissioner Jan Malcolm. “Mental health is an essential part of a person’s overall well-being, and the stresses of the pandemic have made it more important than ever to ensure everyone in Minnesota can access quality care when they need it. This report is an encouraging step toward that goal.”

In May 2019, the Rural Health Advisory Committee formed a workgroup to assess mental health care in the rural parts of the state. The work group convened six times from 2019 to 2020 and hosted three regional listening sessions to learn from rural communities in different parts of the state. Those in Greater Minnesota often lack access to critical mental health services, due in part to an insufficient mental health workforce with a ratio of 1,518 people to each mental health provider in isolated rural areas as compared to 304 people per provider in metropolitan areas.

Telehealth in MN – how to find it, what insurance pays for, how to get it

The UpTake has a useful article on the how-tos and some of the whys of telehealth policy during/because of COVID. It might be helpful to folks you know (or you) but also I think it’s helpful as a policymaker or community leader to think about telehealth from the perspective of the patient or provider.

How does insurance coverage for telehealth work in Minnesota since the pandemic…

Minnesota has been following the federal recommendations for COVID-19 emergency telehealth coverage since March 2020, including requiring that insurers cover telehealth sessions at the same rate as in-person appointments. At the time this article is written, clients’ homes are still considered an appropriate originating site for telehealth appointments.

This means that your insurance company should continue to cover your telehealth sessions at this time, and you would have the same out-of-pocket expense as if you had come to the office in person. It also means that your insurance will not require you to travel to an approved originating site.

Currently, Minnesota’s emergency telehealth coverage is tied to the federal state of emergency. Coverage is ongoing, as the pandemic is ongoing. States that have made changes to these policies have given a minimum of 30 days notice, and providers have a responsibility to be attentive to these regulations. As changes occur, providers will give their clients as much notice as possible about how this might impact their treatment and options for services.

How does it work for telehealth work for providers…

The state of Minnesota requires that clinicians submit a statement indicating that they are qualified to provide telehealth services. This is something that clients do not need to do, and the therapist has the responsibility to take this step prior to providing telehealth services.

What if my provider is not in MN…

Since before the pandemic began, licensure requirements for mental health professionals have been based on the client’s physical location at the time of service. This means, as a therapist, I must be licensed where my client is when they check in for a telehealth session.

Previously, Minnesota had allowed out-of-state providers to offer telehealth services to Minnesota residents due to the COVID-19 state of emergency. This has been important for those living near boarders who had received in-person services in another state but now needed to be seen from home for safety reasons. However, this reciprocity is no longer in effect.

This means that providers in South Dakota, North Dakota, Iowa, and Wisconsin now need their clients to either come in person to the office or use an approved originating site across the border based on that state’s guidelines.

How can I get the services I need…

If you are uninsured, Walk-In Counseling Center continues to offer telehealth services in Minnesota, and Open Path Collective offers a national therapist directory to help individuals find low-cost therapy services.

If you have insurance, you can reach out to your insurance company to see which Minnesota providers are paneled with your plan. You can ask questions about which services are covered and whether you have to meet a deductible or will have a copay for each visit.

Essentia Health in Duluth gets nearly $1 million from FCC for telehealth

The FCC reports

The Federal Communications Commission today approved an initial set of 62 applications for funding commitments totaling $41.98 million for Round 2 of its COVID-19 Telehealth Program.  Health care providers in each state, territory, and the District of Columbia, including those previously unfunded in Round 1, will use this funding to provide telehealth services during the coronavirus pandemic.  The FCC’s COVID-19 Telehealth Program supports the efforts of health care providers to continue serving their patients by providing reimbursement for telecommunications services, information services, and connected devices necessary to enable telehealth during the COVID-19 pandemic.

“During the COVID-19 pandemic, access to health care has proven to be not only a national issue, but also a local issue, and it is imperative that every community is given the tools to access this care as safely and effectively as possible.  The FCC is committed to ensuring that every state and territory in the United States receive funding as part of this program,” said FCC Acting Chairwoman Jessica Rosenworcel.  “The FCC took action earlier this year to establish a system for rating applications in Round 2, factoring in the hardest hit and lowest-income areas, Tribal communities, and previously unfunded states and territories.  Now even more doctors and nurses in every corner of our country can establish or expand telehealth services to support patients and their families.”

This first set of awards will go to applications that qualify for the equitable distribution step, as required by Congress and outlined in the FCC’s rules, to ensure nationwide distribution of funding to health care providers in each state, territory, and the District of Columbia.  This step funds the highest-scoring applications in every state, territory, and the District of Columbia plus the second highest-scoring application from the states and territories that did not receive funding in Round 1, if multiple applications were submitted from those areas.

Round 2 is a $249.95 million federal initiative that builds on the $200 million program established as part of the CARES Act.  Now that funding has been committed to the highest-scoring applications from each state, territory, and the District of Columbia, the next funding awards will commit funding to the highest-scoring applications, regardless of geography, until at least $150 million has been committed.  The FCC’s Wireline Competition Bureau will then announce an opportunity for all remaining applicants to supplement their applications, as required by Congress.  After all remaining applicants have the opportunity to supplement, the remaining program funding will be committed.

Here’s the Minnesota recipient…

Essentia Health in Duluth, an integrated health system in Minnesota, serving patients in the upper Midwest, was awarded $981,204 to support the acquisition of remote monitoring devices and video carts with peripheral cameras and stethoscopes/EKGs for care during the pandemic, and to increase wireless broadband coverage at eight clinics to allow for additional space for telehealth patients.

Making the case for ongoing telehealth: the flu is contagious

Minneapolis Star Tribune reports…

Visiting a doctor’s office after a patient with flu-like illness appears to be a risk for getting sick, according to University of Minnesota research that could have implications for infection control and the use of online visits for primary care.

Researchers from the U, Harvard University and athenahealth, reviewed electronic medical records for 6,709 U.S. primary care clinics in 2016 and 2017 and found that people who visited their clinics the same day after patients with flu-like illnesses were more likely to return within two weeks with their own respiratory ailments.

The risk is only slight, as the rate of post-visit illnesses was 2.9 per 1,000 in people who visited clinics the same day after flu patients, compared with 2.2 per 1,000 in patients who visited clinics before flu patients. However, lead author Hannah Neprash said the nearly 32% difference in the rates was significant and provided some of the first documented evidence that clinics can be infection sources for patients — not just hospitals.

Seems like a good reason to promote continued telehealth, especially with folks with flu-like (or pandemic symptoms)…

Doctor visits in the study occurred well before the declaration in early 2020 of the COVID-19 pandemic, but Neprash said lessons learned in the pandemic could likely address the causes of infections in clinics. Mask-wearing in clinics could be one solution along with the continued use of telehealth services for basic primary care when appropriate.

“Maybe some of it should stick around even after we emerge from the pandemic,” Neprash said.

Mayo’s video visits up 5000 percent but how does that impact Rochester’s local economy?

The Post Bulletin reports

“We’re currently touching, caring for more patients on a given day now than they were pre-pandemic when you add in telemedicine activities, plus the patients coming on site for care here,” said Dr. Steve Ommen, a cardiologist and the medical director for experience products for Mayo Clinic’s Center for Digital Health.

Video visits skyrocketed more than 5,000% from 278 visits in February 2020 to 16,532 in December at Mayo Clinic-Rochester. Phone telemedicine visits also soared from 169 to 7,590 in the same timeframe, peaking at 24,670 visits in April 2020.

A looming question remains: How will this affect Rochester’s economy when much of the downtown and the largest private-public economic partnership in state history has been built with the presumption that many of Mayo’s patients will be visiting the city in person?

Sounds like the local economic developers aren’t too worried…

Holly Masek, executive director of the Rochester Downtown Alliance, said her team hasn’t specifically studied how telehealth use could affect the downtown. The general consensus is that there are enough patients traveling to Rochester for extended stays and more specialized care that businesses will not see a significant decrease in income because of telemedicine use.

There are pluses and minuses with remote working too…

Fewer Mayo Clinic employees are working downtown than before the pandemic, though telemedicine certainly can’t be pinpointed as the sole cause of this shift.

“Approximately 2,900 staff who were previously based in downtown Rochester will now work off campus a majority of the time,” Mayo Clinic spokeswoman Ginger Plumbo said to the Post Bulletin’s Jeff Kiger in early July. “This number evolved as Mayo Clinic continued to assess the workforce beyond the initial group of non-clinical administrative staff.”

The number went up from the 1,500 figure Mayo Clinic reported in October 2020.

It looks like the Mayo, more than the city, will need to look at the impact…

Preliminary studies from other healthcare institutions across the country provide a picture into how telemedicine use affects revenue. An April 2021 study by the Department of Orthopaedics at the University of Pennsylvania found that the adoption of telemedicine services resulted in just a -.8% hit to the department’s revenue.

“Given that the nation’s health systems are operating on thin margins amid rising payment and cost pressures, the findings of our study underscore the need for thoughtful examination to ensure telemedicine is used and supported effectively and sustainably,” read the study.

Legislative changes makes it easier to offer and afford telehealth…

Legislation passed in June 2021 as part of the Health and Human Services bill made these changes part of law, not just part of the emergency powers declaration.

For Mayo Clinic campuses in Arizona and Florida, the number of patients receiving care via telemedicine may differ. Arizona recently passed similar protections to Minnesota, while Florida rolled back telehealth regulations passed during the pandemic.

Even if Mayo Clinic’s bottom line isn’t greatly affected by telemedicine use, the patient’s pocketbook may be.

A 2014 study found that the average estimated cost of a telehealth visit is $40 to $50 compared to average cost of $136 to $175 for in-person acute care.

Minnesota legislation regulates the cost of telemedicine services to not surpass what the in-person cost would be.

Can broadband help with these wild fires? Turns out yes!

I am in St Paul and I can tell you the air is thick and air quality seems poor. My colleagues up North say it’s worse there (between storms!). So this story from Urgent Communications seems particularly apt today…

Members of the Verizon Response Team (VRT) are using a variety of solutions to deliver broadband communications to public-safety agencies battling wildfires throughout the U.S.—at no additional cost—as part of the carrier’s Verizon Frontline offering, according to a Verizon official.

Cory Davis, director of Verizon Response and public-safety operations, said the VRT has been “super busy,” responding to a total of 74 named wildfires already in what is proving to be a very active wildfire season.

“We’ve had 88 deployments across the United States, from California, Oregon, Arizona, Montana, all the way to Minnesota,” Davis said during an interview with IWCE’s Urgent Communications. “There’s a huge fire—the Delta Lake fire—that’s burning right now along the Canadian border. We sent a team up there to help support the operations center, working really closely with the COMLs up there.”

Apparently some states are used to this, Minnesota is listed as a newer or less frequent fire place…

“This is the first time my East team went to a large forest fire in that part of the country,” Davis said. “Places like Canada and Minnesota just generally don’t have large forest fires that often like the West does. But as things are getting warmer and the climate is changing, we’re seeing that fires are popping up everywhere—I had my team out in North Carolina at a fire about a month ago.

The goal is bringing the network closer to the emergency workers…

Firefighters often work to control and extinguish wildfires in locations where terrestrial wireless coverage is not available, so many of the VRT solutions utilize geosynchronous (GEO) satellite communications with “public-safety-grade priority” to provide backhaul, according to Davis.

“We can get an average of 30 mbps downlink and 10 mbps uplink,” he said. “Obviously, there will be bursts with more [data throughput] being available.

“The biggest thing is dealing with latency when you use satellite backhaul—anywhere between 600 and 800 milliseconds—but first responders can do a lot with 30 mbps.”

Davis said that Verizon is closely monitoring developments in the low-earth-orbit (LEO) satellite arena and will consider leveraging that technology in the future. This assessment process include testing of LEO-based offerings from companies like Lynk and AST SpaceMobile, which have announced satellite LTE services that will connect directly to a smartphone, as opposed to requiring the user to deploy a satellite dish or a specialized device, he said.

In addition to traditional deployable communications solutions—from those on vehicles to offerings housed in Pelican cases that can be carried by hand to a location—VRTs are using satellite pico cells on trailers (SPOTs) to deliver broadband in a focused area to help support first-responder communications.

“Essentially, we can provide not only a 4G LTE bubble but also a Wi-Fi bubble for—and it depends on the environment—about 6,000 to 7,000 square feet. So, it’s really good for base camps,” Davis said.

“Since it is enclosed, we also have the capability to have it be like a mini operational command-center—you can fit two or three good-sized adults in there. So, you can turn it into not only an asset that deploys coverage and capacity, but it can also work as kind of a makeshift operations center for a very, very small group.”

Verizon cannot use the high-power user equipment (HPUE) that is only permitted on the 700 MHz Band 14 spectrum licensed for FirstNet, but VRTs do have some solutions that can be deployed when extra range is needed, Davis said.

Telemedicine gains momentum during pandemic and policy changes will keep it going

The Pine Journal reports…

Behavioral and mental health treatment was ahead of other specialties in terms of telemedicine use before the pandemic, but patients have still increasingly turned to those services over the past year.

One study found that telemedical care for mental health or substance abuse disorders increased from 1% of visits before the pandemic to 41% in October 2020.

For most people providing and receiving medical care, the escalated adoption of telemedicine is one of the silver linings amid the devastation of the pandemic. The funds funneled into the technology reflect its increased use. Investment in telehealth technologies in the first half of 2021 was greater than all of 2020, according to an analysis from management consulting firm McKinsey & Company.

While the benefits of telemedicine have been especially appreciated among people who live with physical disability or mental illness, telehealth has also created new barriers for users during a time when medical support was vital.

Telehealth was an important tool…

A NAMI survey found that telehealth visits provided connection in a time when people were starved for it, especially while grappling with mental illness.

“Great to be able to connect with services right from my home. Being able to continue to be in visual connection with my therapist during the most isolated days/weeks of this pandemic was crucial. Nice to see people without masks on!” one respondent wrote.

Several respondents stated that they appreciated the relief of not having to figure out transportation for in-person appointments. Others wrote that they thought it was the safest option for themselves and their families during the pandemic, and it allowed them to stay in a comfortable environment on days they weren’t feeling well.

Unfortunately access to technology was a barrier to some…

“The elderly and kids are the ones who probably lost the most ground in terms of the pandemic and having to move to telehealth,” Abderholden said.

survey conducted by the Minnesota Department of Health also found that these were the groups most affected by barriers with technology.

Although many communities found some solutions…

The SEMCIL [Southeastern Minnesota Center for Independent Living] team offered a repository of 20 iPads and 50 Chromebooks to those in need during the pandemic, fueled largely by CARES Act dollars.

But access wasn’t the only issue…

Older patients seeking treatment for mental illness often encountered technological issues, sometimes only accessing their telehealth services after a provider walked them through how to download the software. Some users stuck with audio-only services, a lifeline for those living in areas with poor internet access.

Even for technology savants, telehealth posed a different problem: screen-time burnout.

School-age children who spent all day in front of their computers engaging in remote schooling would often not feel like diving into emotional issues in the same setting.

“The technology worked fine, but my child was burnt out on doing everything via video and started ending the sessions early. I’m not sure how to make the engagement better though,” wrote one respondent to the NAMI survey.

There were also privacy concerns for people who shared spaces with family members and couldn’t find a discreet area to candidly express their struggles with a mental health professional. Bastin found herself moderating what she said and when, even as she logged into her therapy sessions in the privacy of her room, because she worried family members might hear through the walls.

Regulations have been changed to make telemedicine easier now and in the future…

For years, advocates have tried to loosen restrictions surrounding telemedicine access. When the pandemic prompted widespread use of telehealth services, legislative changes finally followed.

The location where patients are eligible to receive telehealth services broadened in spring 2020 under emergency power authorization, enabling in-home care, and not solely in-hospital or clinic care. A second change allowed for audio-only care, a shift from previous regulations that restricted telehealth visits to video.

Legislation passed in June 2021 as part of the Health and Human Services bill made these changes part of law, not just part of the emergency powers declaration. The coverage of audio-only services is still in question due to concerns regarding quality of care, Renner said, but it is protected for at least the next two years.

Mayo Clinic’s new mobile health bus for medical services and broadband access

KAALTV reports

As a way to improve health care access for those in rural communities across southern Minnesota, Mayo Clinic Health System unveiled its new mobile health clinic.

The mobile clinic includes two exam rooms and an onsite laboratory bringing health care directly to patients, for in-person care or virtual care via the onsite telehealth equipment.

Along with the wide range of medical services, they telehealth bus will also provide broadband access to those who need it…

The mobile health clinic will travel to communities across southern Minnesota. The mobile health clinic will also be offering high-speed internet connections so that patients can come and access their patient online service account, do express care online, and even conduct their own video visits with their provider or other providers within the Mayo Health System. Mayo says it will add stops to the mobile clinic when they identify the needs in rural communities.

Quarantine rules help spread telehealth options for rural moms-to-be in Bemidji

The Bemidji Pioneer reports

If there’s a silver lining to the COVID-19 pandemic, it may be how it sped up a change in prenatal care that could improve outcomes for rural mothers and babies.

Dr. Johnna Nynas, an OB/GYN physician at Sanford Health in Bemidji, discussed her hospital’s move to offering virtual visits during the past year.

“We started laying the groundwork a couple of years ago,” said Nynas. “We looked at implementing a virtual visit option that provided patients with some equipment to monitor their pregnancies at home, including a blood pressure cuff, and then a Doppler, so they can listen to their baby at home. But what really thrust us to the forefront and accelerated the timeline was the COVID pandemic.”

Technical and legal challenges involved the interface between patients at home and their medical records. But with the onset of the pandemic, Nynas said, “there were rapid changes in Congress that made it much easier for health care organizations to initiate telehealth.”

They need better broadband…

There are still barriers that need to be addressed, such as broadband and cellular access in rural areas and for lower-income families. And there are days when the technology doesn’t work as well as others, and doctors have to make do with voice-only telephone visits.

Still, Nynas said, virtual visits will likely continue even after COVID-19 fades from public awareness.

There is a need…

The disparity is real. Nynas quoted shocking statistics: 23 percent of American women live in rural areas, but only 6% of OB/GYNs practice in rural areas. “That’s the challenge that we’re up against,” she said.

The benefit of prenatal care is also real, even for women whose pregnancies are considered low-risk. “It’s better to connect with prenatal care and get that care when and however you can,” said Nynas, “because getting no prenatal care is definitely correlated with worse outcomes.”

At the same time, the costs of running a labor and delivery unit while performing fewer deliveries are widening the gap between rural patients and the care they need. “That’s where being able to offer services remotely can be a really helpful thing,” she said.

EVENT Jun 15: Rural Broadband & Telehealth Financing

Looks like an interesting session…

Rural Broadband & Telehealth Financing
Tuesday, June 15 at 2:00 PM Eastern —
The COVID-19 pandemic has caused many disruptions in our daily lives and highlighted disparities among communities. Schools have gone remote, healthcare providers have increased seeing patients virtually, and small businesses have shut their doors to in-store customers. These disruptions have particularly impacted rural communities where there is already a gap in accessing high-speed internet.

Join us for the CDFA // BNY Mellon Development Finance Webcast Series on Tuesday, June 15 at 2:00 PM Eastern to hear experts explain how rural communities can embrace the challenges of financing high-speed internet for the economic and societal gains provided by broadband.

Speakers:

  • James Young, Vice President, The Bank of New York Mellon, Moderator
  • Caitlin Cain, Vice President and Rural Director, Local Initiatives Support Corporation
  • Lindsay Miller, Of Counsel Attorney, Ice Miller LLP
  • Kenneth Neighbors, Partner, McGuireWoods LLP

To participate, register below. You will receive the login information on the day of the webcast. Registration is free and open to all interested parties.

Get Engaged! Contact Allison Rowland.