Minnesota’s telehealth policies are noted in State Telehealth Laws report

MHealth Intelligence reports…

In its spring 2018 update of the State Telehealth Laws and Reimbursement Policies Report, the Center for Connected Health Policy reports that 10 states have amended their telehealth policies since August 2016 to specifically make the patient’s home an originating site for Medicaid-accepted telehealth and telemedicine programs. Those states are Delaware, Colorado, Maryland, Michigan, Minnesota, Missouri, New York, Texas, Washington and Wyoming.

Meanwhile, the report notes that six states have limited the geographic requirement altogether since 2013. And 16 states have added schools to the list of approved originating sites, though some are placing restrictions on those services.

According the CCHP’s sixth annual report, some 160 telehealth-related bills have been introduced during the 2018 legislative session in 44 states, continuing a digital health trend that saw more than 200 pieces of legislation introduced during the 2017 session. But not all of those bills are supportive of new healthcare services.

Minnesota also gets a nod for telehealth licensure…

In terms of telehealth licensure, the report finds that nine states – Alabama, Louisiana, Maine, Minnesota, New Mexico, Ohio, Oregon, Tennessee and Texas – issue specific licenses to use telehealth, while 22 states have joined the Federation of State Medical Boards’ Interstate Medical Licensure Compact, which offers an expedited process to applying for licenses to practice in member states. Three states, Tennessee, Montana and Nevada, dropped individual license requirements to join the compact (though Tennessee’s Osteopathic Board is still issuing telehealth licenses).

Healthcare facilities in Pipestone County need broadband for telehealth applications

The Pipestone Star posted about Senator Klobuchar’s recent visit to Pipestone, where broadband came up…

“In a rural setting as a physician you feel like you’re on an island and don’t have the resources available and with our telecommunications system, it’s never like that,” he said.
He said they’re in good shape with broadband at PCMC, but other facilities across the Avera system don’t have the same access which creates barriers. Klobuchar said they included $600 million in the federal budget to address rural broadband issues, money that “trickles through from the states,” she said, and must also reach the agricultural industry.
“Ag, more and more, precision agriculture, is using broadband,” she said.

USDA RUS Distance Learning and Telemedicine Grant Program applications due June 4

The details of the Distance Learning and Telemedicine grants were recently released in the Federal Register

The Rural Utilities Service (RUS), an agency of the United States Department of Agriculture (USDA), herein referred to as RUS or the Agency, announces its Distance Learning and Telemedicine (DLT) Grant Program application window for Fiscal Year (FY) 2018. The Agency is publishing the amount of funding received in the appropriations act on its website at https://www.rd.usda.gov/newsroom/
notices-solicitation-applications-nosas.
Expenses incurred in developing applications will be at the applicant’s risk.
In addition to announcing the application window, RUS announces the minimum and maximum amounts for DLT grants applicable for the fiscal year. The DLT Grant Program regulation can be found at 7 CFR part 1734,
subpart B. This DLT Grant Program regulation replaced the previous DLT Grant Program regulation, 7 CFR part
1703, subpart E, on December 27, 2017.

Great broadband digital inclusion project ideas from Minnesota

The Blandin Foundation works with communities to help them better use better broadband. They’ve been doing it for years and sometimes I get lucky enough to be a part of the projects. Each community works with a community broadband coach (Bill Coleman – another consultant on the Blandin Broadband Team); he helps them figure out their community priorities and where broadband fits in.

Then each community submits broadband proposals (to the community team, then Blandin) for potential funding. These projects are well thought out, vetted and most are well executed. (As my kids say – sometimes you win, sometimes you learn. Sometimes the projects are good learning opportunities and those lessons get shared.)

Today I’m pleased to share a matrix of the most recent projects. It’s a great list of ideas you could try in your own community. I suspect the layout of the projects will not be perfect – you can get a nicer, printable version too.)

Also – it’s a gentle reminder that Blandin is looking for future communities – deadline is May 31, 2018. (You can learn a lot more about the program in this archive of a recent webinar on it.)

 Community Project Owner Project Name Project Description
Aitkin County Aitkin County Aitkin County Community Calendar Create a county-wide landing page for events sponsored by Aitkin County Chambers, Schools and other organizations.
Aitkin County Aitkin County Community Conference Centers Provide three small communities with conference/meeting suites, including a mobile computer lab, smart boards, other digital equipment, and Wi-Fi hotspots for use by residents, community education and others.
Aitkin County Aitkin County Wi-Fi Network for Small Cities Provide Wi-Fi for the central hub of Palisade to attract commercial growth, promote connectivity, enhance education, and promote telehealth. This project will serve as a pilot for Wi-Fi networks in other small cities.
Aitkin County Aitkin County Wi-Fi at Berglund Park Provide Wi-Fi at the Palisade city park campground – a main entry point for the Northwoods ATV Trail and important source of economic activity. Park usage is anticipated to increase with Wi-Fi availability.
Aitkin County East Central Regional Library Mobile Wi-Fi Hotspots The East Central Regional Library will obtain 14 mobile hotspots and make them available to patrons at the Aitkin Library and other outreach locations in Aitkin County, providing internet access to county residents who don’t have broadband.
Aitkin County ISD 1 Aitkin Public Schools Wi-Fi Enabled Buses Install Wi-Fi on four school buses so students will be able to work on homework while traveling to and from home, and on longer trips.
Aitkin County Long Lake Conservation Center Wi-Fi and Increased Bandwidth at Long Lake Conservation Center Increase the Internet bandwidth to the LLCC campus, and improve the Wi-Fi network. This will improve working conditions for the staff, increase the effectiveness of programming offered, and make the center a more desirable event venue.
Chisholm Chisholm Community Education Community Training Sessions Training sessions on internet use (social media, security, Facebook) to be offered free of charge to the community. CHS students will be on hand to help class participants as they utilize the training.
Chisholm Chisholm EDA Community Website/Portal Develop a community portal and calendar for community information and events, including marketing, tourism, school events, city and chamber.
Chisholm Chisholm EDA Community Hot Spots Provide Wi-Fi hotspots at the Chisholm Public Library, Lake Street Pocket Park, Balkan Community Center, and HRA Apartment Complex.
Chisholm Chisholm EDA The “Business Perks” Building Develop a technology center with rental space/incubator space available for businesses. Broadband/Internet/website/social media training opportunities for businesses will be offered.
Chisholm Chisholm Public Library Hot Spot Check-Out System Provide fifteen hotspots with mobile data plans for check out at the Chisholm Public Library.
Chisholm ISD 695 Chisholm Public Schools Wi-Fi on Buses Install Wi-Fi on two school buses, allowing students taking longer bus trips to have access to the internet. Bus Wi-Fi may be used for community events as well.
Chisholm Minnesota Discovery Center Minnesota Discovery Center Broadband Connection Upgrade Wi-Fi throughout the Minnesota Discovery Center, allowing for better access during meetings, for events, and for patron/staff use.
Chisholm / Hibbing / Mt. Iron-Buhl Chisholm EDA Central Range Area Feasibility Study Hire a consultant to conduct a feasibility study to better understand options for improving broadband infrastructure and services within the designated area, present the resulting plan and funding options to city councils, townships, school boards and the St. Louis County Board, and assist with grant writing as requested.
Ely City of Ely – Ely EDA Homegrown Ely Website (Elyite.com) Create a website to showcase Ely to prospective residents, businesses, and visitors. The site will include information on the cost of living, the arts, restaurants, churches, business opportunities, infrastructure, etc.
Ely Entrepreneur Fund Digital Marketing for Small Businesses Engage seven small business owners (selected through an application process) in hands-on consulting to build brand awareness and increase revenue by developing and implementing affordable website and social media strategies.
Ely Incredible Ely Ely Technology Center Utilize current space in the downtown business district to provide a shared office space with high-speed Internet for local telecommuters, entrepreneurs, and visitors.
Ely Entrepreneur Fund Ely Small Business Workshop Series Provide three structured workshops on timely topics for small business owners. Local facilitators will share practical tools and ideas on topics such as digital marketing, employee recruitment, and QuickBooks.
Ely City of Ely Ely Area Broadband Feasibility Study Conduct a feasibility study that will provide factual information about market demand, technology alternatives, deployment and maintenance costs, network operation and marketing. It will include installation of fiber within the City of Ely, and extending throughout the entire school district area. Project partners will use the data generated to develop a plan for service delivery.
Ely Incredible Ely Business Development/Broadband Survey Conduct a survey on business development and internet usage data as well as projected broadband usage information, with the goal of bringing broadband to Ely and making it an economic success.
Grizzlies

(Bois Forte, Cook, Orr)

Bois Forte Band of Chippewa Indians Business Training and Community Education Design and provide community technology education programs at Bois Forte, Orr Center, Cook Library and Community Center, and North Woods High School. Topics will be determined based on community feedback.

 

 

 

Minnesota is a top telehealth using state

MHealth Intelligence reports on a White Paper done by FAIR Health…

The report showed that from 2011 to 2016, telehealth service use increased substantially, especially in rural areas (960 percent). In comparison, telehealth use grew by 629 percent in urban areas, and by 643 percent nationally.

However, more recently urban usage has grown to match and even surpass rural usage. Between 2015 and 2016, urban areas saw a jump from just over 25 percent to over 45 percent, while rural growth increased from 35 percent in 2015 to just over 40 percent in 2016.

In 2016, the states with the greatest number of claims lines with telehealth usage were Massachusetts, California, Texas, South Dakota and Minnesota.

What are the biggest reasons for telehealth appointments?

The results also showed that patients overwhelmingly use telehealth for mental health reasons. Mental health accounted for 31 percent of the telehealth claim line distribution in 2016. Acute respiratory infections were the second most common use for telehealth, accounting for 15 percent of claim line distribution.

These findings make sense when considering past research on mental healthcare in the US, which shows that the growth of the patient population has outpaced the number of available psychiatrists, particularly in rural areas.

The article outlines the importance of the research in terms of how hospitals and medical schools can adapt to make better use of telehealth. I might add that it’s important for infrastructure planning too.

Lack of broadband a potential barrier to keeping a job

Earlier this week the State House Health and Human Services Reform met to discuss legislation (HF3722/SF3611) that would require some people who receive Medical Assistance to report they are either working, looking for work, or completing training or community service activities in order to receive MA health care and supports. They heard from 30 testifiers who had concerns about the bill – one mentioned access to the internet and technology as a barrier to keeping a job (via This is Medicaid)…

Monica Nilsson, on behalf of the Dakota county homeless shelter she opened last year, spoke to the significant hurdles some MA [Medical Assistance] residents there already face:  “People stayed in the shelter seeking to maintain their blood sugar, refrain from vomiting with the flu, abstain until they can get into treatment, or restrain the demons in their heads that no one is helping them leave behind. . . . They don’t have a mailbox, enough minutes on their phone, library access for a computer, and in some rural areas, good access to the internet to receive regular updates.  They show up for shifts that have been cut, they miss changes in the schedule.  Employers don’t understand why or how.”

Bill to create a task force to innovate health-related telepresence (HF4045) is introduced

The House Introduction of Bills reports…

Olson, Schultz and Flanagan introduced:

  1. F. 4045,A bill for an act relating to health; creating a task force to facilitate person-centered innovation in health and human services through a statewide expansion of telepresence platform access and collaboration; requiring a report.

The bill was read for the first time and referred to the Committee on Health and Human Services Reform.

Here’s the proposed text

A bill for an act
relating to health; creating a task force to facilitate person-centered innovation in
health and human services through a statewide expansion of telepresence platform
access and collaboration; requiring a report.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1. TASK FORCE ON PERSON-CENTERED TELEPRESENCE PLATFORM
EXPANSION.

Subdivision 1.

Purpose. 

Minnesota’s aging population and scarce workforce has caused
pressure on all industries, including health and human services, to improve productivity.
Innovation is the main source of productivity improvement. Thriving industries in the United
States are transforming digitally, focusing on improving customer experiences, innovating
industry business and platform models, and driving costs down by leveraging scale and
cloud opportunities. The Minnesota community innovation model has demonstrated the
value of adapting these strategies for person-centered innovation using Internet telepresence
to incentivize local and regional collaborative initiatives in health and human services and
related education and correctional services. The purpose of the task force is to share
knowledge at the local level and create the opportunity to adapt and expand this innovation
model throughout Minnesota.

Subd. 2.

Membership. 

The task force on person-centered telepresence platform expansion
consists of the following 22 members:

(1) two members of the senate, one appointed by the majority leader and one appointed
by the minority leader;

(2) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the minority leader;

(3) the commissioner of MN.IT services or a designee;

(4) the commissioner of corrections or a designee;

(5) the commissioner of human services or a designee;

(6) the commissioner of health or a designee;

(7) the commissioner of education or a designee;

(8) three members appointed by the governor representing county services in the areas
of human services, health, and corrections or law enforcement. These members must represent
counties outside the metropolitan area defined in Minnesota Statutes, section 473.121;

(9) one member appointed by the governor representing public health;

(10) one member appointed by the Minnesota American Indian Mental Health Advisory
Council;

(11) one member appointed by the Minnesota Medical Association who is a primary
care provider practicing in outstate Minnesota;

(12) one member appointed by the NAMI of Minnesota;

(13) two members appointed by the Minnesota School Boards Association;

(14) one member appointed by the Minnesota Hospital Association to represent rural
hospital emergency departments;

(15) one member appointed by the governor to represent community mental health
centers;

(16) one member appointed by the governor representing adolescent treatment centers;
and

(17) one member appointed by the chief justice of the Supreme Court.

Subd. 3.

Appointment deadline; first meeting; chair. 

Appointing authorities must
complete appointments by June 15, 2018. The director of telepresence integration shall
convene the first meeting of the task force by July 15, 2018. The task force shall select a
chair from among their members at their first meeting.

Subd. 4.

Compensation. 

Members shall be compensated and may be reimbursed for
expenses as provided in Minnesota Statutes, section 15.059, subdivision 3.

Subd. 5.

Duties. 

The task force shall:

(1) explore opportunities for improving behavioral health and other health care service
delivery through the use of a common interoperable person-centered telepresence platform
that provides connectivity and technical support to potential users;

(2) review and coordinate state and local innovation initiatives and investments designed
to leverage telepresence connectivity and collaboration;

(3) identify standards and capabilities for a single interoperable telepresence platform;

(4) identify barriers to providing a telepresence technology, including limited availability
of bandwidth, limitations in providing certain services via telepresence, and broadband
infrastructure needs;

(5) identify and make recommendations for governance to assure person-centered
responsiveness;

(6) identify how the business model itself can be innovated to provide an incentive for
ongoing innovation in Minnesota’s health and human service ecosystems;

(7) evaluate and make recommendations for a potential vendor that could provide a
single telepresence platform in terms of delivering the identified standards and capabilities;

(8) identify sustainable financial support for a single telepresence platform, including
infrastructure costs and start-up costs for potential users; and

(9) identify the benefits to the state, political subdivisions, and tribal governments, and
the constituents they serve in using a common person-centered telepresence platform for
delivering behavioral health services.

Subd. 6.

Report. 

The task force shall report to the chairs and ranking minority members
of the committees in the senate and the house of representatives with primary jurisdiction
over health and state information technology by January 15, 2019, with recommendations
related to expanding the state’s telepresence platform and any legislation required to
implement the recommendations.

Subd. 7.

Administrative support. 

The commissioner of human services shall provide
meeting space and administrative services to the task force.

Subd. 8.

Sunset. 

The task force sunsets July 31, 2019, or the day after the task force
submits the report required in this section, whichever is earlier.