The Kentucky The Kentucky TeleHealth NetworkTeleHealth Network

We should be doing so much moreWe should be doing so much more

NASHP Annual ConferenceNASHP Annual ConferenceDenver, CODenver, CO

October 15, 2007 October 15, 2007

The Kentucky The Kentucky TeleHealth NetworkTeleHealth Network

We should be doing so much moreWe should be doing so much more

NASHP Annual ConferenceNASHP Annual ConferenceDenver, CODenver, CO

October 15, 2007 October 15, 2007

Rob Sprang, MBARob Sprang, MBADirector, Kentucky TeleCare - University of KentuckyDirector, Kentucky TeleCare - University of Kentucky

Project Manager, Kentucky TeleHealth NetworkProject Manager, Kentucky TeleHealth Network

From our Session’s DescriptionFrom our Session’s DescriptionFrom our Session’s DescriptionFrom our Session’s Description

……will explore how states will explore how states (Kentucky)(Kentucky) are using and are using and paying for Telehealth and paying for Telehealth and the barriers states have the barriers states have encountered…encountered…

““Of all the forms of inequality, Of all the forms of inequality, injustice in health care is the injustice in health care is the

most shocking and inhumane.”most shocking and inhumane.”

Dr. Martin Luther King, Jr. Dr. Martin Luther King, Jr.

Telehealth’s History in KYTelehealth’s History in KY 1994 – Target medically underserved1994 – Target medically underserved 1997 – School and correctional health1997 – School and correctional health 1998 – RMHC & APA international awards1998 – RMHC & APA international awards 1999 – Need for Medicaid/private payors1999 – Need for Medicaid/private payors 2000 – Telehealth legislation2000 – Telehealth legislation 2000 to present – Build a statewide initiative 2000 to present – Build a statewide initiative

with more involvement of state government. with more involvement of state government. Dramatically increase Correctional contracts.Dramatically increase Correctional contracts.

2006 – Launched industrial medicine project 2006 – Launched industrial medicine project with coal companies.with coal companies.

ii

Family VisitsFamily Visits

KentuckyKentucky

Kentucky PROACT

2 31

1010

6

78

4

9

11

13

12

14

1516

5

18

17

19

20

Connect to CDC’s Emergency Operations Center Videoconference Unit in Atlanta

Connect to National Video Bridging Service

for interconnectivity between states

Freedom Calls

Telehealth can…Telehealth can…

•Get the right care

•To the right people

•At the right time

•In the right place

Legislative/Regulatory ChallengesLegislative/Regulatory Challenges

ReimbursementReimbursement M-care limits codes/sites - $26 facility feeM-care limits codes/sites - $26 facility fee KY M-caid limits codes & visits/yr – No facility KY M-caid limits codes & visits/yr – No facility

feefee Other Medicaid/Private payors vary widelyOther Medicaid/Private payors vary widely

Privileging/credentialing Privileging/credentialing – – CMS and CMS and JCAHO conflict on requirementsJCAHO conflict on requirements

LicensureLicensure – – Must be licensed in the state Must be licensed in the state where the patient is seen. Nursing compactwhere the patient is seen. Nursing compact

Losing our directionLosing our direction Losing our directionLosing our direction

The original mission of Kentucky TeleCare was The original mission of Kentucky TeleCare was to help poor, medically underserved to help poor, medically underserved KentuckiansKentuckians

“…“…insure that all geographic areas of Kentucky insure that all geographic areas of Kentucky will have access to a full range of services by will have access to a full range of services by licensed health care professionals, to the extent licensed health care professionals, to the extent that these services may be performed within that these services may be performed within acceptable standards of medical practiceacceptable standards of medical practice…”. …”.

2007 – over 6,500 expected clinical encounters 2007 – over 6,500 expected clinical encounters and over 5,000 will be under correctional or and over 5,000 will be under correctional or industrial medicine contractsindustrial medicine contracts

Your call to actionYour call to action Learn about the telehealth initiatives in Learn about the telehealth initiatives in

your stateyour state

Visit the programs and participate in a Visit the programs and participate in a demonstrationdemonstration

Think about how telehealth can help youThink about how telehealth can help you

Think about how telehealth can help othersThink about how telehealth can help others

Promote legislative and regulatory agenda Promote legislative and regulatory agenda that will serve those that are most needythat will serve those that are most needy

Rob Sprang, MBARob Sprang, MBA

Director, Kentucky TeleCare Director, Kentucky TeleCare University of Kentucky University of Kentucky

Co-Project Manager, Co-Project Manager,

Kentucky TeleHealth NetworkKentucky TeleHealth Network

859-257-6404

rsprang@uky.edu