Telemedical access bill would link rural patients to health care

VA sets standards for rural health care

By DON JEPSEN
for the Mail Tribune
February 13, 2008
SALEM — A bill that would allow mental health patients in 18 rural counties to receive treatment via teleconferencing has been approved by a Senate committee, but must clear the budget-writing Ways and Means Committee.

The "telemedical access bill" would link patients with licensed mental health specialists via a video link-up from a secure facility.

Local doctors could in turn confer with Oregon Health and Sciences University psychiatrists in Portland for treatment opitions. OHSU operates a

telehealth program that has served, among others, victims of Hurricane Katrina.

The chief sponsor is Sen. Jason Atkinson, R-Central Point, who was elated when the Senate Health Policy Committee sent the measure, SB1100, out Monday evening.

"They (OHSU) found that it's worked fantastically well when the privacy was there, and the physician was in a clinical environment," Atkinson said. "I've got to put that same option in the hands of local providers in outlying areas of Oregon."

He said his bill could provide world-class clinical medical care to rural people.

Atkinson had hoped to keep the bill out of Ways and Means, given the downturn in the revenue forecast and the vow from the co-chairs to allow few, if any, new programs to be funded.

The Central Point legislator now has a major hurdle in convincing the parsimonious Ways and Means Committee to give his bill the green light by showing that with grants, Medicaid reimbursements and private insurance there should not be a cost to the state.

As originally introduced, the bill included all health services, with an estimated price tag pegged at $900,000 by the Legislative Fiscal Office. As a result, Atkinson scaled it back.

The measure has the strong backing of the Association of Oregon Counties, a major lobbying group.

"It's in our (the counties) best interest to provide the best care we can," said Gina Nikkel, executive director of AOC's mental health section.

While care currently is adequate, given fiscal constraints at the local level, Nikkel said the counties can "do better." She said a telehealth system "saves everybody time and money."

Becky Martin, mental health director for Jackson County, said the system could provide improved access to more rural areas of the county. Jackson County's program was once supported by county timber revenues,

but with the reduction in harvests it now operates with with Medicaid reimbursements, some Medicare and state general fund dollars.

"But each county is different," she said.

Josephine County contracts out its program to a private nonprofit organzation, Options, according to Rep. Ron Maurer, R-Grants Pass. "Medicaid by and large pays for it," said Maurer.

Martin and Maurer praised the bill.

Martin said her agency serves mainly those people on the Oregon Health Plan, or those who are in crisis. She said the uninsured who are not in crisis and live in remote areas are the ones who could benefit greatly from a telehealth system.

"This is an area the state has to explore," said Maurer. He cited the Department of Veterans Affairs' telehealth program as a model the state should study.

"They're way ahead. They know how to do it," he said. He said more frequent, short contacts with patients could go a long way to making them better.

Added Maurer, "It's all about linking experts with local medical professionals where time and distance are a big hurdle to adequate treatment."

Don Jepsen is a freelance writer living in Salem.

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