RD509 - Options for Increasing the Use of Telemental Health in the Commonwealth - Interim Report – November 21, 2017

Executive Summary:

A 2017 budget amendment (HB1500 Item 30 #1c) mandated that the Joint Commission on Health Care (JCHC) study options for increasing the use of telemental health in the Commonwealth and to focus on the issues and recommendations made by the Telemental Health Work Group (The Work Group) which is a sub-group of the Joint Subcommittee Studying Mental Health Services in the Commonwealth in the 21st Century. The JCHC study will span two years and include this interim report and a final report to be submitted by November 2018.

The Work Group identified six barriers to expanding telemental health in the Commonwealth, offered twenty-nine options, and proposed twelve recommendations based on their potential for high impact and an ability to be achieved within a twelve-month period. The JCHC interim report focused on a sub-set of the twelve recommendations that are most amenable to action during the 2018 General Assembly session. Several of the recommendations fit together synergistically to address access issues in Southwestern Virginia and statewide, and if implemented could help address the opioid crisis in the region. These recommendations include: (1) Project ECHO, which provides clinical support and education to health care providers who are not in behavioral health settings; (2) updating the Southside Training and Telehealth Academy (STAR) resources that provide technical and management training needed to operate and administer a telehealth service; (3) establish a pilot telemental health network to expand access to behavioral health involving the Virginia Telehealth and Appalachian Telemental Health Networks. State funds provided for this effort may be used to leverage additional grant funds from the Tobacco Regional Revitalization Commission and the Appalachian Regional Commission to help expand broadband capacity; (4) create a directory of telehealth providers that can be accessed by laypersons and used by non-behavioral health services providers to refer patients in Appalachia and possibly statewide; and (5) request that the JCHC conduct a study to determine the feasibility of central or regional telepsychiatry contracting that to serve all the Community Services Boards (CSBs) in the state.

In total, the Work Group estimates that $1,100,000 of State General Funds per year for three years would be required to implement the recommendations. The Work Group anticipates that these activities will be sustainable after the three-year funding period. The final JCHC report on this issue will address progress achieved between this interim report and November 2018, as well as other Work Group recommendations.

By the date of the JCHC Decision Matrix meeting, in which members vote on the policy options in the staff studies, the Joint Subcommittee to Study Mental Health Services in the 21st Century had not yet formally considered or voted on the recommendations in the report from the Telemental Health Work Group on Policy Development. As such, JCHC members chose to not vote on the JCHC policy options at that time; and instead voted to “take no action." These recommendations will be brought to the Joint Subcommittee to Study Mental Health Services in the 21st Century’s full committee in December 2017.