Mobile Telehealth Funding

Mobile Telehealth Funding Chris LaPage, MHA Grants Development Consultant Grants Office, LLC

Grants Office Webinar for Healthcare Sponsored by AT&T Mobile Telehealth Funding April 26, 2011 2:00 PM ET Sharon Barnes (Host/Moderator) Dana Stoker-Jones (Co-Moderator) att.com/healthcare Christopher LaPage is a Grants Development Consultant for Grants Office, LLC. Grants Office provides innovative grants development services that enable corporations, municipalities and nonprofit organizations to maximize their grant initiatives. Chris provides grant research and consultation to a variety of healthcare organizations across the country. He has a B.S. in Policy Analysis and Management with a Health Concentration from Cornell University and a Master's in Health Administration from Cornell University's Sloan Program. Chris previously worked as a legislative aide for the New York State Assembly Committee on Health. He has also served in a project management capacity, including the oversight of HIT implementations, for a variety of healthcare organizations ranging from healthcare clinics to major academic medical centers.

Agenda Overview: Mobile Telehealth Applications & Projects Funding Overview: Grantseeking Basics Mobile Telehealth: Federal Funding Mobile Telehealth: Examples of State Funding Mobile Telehealth: Earmarks and Foundation Funding Project Piggybacking & Telehealth Resources Q&A Page 3

Overview Mobile Telehealth: Applications & Projects Page 4

Overview: Telehealth Telehealth Vehicle of delivery: wireless and wire line telecommunications Health care service delivery Consult Diagnosis Treatment & patient education Monitoring Health professional education Distance learning methodologies Used in formal and continuing education Used to monitor practical experience residencies and nurse traineeships Page 5

Overview: Mobile Telehealth End-user wireless and wire line telecommunication devices are not in fixed location or end-user sites are not fixed Equipment examples Laptops PDAs/Tablets Portable patient monitoring devices Custom mobile telehealth units Setting examples EMS Vehicles & Ambulances Homes Schools Outreach vehicle (mobile RV unit) Community settings (mall, church, etc.) Page 6

Overview: Project Examples Connecting hospitals and paramedics Pre-triage in EMS vehicle or at point of EMS pick-up Send information to hospital to prepare for patient arrival The unit can be fixed in vehicle or mobile so that it can be used in patient home Even if unit is fixed in vehicle, the ambulance (site) is not confined to fix location. Still mobile telehealth project. Disease management program for Diabetes CHF patients are seen in their homes, with vitals, blood sugar and other medical data taken by tech that runs mobile telehealth unit. Unit allows data to be sent to medical providers for direct monitoring, input into electronic record for subsequent review or direct feedback from provider on data sent and direct observation through video conferencing. Mobile unit allows podiatrist consult upon visual inspection of a foot wound. Page 7

Funding Overview: Grantseeking Basics Page 8

Funding Mechanisms Sources - Federal State Foundation Methods - Competitive Formula Earmark Funding Process - Direct Pass-through Page 9

Funding Sources Federal - $400 billion per year for regular FY Programs Federal Programs tend to be large and restricted to national priorities State - May grant state funds or re-grant federal funds Typically less competitive and smaller than federal grants Foundation - $35 billion annually Locally responsive Smaller grants fill in gaps Page 10

Types of Grants: Competitive Six weeks from date of announcement to apply Request for proposals (RFP, NOFA, etc.) specifies application requirements Review & scoring against established criteria You must apply to be funded Not everyone who applies will be funded Page 11

Types of Grants: Formula Usually an annual deadline Requires forms No competitive scoring Based on this criteria funds are typically totaled (a formula) HPP based on population and natural disaster statistics Page 12

Types of Grants: Earmark Little Competition Assigned by/for Congress A $35 billion reality Future? Page 13

Direct vs. Pass-through Direct Grants Usually national programs with specific purpose Everyone is responding to the same program guidance Fed Local Pass-through Grants Many of the larger Federal programs State determined priorities and methods Fed State Local Page 14

Mobile Telehealth Federal Funding Page 15

What do you need funded with grants? Actual service/distance learning delivery? Historically, a big issue Payor reimbursement is starting to catch up Expensive start-up equipment & Ongoing maintenance Video conferencing technology Computers, monitors, hardware and software Routers, switches and other end-site equipment Underlying infrastructure Actual broadband transmission wiring, etc Wireless infrastructure to support telecommunications activities Page 16

Emergency Preparedness Angle Hospital Preparedness Program (HPP) ~$360 million pass-through program UASI: Nonprofit Security Grant Program (NSGP) Up to $75k per project in select urban areas Tie into anti-terrorism efforts at municipal level Metropolitan Medical Response System (MMRS) ~ $40 million for 124 metropolitan areas Surge capacity projects Public Health Emergency Preparedness (PHEP) Page 17

Distance Learning & Education Nurse Education Practice Quality and Retention (NEPQR) Faculty Development: Integrated Technology into Nursing Education and Practice Initiative Advanced Nursing Education Area Health Education Centers (AHEC) Infrastructure Development Awards Grants to Expand Substance Abuse Treatment in Targeted Areas of Need - Technology Assisted Care Page 18

AHRQ Grants Agency for Healthcare Research and Quality (AHRQ) Value Portfolio Health IT Portfolio Comparative Effectiveness Portfolio Prevention/Care Management Portfolio Patient Safety Portfolio Innovations & Emerging Areas Portfolio Page 19

AHRQ Grants AHRQ Health Services Research Demonstration and Dissemination Grants (R18) Funds all 6 Portfolios; $2.5 million over 5 years Utilizing Health IT to Improve Health Care Quality (R18) $1.2 million over 3 years; ambulatory/outpatient focus Small Research Grant to Improve Health Care Quality Through Health IT (R03) Exploratory and Developmental Grant to Improve Health Care Quality Through Health IT (R21) Partnerships in Implementing Patient Safety II (R18) Page 20

Rural Focus Distance Learning and Telemedicine Program (DLT) - USDA Up to $500k per project, 15% minimum match required, 260 awards Telehealth Network Grant Program (TNGP) - HRSA Up to $750k per project over 3 years, 8-15 awards per year Telehealth Resource Center Grant Program (TRCGP) HRSA Up to $1.625 million over 5 years; 3 awards per year Rural Health Care Services Outreach Grant Program - HRSA Up to $375k per project over 3 years; 90 awards per cycle Medicare Rural Hospital Flexibility Program (FLEX) - HRSA Pass-through funding to States; applicants can seek up to $750k per project Page 21

Rural Focus Rural Health Network Development Planning Grant - HRSA Up to $85k per project, 1 year project period, 15 awards per year Rural Health Network Development Program- HRSA Up to $540k per project over 3 years, 25 awards per year Rural Health Information Technology Network Program HRSA Up to $900k over 3 years; 40 awards, FY 2011 first offering Community Facilities Grant Program - USDA Fund up to 75% of project costs; pass-through competitive Community Connect - USDA Up to $1.5 million per project, 15% minimum match required Rural Economic Development Loan and Grant Program (REDLG) Up to $750k for loans, $300k for grants, 20% match requirement Page 22

Federal Grants Special Populations Ryan White HIV/AIDS Grant Funding Parts A, B, C and D Capacity-building and Health IT specific grants Tribal/IHS Grants Not just population-specific you must include HIS/Tribal health facilities Veteran Affairs (VA) Grants VA facilities typically involved, but looking to address population in general as well. Disease-specific & Population-based Innovative Strategies in Serving Children and Youth with Epilepsy Page 23

Mobile Telehealth Examples of State Programs Page 24

State Programs State Department of Health State USDA Rural Development Office State Office of Rural Health (SORH) Example: Rural Health Care Access Program (Idaho) Focus is on rural Idaho communities, designated as Health Professional Shortage Areas and Medically Underserved Areas Example: Rural Health Technology Grant (Texas) Designed to assist Texas Critical Access Hospitals acquire health information technology and capital equipment Wisconsin Telehealth Program (similar to DLT) Page 25

Mobile Telehealth Earmarks and Foundation Funding Page 26

Earmarks Federal appropriations cycle States mimic the process Target the right rep Congressionally-Mandated Health Information Technology Grants Telehealth is the number 1 priority with these funds Up to $1 million per project Health Care and Other Facilities (HCOF) Space, Renovation, Construction & Mobile Equipment Up to $1 million per project Page 27

Foundations Lower-hanging fruit LOI Process Find the right fit, Telehealth = Access to Health Services National Abbott Fund Hearst Foundation Kresge Foundation Regional Gladys Brooks Foundation Hospitals & Clinics Program (12 states) Local Page 28

Resources Project Piggybacking & Telehealth Resources Page 29

Project Piggybacking FCC Rural Healthcare Pilot Program Projects are just getting off the ground dating back to grant support from 1997 http://www.fcc.gov/cgb/rural/rhcp.html HRSA s Office for the Advancement of Telehealth (OTA) http://www.hrsa.gov/ruralhealth/about/telehealth/ Page 30

Resources Telehealth Regional Extension Centers (http://telehealthresourcecenter.org/) National Center for Telehealth and Technology (http://www.t2health.org/) Telemedicine Information Exchange (http://tie.telemed.org/default.asp) American Telemedicine Association (www.americantelemed.org) National Rural Health Association (http://www.ruralhealthweb.org) Page 31

QUESTIONS? Page 32

Key Takeaways Mobile telehealth is a broad category of projects Understand various funding Vehicles Determine which components of telehealth initiative need funding at the start of the project Focus on setting, population and type of mobile telehealth project when sifting through funding opportunities Regional collaboration is key ingredient to being approved for funding Piggyback off of other projects and utilize essential resources Page 33

Post-Webinar Questions? g08375@att.com Grant Education http://www.corp.att.com/healthcare/ THANK YOU! Page 34