Supporting WA State Behavioral Health Providers to Optimize Telehealth in Response to COVID-19
Northwest MHTTC and the Behavioral Health Training, Workforce and Policy Innovation Center of the BHI partnered to present an 8-session telehealth learning series for behavioral health providers across the continuum of behavioral health care in Washington State in response to COVID-19.
The webinar series met twice weekly for four weeks and addressed a variety of topics related to telehealth, including operational and administrative issues (such as billing), equipment and technology requirements, and strategies to provide effective clinical care.
This learning series is part of a coordinated statewide response to provide technical assistance to behavioral health organizations in the context of the COVID-19 pandemic and beyond. These efforts are led by the University of Washington Behavioral Health Institute in partnership with WA State Health Care Authority (HCA); WA Division of Behavioral Health and Recovery (DBHR), the University of Washington Department of Psychiatry and Behavioral Sciences, the nine Accountable Communities of Health, the five Medicaid Managed Care Organizations, and the Northwest MHTTC and others. These training sessions and other telehealth resources will be posted to a new Behavioral Health Telehealth Resource Website.
The series specifically helps the continuity of operations in WA to support access to care, equipment, technical assistance, billing and staff training for behavioral health providers in Washington State.
Sessions & Topics
Wednesday, April 22, 2-3pm PT -- Training #1: Telehealth Nuts & Bolts Kick-Off
- Review the definition of telehealth
- Review access to HCA laptops and Zoom accounts
- Review Zoom tips and functionality
- Review HIPAA regulations for telehealth
- Identify needs for further training and assistance
Washington Health Care Authority:
- Request a Zoom license to connect with patients (during the COVID-19 pandemic)
- Request a laptop for telehealth (during the COVID-19 pandemic)
- Activating your Washington Health Care Authority Zoom account
- FAQ on Apple Health (Medicaid) behavioral health policy and billing during the COVID-19 pandemic
Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS):
- Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency
Friday, April 24, 11am-12pm PT -- Training #2: Telehealth: Myths and Facts You Need to Know
Washington Health Care Authority:
- Apple Health (Medicaid) telemedicine and telehealth brief (includes billing guidance)
- Understand common myths that patients and providers might have about Clinical Video Teleconferencing.
- Review the literature that supports Clinical Video Teleconferencing and refutes these myths.
- Begin to develop confidence in providing care using Clinical Video Teleconferencing.
Wednesday, April 29, 2 - 3pm -- Training #3: Telehealth Billing & Reimbursement
- Review Medicare billing and reimbursement for telehealth during the Covid19 public health emergency
- Review private payer billing and reimbursement for telehealth during the Covid19 public health emergency
- Gail Kreiger, Section Manager, Medicaid Compliance Review and Analytics, Medicaid Program Operations and Integrity, Washington Health Care Authority
- Cathy Britain, Executive Director of the Telehealth Alliance of Oregon
Washington Health Care Authority
- Information about novel coronavirus (COVID-19) for behavioral health providers
- COVID-19 and opioid treatment programs
Resources on Medicare
- Medicare list of eligible services
- Medicare Telemedicine Health Care Provider Fact Sheet
- Medicare Telehealth Frequently Asked Questions (FAQs)
- List of services payable under the Medicare Physician Fee Schedule when furnished via telehealth
- Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19
- Medicare Coverage and Payment of Virtual Services. This video answers common questions about the Medicare telehealth services benefit.
- General Provider Telehealth and Telemedicine Tool Kit
- Center for Connected Health Policy: Private payer legislation and policy by state
- VSee: Billing and Coding for Telehealth During COVID-19 with Michael Enos video.
Resources on Private Payers and ERISA
- Proclamation by the Governor Amending Proclamation 20-05. Check with the Washington Health Authority and/or Washington State Office of the Insurance Commissioner for further information.
Friday, May 1, 11am-12pm PT -- Training #4: Introduction to Digital Health: Getting Started and Safety Planning
- Brad Felker, MD. VA Puget Sound Health Care System; Professor, University of Washington Department of Psychiatry & Behavioral Sciences
- Dos and Don’ts to seeing up your clinic space and providing quality Clinical Video Teleconferencing (CVT) care
- Dos and Don’ts to preparing the patient for their first clinical session via CVT
- Dos and Don’ts to Safety Planning
- Sample clinical video teleconferencing (CVT) header template for initial appointment
- Sample of home-based follow-up header for CVT appointment
- Sample of follow-up header for CVT appointment
Wednesday, May 6, 2 - 3pm PT -- Training #5: Creating a Clinical Workflow for Telehealth
- Jennifer Erickson, DO, Acting Assistant Professor in the UW Department of Psychiatry and Behavioral Sciences
List the four components of a telemedicine clinic work flow.
Friday, May 8, 11am-12pm PT -- Training #6: Telehealth and Substance Use Disorders
- Mark Duncan, MD, Assistant Professor, UW Department of Psychiatry & Behavioral Sciences; Co-Medical Director UW PACC, Telepsychiatry Rotation, and Advanced Collaborative Care - Addictions Medical Education
- Briefly review what the evidence says about telehealth SUD treatment
- Outline a telehealth SUD visit
- Develop understanding around special considerations for SUD treatment
- Highlight changes in SUD treatment due to the Pandemic
- Describe supplemental digital programs
Wednesday, May 13, 2 - 3pm PT -- Training #7: CFR Part 2 and HIPAA
- Christine Khaikin, JD - CoE-PHI Health Policy
- Sally Friedman, JD - CoE-PHI Senior Health Privacy Training and TA Director
- Caroline Waterman, MA,LRC,CRC - CoE-PHI SUD Lead
- Michael Graziano, MPA - CoE-PHI Project Director
- Identify basic requirements of 42 CFR Part 2 and HIPAA
- Explore recent changes to federal privacy laws outlined within the CARES act
- Explore privacy law application to telehealth in accordance with recently released SAMHSA and OCR guidance
- Describe how to access resources and TA provided by the Center of Excellence for Protected health Information (CoE-PHI)
- Center of Excellence for Protected Health Information (CoE-PHI) Resource Library
- Center of Excellence for Protected Health Information (CoE-PHI) Request Technical Assistance
- Video: Tips to Keep Your Telehealth Visit Private
- Telehealth and Privacy Tips for for Providers
- Telehealth and Privacy Tips for Clients
Friday, May 15, 11am-12pm PT -- Training #8: Telemedicine with Children & Adolescents
- Robert Hilt, MD, Professor UW Department of Psychiatry & Behavioral Sciences; Seattle Children's Hospital; Program Director, Partnership Access Line (PAL)
- Discuss the use of telemedicine for children and adolescents
- Review consenting and privacy issues for telemedicine with children
- Telemedicine Resources from the American Academy of Child & Adolescent Psychiatry
- Sample Telemedicine Acknowledgement Form
- Coding for Telemedicine Services from American Academy of Pediatrics
Bradford Felker, MD:
Dr. Felker is dually trained in psychiatry and internal medicine. His career has focused on integrated care, curriculum design, and Health Services Research. It was through this work he developed an interest in Digital Health. He developed, implemented, and led the Telemental Health Service at VA Puget Sound. He is a Professor with the University of Washington Department of Psychiatry and Behavioral Sciences. He also serves as a Captain in the US Navy Reserve.
Marc Avery, MD:
Dr. Avery is a psychiatrist and is a Principal Consultant for Health Management Associates. He has spent much of this clinical and academic career working in the development of person-centered, integrated primary and mental health care for high needs and safety-net patients. He has served as clinical lead for a number of very large integrated care projects, both large and small, in California, Oregon, and Washington State, including development of the Psychiatric Consultation and Telepsychiatry program at the University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences.
Cara Towle, MSN, RN, MA:
Ms. Towle is the Associate Director for Telepsychiatry at the University of Washington. A nurse by training, she has over 20 years of experience in developing and managing international, regional and rural telehealth programs at UCSF, Stanford, and the UW, with a recent focus on using telehealth technology and innovative care models and training to improve access and quality for mental health care services. She is a founding board member for the Northwest Regional Telehealth Resource Center, and a board member of the Washington State Telehealth Collaborative, continuing to work closely with colleagues to further advance the adoption of telehealth through outreach, education, and legislation.
Rande Gray is a Senior Computer Specialist with UW Telehealth Services. An expert in video teleconferencing, he has been a key figure in deploying telehealth technologies and training providers and staff across UW Medicine and at community-based health care facilities across the WWAMI region for over 20 years, and has developed an expertise in Zoom technologies.
Melody McKee, MS, SUDP:
Melody McKee is the Program Director for the Behavioral Health Training, Workforce and Policy Innovation Center through Harborview Medical Center’s Behavioral Health Institute. She has a Master’s Degree in Mental Health Counseling and has worked in the Behavioral Health Field for 16 years. She has spent the bulk of her time in the field developing and implementing innovative approaches to serving diverse populations with a focus on workforce retention, quality service delivery, curriculum enhancement and training.
Catherine Britain is the Executive Director of the Telehealth Alliance of Oregon (TAO) a membership organization focusing on telehealth policy development and education for Oregon health care providers, policy makers and payers in Oregon. She is also an advisory board member for the Northwest Regional Telehealth Resource Center (NRTRC) and contributes to the NRTRC Telehealth 101 workshops, addressing billing and reimbursement for telemedicine.
Gail Kreiger, BSN:
Gail Kreiger is Section Manager of the Medicaid Compliance Review and Analytics Section of the Medicaid Program Operations and Integrity Division in the Medicaid program of the Washington Health Care Authority. This section is responsible for the oversight of the managed care organizations’ administration of the Medicaid benefit and the quality of care provided under that delivery model. A graduate from Alderson Broaddus College Nursing program. A state employee for 31 years having worked for Labor and Industries, Department of Corrections and Medicaid, under the Department of Social and Health Services and the Health Care Authority.
Jennifer Erickson, DO:
Jennifer Erickson, DO, is an Assistant Professor in the UW Department of Psychiatry and Behavioral Sciences. She works at the UW Medical Center, three outpatient clinics, and one telepsychiatry clinic that use the Collaborative Care model. She teaches telepsychiatry curriculum for both the fulltime Integrated Care Fellowship and the Community-Based Integrated Care Fellowship. She also leads the quarterly in-person sessions for the Community-Based Fellowship and is a member of the UW Medicine Psychiatry Consultation and Telepsychiatry Program. Dr. Erickson's interests include neuropsychiatry, medical ethics, population health, and medical education.
Mark Duncan, MD:
Assistant Professor, UW Department of Psychiatry and Behavioral Sciences; Co-Medical Director UW PACC, Telepsychiatry Rotation, and Advanced Collaborative Care - Addictions Medical Education. Dr. Duncan currently works in an outpatient psychiatry clinic with general psychiatry patients, consults in addiction psychiatry, is a consultant for both the Behavioral Health Integration Program (BHIP) and Mental Health Integration Program (MHIP), works on the Harm Reduction with Pharmacotherapy (HARP) study in alcohol abuse and homelessness, and works with family medicine residents to improve their training in mental health work. He loves his work because it is interesting, there is opportunity to help people and improve lives, and there are opportunities for innovation and creativity. Five years from now, he hopes that collaborative care has stretched to better treat addictions and opiate use to fill the need and potential within that field.
Robert Hilt, MD:
Professor of Psychiatry at the University of Washington and Seattle Children’s Hospital. Trained as a general pediatrician and as an adult and child psychiatrist, he has worked as a primary care pediatrician and as a pediatric hospitalist before his current career as a child psychiatrist. Dr. Hilt is the Program Director for the Partnership Access Line (PAL), a child mental health consultation service for primary care providers in both Wyoming and Washington. He is also the Program Director for the Medicaid psychiatric Medication Second Opinion Programs of Wyoming, Washington and Alaska, and Multidisciplinary Team (MDT) Psychiatric Consult Service in Wyoming.
- Washington State Health Care Authority (HCA) supports increased telehealth options for Medicaid clients, public and school employees
- Northwest Regional Telehealth Resource Center
- Telehealth Alliance of Oregon (TAO)
- Center for Connected Health Policy
- National Telehealth Technology Assessment Resource Center