Florida League of Cities and Florida Association of Counties - Economic Stimulus Summit Agency for Health Care Administration Florida Center for Health

Florida League of Cities and Florida Association of Counties - Economic Stimulus Summit

Agency for Health Care Administration Florida Center for Health Information and Policy Analysis

The American Recovery and Reinvestment Act of 2009

Broadband Connectivity and Health Information Technology

Florida League of Cities and

Florida Association of CountiesEconomic Stimulus Summit

May 15, 2009



The American Recovery and Reinvestment Act of 2009 (ARRA) Funding for Health Information Technology

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This talk will cover a summary of the provisions under ARRA for health information technology, broadband access and an example of an HIT implementation to rural hospitals in the Florida Panhandle:

1.ARRA funding for broadband

2.ARRA funding for health information technology

3.FCC Rural Health Care Pilot Project



HIT Strategy Model for ARRA Funding

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ARRA – Broadband Access

Under ARRA, $7.2 billion in grant and loan funding for the Broadband Technology Opportunities Program (BTOP) was provided for broadband development to:

Provide access to broadband service to consumers residing in unserved areas and improved access to consumers residing in underserved areas

Improve access to, and use of, broadband service by public safety agencies; and

Stimulate the demand for broadband, economic growth, and job creation.

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ARRA Funding for NTIA

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ARRA allocated $4.7 billion to the National Telecommunications and Information Administration (NTIA) in the Department of Commerce for grants.

Funding covers 80% of cost, with a match of 20%

$3.9 billion in grants for infrastructure development

$200 million in grants to expand public computer center capacity at community colleges and libraries

$250 million in grants for innovative programs to encourage sustainable adoption of broadband

$350 million for broadband mapping



ARRA Funding for RUS

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ARRA allocated $2.5 billion to the Rural Utilities Service (RUS) in the Department of Agriculture for the Community Connect Grant Program and the Rural Development Broadband Loan Program.

Funding includes grants and loans:

Loan programs include 4% loans

75% of service must be in a rural area without sufficient access to high-speed broadband service to facilitate rural economic development



ARRA Grant Expectations

Competitive grants under BTOP are intended to:

Acquire equipment, networking capability, hardware and software, and broadband infrastructureConstruct, deploy and ensure access to broadband services by community and anchor institutions;Facilitate access to broadband service by vulnerable populations to provide educational and employment opportunities to themConstruct and deploy broadband facilities that improve public safety broadband services

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BTOP Grant Considerations

BTOP grants are expected to:

Award at least one (1) grant to each State;

Deploy broadband infrastructure to increase the affordability of service to the greatest population

Provide the greatest broadband speed possible

enhance service for health care delivery, education, or children to the greatest population

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ARRA Funding Requirements for BTOP

BTOP funding has specific time and access requirements:

All BTOP grants must be awarded by Sept. 30, 2010 All of the BTOP funds must be spent by grantees within two years of the grants awardsAll grants must adhere to the non-discrimination and network interconnection obligations contained in the FCC’s broadband policy statement (FCC 05-15):

“…consumers are entitled to competition among network providers… service providers, and content providers.”

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ARRA Funding for Health Information Technology Planning and Implementation Grants to States

for Health Information Exchange

Loans for Electronic Health Record Systems

Grants for Regional HIT Extension Centers

Grants for HIT Research Centers

Medicare/Medicaid Incentives to Providers for Adoption of Electronic Health Records

Medicare/Medicaid Incentives to Acute Care Hospitals for HIT



ARRA Funding to the Office of the National Coordinator for Health Information Technology (ONC) $2 Billion to ONC for investment in HIE

$300 million immediately distributed to states or state designated entities for HIE

$1.7 billion for other discretionary uses

• HIE – Additional funding as determined by ONC

• Electronic Health Record Adoption Loan Programs

• Technical Assistance – Regional Extension Centers

• HIE Research Centers



ARRA Grants to States to Promote Health Information Exchange Broad range of use of ARRA Funds

Enhancing broad and varied participation in HIE

Technical assistance for dissemination of solutions to barriers to HIE

Assisting patients in utilizing health IT

Supporting public health agencies use of and access to electronic health information

Promoting use of EHRs for quality improvement including reporting of quality measures

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ARRA Provides Funding for HIT Through Medicare and Medicaid Incentives $19 Billion allocated for Medicare and Medicaid

incentives to physicians

Medicare incentives to providers for “meaningful” use electronic health record systems and engaging in health information exchange

Medicaid funding is aimed at eligible physicians, Federally Qualified Health Centers, rural health clinics, acute care and children hospitals for installing health information technology

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ARRA Medicare Incentives

“Meaningful use” of an EHR in 2011 or 2012 provides incentive payments between $15,000 and $18,000 for the first payment year, and declining amounts in payment years 2013 through 2016

Payment reductions for eligible professionals who do not demonstrate "meaningful use" of an EHR will begin in 2015

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ARRA Medicare Incentives: Eligible Medicaid Provider Types Independent physicians, dentists, nurse mid-

wives, and nurse practitioners with greater than 30% patient volume

Federally qualified health centers with greater than 30% needy individuals

Pediatricians with greater than 20% patient volume

Hospitals with greater than 10% patient volume or children’s hospitals

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ARRA Medicaid Incentives

States are authorized to make payments to eligible Medicaid physicians for 85% of the allowable costs for certified EHR technology

Limit of $25,000 in year one

Limit of $10,000 per year five years through 2021

Hospitals are paid on a formula basis

Eligibility based on level of Medicaid patient volume

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ARRA: Other HIT Related Funding

$1.5 billion for community health centers, a sum that can be used toward health IT acquisition

$500 million for the Social Security Administration for processing disability and retirement workloads, of which up to $40 million may be used for health IT research and adoption

$1.1 billion to the Agency for Healthcare Research and Quality, Health and Human Services, and the National Institutes of Health for research into the comparative effectiveness of health IT

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FCC Rural Health Care Pilot Program

o This contract will allow the Big Bend Health to connect rural hospitals with gigabit fiber and provide its Regional Health Information Network services to them

o Providing broadband connections to rural towns and cities supports their potential for generating economic development in all business sectors - to create a healthy economy

In November 2007 the Federal Communication Commission awarded $9.6 million to Big Bend Health and the Agency for Health Care Administration to build a broadband network connecting rural hospitals and surrounding clinics in the Florida Panhandle



Connectivity in Rural Areas of Florida

The Florida Panhandle is the largest rural area in Florida, as shown by the purple sections in the map

While urban areas have high speed connections, rural areas of the state have limited broadband access



The Goal of the FCC: A Nationwide Network of Health Care Facilities



Rural Health Care Pilot Construction Plan

In 2009 Big Bend Health plans to run optical fiber from Florida LambdaRail interface points to a Point of Presence (POP) in each rural county.

From the POP, optical fiber will be run the last mile to complete the broadband connections to the nine rural hospitals and one VA clinic in the project.

In Phase 2 of the project, a wireless broadband network will be deployed to connect other providers.

The project proposes to connect the rural hospitals to urban hospitals in Tallahassee, Panama City and Pensacola.



Radiology

TDI

CRMC

TMH

VSA

CHP

pMAN

CHP.

CHP.

NFWC

TNC

VPN

Remote&

VPN Users

BBRHIO RHIN

Urology

Big Bend Health Private Medical Area Network

The Big Bend Health pMAN is a 1 Gigabit fiber ring with high-speed connections

to providers





FCC Rural Broadband Pilot Project Connecting Nine Rural Hospitals in the Florida Panhandle



Connecting Calhoun-Liberty Hospital in Calhoun County

Calhoun-Liberty Hospital

Point of Presence



Target Rural Areas in Florida’s Panhandle

Fifteen hospitals and clinics will be connected to the Florida Panhandle Health Care Network and will be eligible for health information exchange services from Big Bend Health.



Hospitals Included in the FCC Pilot Project

o Calhoun-Liberty Hospital, Blountstown, Calhoun County

o George Weems Memorial Hospital, Apalachicola, Franklin County

o Sacred Heart Hospital, Port St Joe, Gulf County

o Doctor’s Memorial Hospital, Bonifay, Holmes County

o Campbellton-Graceville Hospital, Graceville, Jackson County

o Jackson Hospital, Marianna, Jackson County

o Marianna Veterans Clinic, Jackson County

o Madison County Memorial Hospital, Madison, Madison County

o Doctor’s Memorial, Perry, Taylor County

o Northwest Florida Community Hospital, Washington County

o TMH Family Medicine Quincy, Quincy, Gadsden County



Health Information Exchange Services

Big Bend Health maintains a community repository for the storage and retrieval of:

Demographic/encounter dataMedication claims data and e-prescribingDocument viewer including lab/radiologySecure messaging

Disaster recovery

Remote data backup outside service area



Big Bend Health Record Locator Service

Patient record

locator for medical records



Big Bend Health Provides Clinical Records

Clinical data display can include: lab reports, radiology reports, allergies, problem list, provider encounter data, demographic data on patients



Big Bend Health Supports e-Prescribing

e-Prescribing and Medication

History



Big Bend Health Accepts Paper Records

Paper records can be scanned and retrieved from the Big Bend Health record repository



Benefits of ARRA for Health Care in Florida

Delivering high speed broadband connections to health care providers in Florida will create many new opportunities:

oProvide telemedicine services not available today

oImprove access to health care services for rural Floridians and reduce drive time for appointments

oIncrease the quality of health care by supporting the timely and secure delivery of health care information

oConnect providers in a secure, dedicated network

oImprove the economic health of the rural communities by creating new business and job growth



Christopher B. Sullivan, Ph.D.Administrator, Office of Health IT

Florida Center for Health Information and Policy Analysis

Agency for Health Care Administration

[email protected] Updates on the FCC project are available at:

http://www.fhin.net/FHIN/HITinitiatives/RHCPP.shtml

Documents

Florida League of Cities and Florida Association of Counties - Economic Stimulus Summit Agency for Health Care Administration Florida Center for Health