- Arkansas lawmakers are moving toward new telehealth regulations that would resolve an “originating site” issue that caused problems last year. But they may be wading into new problems with school-based programs.
The state Senate’s Public Health, Welfare and Labor Committee voted this week to approve amendments to the state’s telemedicine rules that would, among other things, enable residents to access telehealth services from their home or other remote locations. The bill now passes to the full state Senate.
Arkansas Act 887, signed into law in 2015, stipulates that an originating site must be in a healthcare setting, such as a hospital, clinic or doctor’s office. That drew the ire of healthcare providers seeking to launch remote monitoring programs and large businesses like Wal-Mart and trucking company H.B. Hunt, who noted the law prevents their employees from accessing telehealth through mobile devices at home or on the road.
Arkansas Senate Bill 146, submitted on January 19 by Sen. Cecile Bledsoe, R-Rogers, would define an originating site as wherever the patient is located.
The bill also states that healthcare providers treating minors in a school telehealth program must either
- be the child’s regular pediatrician or other primary care physician
- have a cross-coverage arrangement with the child’s doctor, or
- have authorization from the child’s doctor.
Nearly all school-based telehealth programs require a parent’s OK for telehealth services – something done in a blanket letter or e-mail to parents at the beginning of the school year. When a child is treated via telehealth, the pediatrician or other primary care provider is notified later and sent all records of the treatment.
According to the Arkansas Time Record, Bledsoe said during the hearing that the amendment is necessary because school students are “a captive audience.” But Mary Doderer, president and CEO of Arkansas Children’s Hospital, which is launching a school-based telehealth pilot program, questioned why schools were singled out for the restriction.
"[W]ould we require that only in a school setting and not require that in a Walmart clinic, in an urgent care clinic, in any other site that telemedicine will be delivered?" she asked.
When told the state’s telehealth laws don’t specify that a child’s parent give permission before telehealth is used on a child, Bledsoe said she’d amend her bill to include that requirement.
Lawmakers last year approved an amendment to the state’s telemedicine laws that eliminated a requirement that a healthcare provider meet in person with a new patient before beginning telehealth treatment. Arkansas had been one of the last states to still require an in-person meeting between doctor and patient – a distinction that has earned the state a low grade on the American Telemedicine Association’s annual report cards on state telemedicine practices.