Testimonial on H.B. 6472: AAC Telehealth

Human Services Committee

February 23, 2021

Submitted By: Stephen Wanczyk-Karp, LMSW

 On behalf of the National Association of Social Workers, CT Chapter, representing over 2,300 members, I urge the passage of AAC Telehealth before the Human Services Committee. Telehealth has become a primary means of delivering health care in the Covid-19 pandemic and it is critically important that current telehealth rules remain in place, beyond the Governor’s executive order, not just temporarily, but permanently.

Telehealth has made it possible for health care providers to serve consumers in a way that is safe for both the consumer and the provider. In the field of behavioral health, clinicians have been able to reach Medicaid recipients who had previously been seen in an office as well as expanding care to consumers who were previously unable to attain therapy due to obstacles such as lack of reliable transportation, employment hours, residing in facilities and family obligations. Many behavioral health clinicians report that with patient consent they are able to meet other family members and caregivers in the home who the patient would not have brought with them to an office visit, making for a fuller understanding of presenting issues. Accessibility to care has undeniably been increased through the expansion of telehealth services, including improvement in health equity. This means Medicaid recipients are getting care when needed before a crisis occurs that creates far greater costs both personally and financially.

H.B. 6472 continues important provisions that have made telehealth successful. First of all, the bill will continue the use of audio when a video option is not available. This particularly benefits older adults and disabled persons residing in long-term care facilities where video is not feasible. It has greatly aided those without video capable equipment, which is most prevalent in the Medicaid population. Additionally, audio only allows for added privacy for those who so choose this option. Audio assures that treatment can be provided even when internet connections are unstable or unavailable. Audio only means that all Medicaid patients can utilize telehealth. It is crucially important to continue the audio only option in Medicaid.

Secondly, the bill continues the payment structure of equal rates for treatment, be it in-person or through telehealth. This is completely appropriate as rates of pay should be based on the treatment, not the location where the treatment takes place. Rate equity also means that there will be an ample number of providers to provide care to those covered under Medicaid telehealth. Having lower rates for telehealth would only serve to reduce the number of providers willing to accept Medicaid. Providers in fact are now, in this pandemic, facing greater costs to practice. Most of our clinicians are paying for offices they cannot use, have the costs of telehealth platforms and additional costs in creating home offices.

AAC Telehealth also makes clear that Medicaid will accept all HIPAA compliant platforms for delivery of care. This eliminates unnecessary costs to providers for multiple platforms.

H.B. 6472 allows for telehealth services to be provided to both ongoing and new patients, an important provision. Verbal consent for services is also specifically allowed, another important aspect of delivery of telehealth services. AAC Telehealth eliminates obstacles that have in the past made telehealth services less feasible.

NASW/CT urges the Human Services Committee to make telehealth coverage under Medicaid permanent. We have heard consistently from licensed clinical social workers who are Medicaid providers that telehealth has increased accessibility to care. There is no need for a study as to whether accessibility will be increased and if Medicaid recipients have benefited from telehealth. From the past years’ experience, we already know the answer, it is yes. Likewise, the cost of transportation and the problems experienced in arranging and receiving transportation are reduced under telehealth just by definition of it being telehealth. Consumers and providers will benefit from a stable health delivery system that does not create uncertainty as to whether telehealth services will continue past June 30, 2023.

We are in the midst of a pandemic, with no one knowing for sure when this pandemic will subside. What we do know is that the impact of the pandemic will have far reaching, long-term effects. Following the 2001 World Trade Towers attack, the 2003 SARS outbreak in Toronto, and the 2011 Fukushima Daiichi nuclear disaster in Japan, behavioral health needs dramatically increased and remained so for many years after, and these disasters did not have the far reach of Covid-19. Behavioral health experts predict a tsunami of behavioral health needs coming out of the pandemic that demands continued full coverage for telehealth care under Medicaid.

We urge the Human Services Committee to amend H.B. 6472 by making Medicaid coverage of telehealth permanent, and to unanimously pass the bill.

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