FCC Telehealth Funding Available – Apply Today!

Elana Zana (ezana@omwlaw.com)

Starting at 9 AM Pacific on April 13, 2020, the FCC will begin to accept applications for its COVID-19 Telehealth Program, funded by $200 million dollars allocated by the CARES ACT. This program will fully fund telecommunications services, information services, and devices necessary to provide critical connected care services.

The FCC does not expect to award more than $1 million to any single applicant. Healthcare providers may use the funds for purchases made on or after March 13, 2020, and such funds may be used for monthly recurring charges through September 30, 2020.

Applicants must obtain (1) an eligibility determination from the Universal Service Administrative Company (USAC); (2) an FCC Registration Number (FRN) through CORES – https://apps.fcc.gov/cores/userLogin.do; and (3) register with System for Award Management – https://www.sam.gov/SAM/. The healthcare provider sites which the USAC has already deemed eligible to participate in the Rural Health Care Programs may rely on that determination for this program. Applicants that have yet to receive an eligibility determination from the USAC may still apply while the USAC reviews the FCC Form 460.

The Telehealth Program allows participation of the following types of healthcare entities: (1) postsecondary educational institutions offering health care instruction, teaching hospitals, and medical schools; (2) community health centers or health centers providing health care to migrants; (3) local health departments or agencies; (4) community mental health centers; (5) not-for-profit hospitals; (6) rural health clinics; (7) skilled nursing facilities; and (8) consortia of health care providers consisting of one or more entities falling into the first seven categories.

The FCC provided the following examples of eligible services and devices:

  • Telecommunications Services and Broadband Connectivity Services: Voice services, and Internet connectivity services for health care providers or their patients.
  • Information Services: Remote patient monitoring platforms and services; patient reported outcome platforms; storage and forwarding services, such as asynchronous transfer of patient images and data for interpretation by a physician; platforms and services to provide synchronous video consultation.
  • Internet Connected Devices/Equipment: tablets, smart phones, or connected devices to receive connected care services at home (e.g., broadband enabled blood pressure monitors; pulse-ox) for patient or health care provider use; telemedicine kiosks/carts for health care provider site.

The FCC application will include the following categories (including how telehealth funding can help free up resources that can then be used to treat COVID-19 patients):

Types of medical services:

  • Patient-Based Internet-Connected Remote Monitoring
  • Other Monitoring (e.g. pulse-ox, BP monitoring)
  • Video Consults
  • Voice Consults
  • Imaging Diagnostics
  • Other Diagnostics
  • Remote Treatment
  • Other Services

Note that the Program will only provide funding for monitoring devices that are connected, not devices that patients can use at home and then share the results with their healthcare provider remotely. The FCC will not require applicants to purchase only those services or devices identified in their applications. Health care providers may use funds to purchase any necessary eligible services and connected devices. Further, applicants may request additional support funds after they have exhausted the initial award.

Conditions to be awarded funds under this Program funding include:

  • Whether the applicant will treat COVID-19 patients directly
  • Whether the applicant will treat patients without COVID-19 symptoms or conditions (applicants will check all that apply):
    • Other infectious diseases
    • Emergency/Urgent Care o Routine, Non-Urgent Care
    • Mental Health Services (non-emergency)
    • Other conditions
  • How using the COVID-19 Telehealth Program funding to treat patients without COVID-19 symptoms or conditions would free up resources that will be used to treat COVID-19.

The FCC Order on April 2, 2020 also launched the Connected Care Pilot Program “to help defray health care providers’ qualifying costs of providing connected care services, with a primary focus on providing these services to low-income or veteran patients.” The funding of this program includes $100 Million over three years, and will cover 85% of the eligible costs of broadband connectivity, network equipment, and information services necessary to provide connected care services to the intended patient population. Applications for this Pilot Program are not due for 45 days from the effective date of the Pilot Program rules, or 120 days from the release date of the FCC order (whichever is later).

For more information about applying for funding, deploying telecommunications services (including software, fiber, and DAS contract review), and telehealth, please contact Elana Zana at 206-442-1308 or ezana@omwlaw.com.

Relevant Resources:

FCC Webinar & Application Materials on COVID-19 Telehealth Program: https://www.fcc.gov/covid-19- telehealth-program

FCC Guidance on COVID-19 Telehealth Program: https://docs.fcc.gov/public/attachments/DA-20- 394A1.pdf

FCC Form 460: https://www.usac.org/rural-health-care/resources/forms/

FCC Order (April 2, 2020): https://docs.fcc.gov/public/attachments/FCC-20-44A1.pdf

Zoom Security & Privacy Hygiene Tips by Elana Zana

Using video conference platforms, specifically Zoom, has become a new way of life to facilitate check-ins, mediations, public meetings, etc.  However, as many users have already identified (e.g. the FBI – https://www.fbi.gov/contact-us/field-offices/boston/news/press-releases/fbi-warns-of-teleconferencing-and-online-classroom-hijacking-during-covid-19-pandemic) there are some security vulnerabilities with Zoom. These vulnerabilities range from stealing login credentials to Zoom bombings – interrupted Zoom meetings by unwanted visitors – jeopardizing the privacy of these meetings and potentially, the security of your system.

Here are a few tips and procedures to follow in order to maintain the security and privacy in Zoom:

  1. Many hackers are embedding URLs into the chat feature within Zoom; do not click on any URLs within this feature. See https://arstechnica.com/information-technology/2020/04/unpatched-zoom-bug-lets-attackers-steal-windows-credentials-with-no-warning/
  2. Enable a password for all meetings (ideally a random one).
  3. When joining a meeting, type in the Meeting ID and Password (rather than following a Zoom link).
  4. Utilize the waiting room feature, in which the host must allow others to join the meeting.
  5. Disable file sharing, or allow only the host to share.
  6. Disable call recording.
  7. Prevent participants from saving chats and disable auto-saving chats.
  8. Periodically inspect the list of participants throughout the duration of the meeting.
  9. Lock the meeting once everyone has joined.
  10. Do not share Meeting IDs on any social media platform.
  11. Ensure that all users are running the most updated version of Zoom (post January 2020).

Another good video meeting hygiene tip: be aware of WHO and WHAT is in your background. Sometimes, the Zoom bombers are not only unwanted hackers, but your own family member(s) not realizing you are on video.

While in many cases you are not the “host” of the meeting, you may want to discuss some of these concerns with the host to make sure that they are aware of the security and privacy issues.

So, what’s the solution? You can still use Zoom – just make sure you use it with the correct settings and actions mentioned above.

Temporary Suspension of Certificate of Need Regulations & Facility Licensing Requirements

March 31, 2020

Elana R. Zana (ezana@omwlaw.com)

 

Governor Inslee announced in Proclamation 20-36 the immediate waiver and suspension of portions of the DOH licensing statutes and rules relating to certain health care facilities to respond to the COVID-19 pandemic.  These waivers are effective until April 29, 2020.

 

Certificate of Need

The following is a brief synopsis of the waiver of the CN review requirements. Please consult the cited, corresponding statute and Proclamation 20-36 for the full rule. The following CN review requirements are waived, in their entirety, for:

  • Construction and development of a new health care facility (RCW 70.38.105(4)(a), WAC 246-310-020(1)(a));
  • Sale, purchase or lease of an existing hospital (RCW 70.38.105(4)(b), WAC 246-310-020(1)(b));
  • Change in bed capacity which increases the total number of licensed beds, or redistributes beds among acute care, nursing home care, and assisted living facilities (RCW 70.38.105(4)(e), WAC 246-310-020(1)(c));
  • Change in bed capacity of a rural health care facility licensed under RCW 70.175.100 that increases the total number of nursing home beds, or redistributes beds from acute care or assisted living facility care to nursing home care (RCW 70.38.105(4)(e);
  • Any expenditure for the construction, renovation, or alteration of a nursing home, or change in nursing home services in excess of the expenditure minimum made in preparation for any undertaking  subject to CN review (RCW 70.38.105(4)(g), WAC 246-310-020(1)(g));
  • Any increase in the number of dialysis stations in a kidney disease center (RCW 70.38.105(4)(h), WAC 246-310-020(1)(e));

The waiver and suspension of the CN requirements are only applicable to projects used to provide surge capacity for the COVID-19 response.  Thereafter, CN approval must be obtained after the expiration of this waiver in compliance with the statutory and regulatory requirements.

The Hospice Cycle 2 and Dialysis Facility concurrent review deadlines will also be delayed by 30-days.  Following the delays, the concurrent review cycles will resume on the same regulatory review timelines but will be set back 30 days.

 

Facility Licensing Requirements

The Governor’s Proclamation also included waivers and suspensions in their entirety of many hospital licensing requirements including, but not limited to, certain patient notices, bed limitations for rural hospitals, notifications of adverse health events, duration of hospital licenses, and MRSA policies.  Included in these waivers are certain hospital licensing regulations contained in WAC 246-320. For a complete list of the relevant statutes and hospital licensing regulations, please see the Governor’s Proclamation 20-36.

 

Further, the Governor’s Proclamation eased the pharmacy assistant rules under RCW 18.64A and modified certain locational requirements for pharmacy licenses under RCW 18.64; specifically, no longer requiring that pharmacy ancillary personnel obtain authorization by the commission, and waiving the requirements of approval of the commission under RCW 18.64A.060, but retaining all other limitations and requirements contained in RCW 18.64A. This waiver also includes modifications to WAC 246-901-020, WAC 245-901-035 regarding specialized functions, and suspension of WAC 246-901-100 in its entirety.

The waiver provisions are further identified in the Governor’s Proclamation 20-36 and are only temporary in nature to provide surge capacity for COVID-19 response.  Hospitals, pharmacies and other healthcare entities must comply with the statutory and regulatory provisions after the expiration of the waiver.

For more information regarding the Certificate of Need or Licensing waivers and suspensions, please contact Elana Zana at 206-442-1308 or ezana@omwlaw.com or Don Black at dblack@omwlaw.com.