Major changes have occurred in policy and legislation related to telemedicine during 2007. 

Many of the long awaited initiatives have been approved that will move the original projects forward and will support the comprehensive expansion of telemedicine throughout California’s rural population as well as urban underserved and disabled populations.

New Broadband Services for Rural Telemedicine

The largest success is the award of a $22 million grant from the Federal Communications Commission to fund the expansion of broadband services to over 300 rural telemedicine sites in California, including 81 rural hospitals.  In addition, up to $8.6 million in financial commitments have been offered by the California Emerging Technology Fund and United Health Group Inc to help support the implementation of this project.   The telehealth network will be used to improve access to care in underserved communities, as well as to provide a resource for emergency services and disaster preparedness. 

A coalition of government agencies, health care providers and associations, including CTEC, worked to develop the successful grant proposal, which was submitted by the University of California Office of the President.   CTEC has been appointed to the Advisory Board and will provide representation to the many rural providers that will benefit from the development of this network.

The FCC awarded a total of $417 million to support 69 telehealth network projects in 42 states, representing the largest government effort to expand access to telehealth across the United States.   California’s award was the second highest award in the country, the largest being awarded to a multi-state consortium.

Newly Enacted Legislation

During the 2007 Legislative Session, three bills were passed regarding telemedicine: 

• AB 329 regulates telemedicine and authorizes the Medical Board of California to establish a pilot program to expand the practice of telemedicine and to use a telemedicine model to deliver healthcare to those with chronic diseases.  The pilot program is required convene a working group from the public and private sectors, including state health-related agencies, healthcare providers, health plan administrators, information technology groups, and consumer groups.
  
  
• AB 1224 allows a licensed optometrist perform and bill for primary open angle glaucoma which was previously restricted by telemedicine to licensed ophthalmologists.
  
  
• AB 234 applies restricts family therapists and psychologists to 125 hours of qualifying experience to be provided via telemedicine.   

Additional Funding Opportunities for Rural Networks

Three California foundations initiated grant programs that allow for  additional funding to telemedicine programs. 

• The California Emerging Technology Fund is funding innovative technology projects that include telemedicine. 
• The California Health Care Foundation issued an RFP on specialty services and plans to directly fund a number of projects related to telemedicine.  
• The Blue Shield of California Foundation is also accepting grant applications and telemedicine proposals are likely to be submitted to this Foundation.

These new funding opportunities should assist in the development of new telemedicine services and the support and expansion of existing telemedicine programs. 

Executive Order on Accelerating the Adoption of Health Information Technology

In March 2007, Governor Schwarzenegger signed Executive Order S-06-07 to accelerate the adoption of Health Information Technology (IT) throughout the state.  The Governor directed state agencies to provide leadership and coordination of the Health IT efforts to achieve electronic health data exchange, leverage State purchasing power, and improve health care outcomes.  The Order directs the state to develop, by December 31, 2007, initial performance metrics to measure the success of health care transparency and accountability efforts in collaboration with a working group of state agencies and key public and private stakeholders.