The Texas Tech Center for Telemedicine is awaiting notification in April of a $6.2 million state-funded contract to create pediatric Medicaid telemedicine opportunities in 30 rural West Texas sites during the next two years.
The proposed contract would result partly from Texas House Bill 15, according to the Health and Human Services Web site, and a 1993 class action lawsuit filed against the state of Texas.
Texas House Bill 15 was designed to appropriate an estimated $1.8 billion for the 2008 to 2009 biennium to support state efforts to correct claims of inadequate Medicaid pediatric access to health care resulting from the 1993 Frew lawsuit ruling, the Health and Human Services Web site reported.
In 2008, the Frew lawsuit was revisited and settled, according to the Texas Medical Association Web site, allowing additional funding for pediatric Medicaid patient opportunities through tools such as Telemedicine.
Debbie Voyles, director of the Tech Center for Telemedicine, said Tech would act as one of four major universities that could receive state funding to create rural pediatric Medicaid access to Telemedicine across Texas from 2009 to 2011 due to the Frew ruling if the contract is granted.
"The 1993 Frew lawsuit against the state alleged that Medicaid children in rural communities were not receiving the same access to health care," she said. "Then in 2008 they took Texas back to court which caused committees to be created to find ways to fix the access problem. That's when they started looking at places like Tech and its Telemedicine program to help with the problem."
According to the Health and Human Services Web site, Texas committees were created to increase services and access for about 1.5 million indigent children represented in the Frew lawsuit.
Voyles said the state of Texas originally proposed $6.2 million to be allocated to each of four Texas universities including Tech, Texas A&M University, the University of Texas and possibly the University of North Texas.
"If our telemedicine program gets the contract, the funding period will be carried out over the course of five months in 2009, from when the contract is initiated to 12 months in 2010 and 11 months in 2011," she said.
The $6.2 million in possible funding, if received by the Center for Telemedicine, would cover the development of patient sites, administrative funds and equipment for 30 rural telemedicine sites in West Texas, Voyles said.
"Although we haven't gotten word yet, I'm pretty confident that we will receive the funding," she said. "In fact I've set a goal of trying to get five sites operational between now and August and 10 sites operational at the end of 2009."
Voyles said two possible West Texas partnership sites have already been discussed by the Center for Telemedicine.
"Right now we are looking at Presidio and Stratford, Texas," she said. "After that we will look at determining the other 28 sites to see which ones have the most interest, need and medical clinics."
Presidio is located near the U.S.-Mexico border with a population of about 4,000, according to the City of Presidio Web site.
Stratford is located in West Texas near the border between Texas and Oklahoma, according to the City of Stratford Web site, with a population of about 2,000.
Both Stratford and Presidio are located in the one to three doctor availability range, according to the Tech Institute for Rural and Community Health Web site.
Voyles said she is planning to visit Stratford in April to meet with the community to discuss the possible telemedicine project and will travel to Presidio in the following week for a similar discussion.
"Right now we are just trying to be ahead of the game," she said. "We're hoping to provide Medicaid children with the best access to pediatric care in rural communities that we can, and we would like to have our campuses in El Paso, Amarillo and Odessa involved so we can do that."
David Lefforge, chief operating officer for the Tech Institute of Rural and Community Health, said if the contract is granted, the Center for Telemedicine, in partnership with the Institute of Rural and Community Health, would work to provide pediatric care to Medicaid patients who do not have or have limited access to pediatricians in their rural communities.
"If you take a look at West Texas, you can see a lack of general pediatric care," Lefforge said. "The intent would then be to identify 30 communities and provide Tech with a link between those communities and the pediatricians here."
Lefforge said while many larger communities such as Lubbock often have pediatricians, smaller communities might not have a single physician, requiring patients to travel many hours to larger towns to reach one.
"Some patients in smaller communities must drive a fairly long distance to reach a pediatrician which means they probably have to take time off of work, maybe two or three days, and time off of school to see the pediatrician," he said, "but some of them, particularly Medicaid patients, since that is the issue here, can't do that and may even be lucky to have a job with the way things are."
According to the Tech Center for Telemedicine Web site, telemedicine is the practice of medicine over distance with the use of telecommunications equipment.
Lefforge said if the contract is granted to the Center for Telemedicine the possibility of decreasing travel time for patients.
"If we can connect with patients more effectively," he said, "we can really increase pediatric care in the rural communities we serve and we can decrease the problems the patients face."
Patti Patterson, a professor of pediatric care at the Tech School of Medicine, said the pediatric department also would work with the Center for Telemedicine to care for patients if the contract is granted.
"I image we will help on the clinical side with doctors and nurse practitioners," Patterson said, "and determining which services would be best for us to provide and the sites that would be best."
Patterson said possible services that could be provided by the Pediatric department in the event the Center for Telemedicine is awarded the contract may include general pediatrics, diabetics, asthma education, epilepsy and nutrition education.
"I imagine we would probably incorporate our Telemedicine services, like nutrition education, into the regular clinic without disrupting the work patterns of our clinicians," she said. "That has been one of our problems in the past - having to go to another clinic all the time for that - but I think they'll want to make this transition more seamless."
Like the Telemedicine program and the Institute of Rural and Community Health, Patterson said, the Department of Pediatric Care must still work out additional details if the contract is granted after receiving clarification.
According to the Texas Health and Human Services Commission Web site, children's Medicaid is provided at no cost to the children of families who qualify, and covers regular checkups, dentist visits, prescription drugs and medical supplies, vaccines and hospital care.
To quality for Children's Medicaid, the child must be 18 or younger, a Texas resident, and a U.S. citizen or legal permanent resident, the Web site reported, while the citizenship or immigration status of the parent does not affect the child's eligibility for coverage.
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