Telehealth Collaborative Earns 2019 National Award
11:00 PM CST
Thursday March 7, 2019
Bienville Family Clinic and Bienville Parish School Board
Announce Receipt of National Rural Health Award
Bienville Family Clinic-Bienville Parish School Board Telehealth Collaborative
Receives National Rural Health Association’s 2019 Award for Outstanding Program
Arcadia, LA, Bienville Parish— Thursday March 7, 2019 —The Bienville Parish School Board and Bienville Family Clinic announced that the parish’s innovative school health Telemedicine program has won the National Rural Health Association’s 2019 award for Outstanding Rural Health Program. The Bienville Family Clinic-Bienville Parish School Board Telehealth Collaborative provides for medical visits for children who visit the school health center with illness at any of the Bienville Parish School System’s six (6) Campuses. Through implementation of specialized equipment facilitating a detailed examination, Bienville Family Clinic providers are able to diagnose illnesses, and thus are able to prescribe medications, as indicated. Students are “presented” to providers by Registered Nurses employed by the Bienville Parish School Board, who are present in the School Clinic, with the child. Services are provided at no cost to children or parents.
Dr. Tara Haskins, Associate Professor of Nursing at Louisiana Tech University at Ruston nominated the program, and in doing so, said this:
Development of a school-based telehealth program in Bienville Parish began with the vision of Randy McKinney, NRHA member, Louisiana Rural Health Association board member and Facility Administrator of a rural health clinic in North Louisiana. Addressing school-aged children healthcare needs, the program forged collaborations with a hospital service district board, rural health clinic, and school district to bring healthcare services directly to six public K-12 schools. The Bienville Parish School District serves over 2200 students across 822 square miles. In 2016, Louisiana Health statistics for all 64 parishes placed Bienville Parish 59th in health outcomes and 43rd for health behaviors, clinical care, social and economic factors. Meeting the healthcare and economic needs of a rural region warranted consideration of long clinic travel times, families with limited transportation and innovative efficient use of existing resources. With funding from the hospital service district board, telehealth was implemented in each six school sites with Bienville Family Clinic serving as the site providing services of a board-certified pediatrician and family practice mid-level providers. This unique model emerged despite the lack of state funding and designation as a certified school-based health center.
The program laid the groundwork to expand full-time school nurse services at each school site thereby grounding a robust school health program across the parish to support the telehealth program. In the 2016/2017 school year, Bienville Parish school nurses facilitated 627 telehealth visits across the parish through Bienville Family Clinic. By 2017/2018 school year, telehealth visits increased having 695 telehealth visits by school year’s end May 2018. While the majority of the visits are with school-aged children, school staff and teachers opted for telehealth care 40 times in 2018. An unintended benefit of the program saw increased Medicaid school billing reimbursement for the school district as a whole with full-time school nurse coverage.
Parents and teachers have expressed overwhelming satisfaction and sense of pride in the program. Students are triaged, seen and treated in the comfort of their school nurse office. During the 2017/18 Louisiana flu outbreak, Bienville Schools never closed; (this was) attributed to the prompt identification and isolation of flu cases. School nurses state that follow-up with students is seamless when they are involved in the triage, diagnosis, and education following the telehealth visit. The telehealth program benefits teachers and staff by helping them maintain their monthly incentive “no absence” bonus and allows them to manage their time for work and family better. The program gives parents the option to either stay at work and participate in the telehealth visit remotely over the phone or come to the school campus. The Bienville School telehealth program has sparked interest and similar implementation in other rural school districts in Louisiana through state and national presentations. Serving as an innovative model for healthcare delivery, the program is a shining example of what rural does best- figuring out what works with our community resources and finding solutions to meet the needs of rural families.
According to Randy McKinney, Bienville Family Clinic Administrator, “This project began during a Bienville Parish Hospital Service District No. 2 Board Meeting. At the time, there was a limited amount of extra money available that could be used for healthcare. One of the board members asked about what we could do that would show a positive health outcome in the lives of the people we serve. The possibility of improving health outcomes for children through School Health Centers was brought to the forefront.”
“We began to consider the possibility of having nurse practitioners physically in the schools to conduct visits. We evaluated putting a pager or cell phone on providers, and allowing them to “rove” to the school campuses, as needed. While we felt that a plan such as this could work, we knew that we couldn’t sustain such a project, financially, for the future. At that point, telehealth delivery was brought to the table as a more cost-effective option.”
“Bienville Family Clinic is a Rural Health Clinic (RHC). A RHC is a clinic designated by the Centers for Medicare and Medicaid Services (CMS) to operate in underserved areas. Under Medicare Guidelines, Medicare Insurance will not currently pay a Rural Health Clinic to provide a primary care visit where the patient is at another location (such as a school campus, nor at most other locations away from the clinic). Knowing, however, that the vast majority of our school-children in Bienville Parish Schools were on Medicaid (and not Medicare), we began to evaluate Louisiana’s Medicaid Payment Laws for Rural Health Clinics. In the guidelines, we found language stating how to get paid for a Telehealth Visit. While this was a new concept, we stood firm in the belief that if Medicaid didn’t want RHCs providing Telehealth visits, the Law wouldn’t detail how to get paid for such a visit.”
“We then contacted the Chief Executive Officers of Louisiana’s five (5) Medicaid contractors. The Medicaid Contractors agreed to pay for Telehealth services in the schools, through the RHC. We always believed that it made good-sense for the contractors to pay, as it is common knowledge that if children (and adults) get timely and adequate primary medical care, that costs associated with emergency room and hospital visits can be reduced staggeringly. The priority here, however, was that the children would have additional access to receive needed medical care where they attend school. It should be noted, as well, that many private insurance companies are paying for Telehealth visits in our schools.”
“We initiated a meeting with Bienville Parish School Officials to gauge their interest in such a program. When we found that the interest was mutual, we each drafted resolutions, our Boards passed them, and the work began. This is the third year of providing Telehealth visits in the schools, and the program seems to become increasingly popular every year. We are now hearing from other Clinics, Hospital Service Districts, and School Districts in Louisiana about starting their own programs. Jackson Parish, our neighboring rural Parish to the Southeast, has started a program, and we’ve heard from one district as far away as upstate-New York.”
“We have the best of providers and clinic staff, school nurses and school faculty and staff, who contribute to this program, every day of the school year. They are dedicated, and they have a great sense of pride, in their ability to have a part in providing cutting-edge services to our children which positively enhance potential health outcomes, not only for the students, but for student’s siblings and parents, for faculty and staff, and for the greater community, as well. It’s been a great program, thus far! It’s a “win” for our children and community.”
For Additional Information:
Randy D. McKinney, M.S., M.P.A.
Administrator, Bienville Family Clinic
1175 Pine Street, Suite 100
Arcadia, LA 71001
Dr. Laureen Mayfield
Director of Special Education
Bienville Parish School Board
1956 First Street
Arcadia, LA 71001
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