Policy Implications of a Gulf Coast Behavioral Telehealth Disaster Response Initiative

The Gulf Coast devastation post-Katrina is an unprecedented public health recovery challenge best described as escalating service need outpacing decimated service capacity. Recent psychiatric assessments confirm that too few providers are responding to rising substance abuse, affective disorder, and anxiety disorder rates. Making matters worse, these adverse findings are affecting providers and patients alike. Post-disaster psychiatric morbidity also affects recovery progress given associated risks for physical illness, violence, and diminished productivity.

The Regional Coordinating Center for Hurricane Response at Morehouse School of Medicine (RCC) has been a sustaining presence since shortly after hurricane landfall. A primary RCC objective is to collaboratively respond to the region's behavioral health care needs. Anticipating both reduced provider availability and increased service need, the RCC developed a plan for telehealth to mitigate post-Katrina behavioral health care disparities.

Telehealth increases service capacity with an efficiency traditional care models cannot. Historically, telehealth has improved access to care for many at-risk populations (e.g. the incarcerated, elderly, and children). Caveats to this success include multiple telehealth programs unable to survive past initial funding. These program failures are attributable to an inhospitable environment for telehealth growth. Current challenges to telehealth sustainability, however, are primarily legislative and regulatory rather than clinical or technologic.

The RCC's model for behavioral telehealth care is an exemplar from which to explore telehealth policy implications. Specific considerations will include licensure, malpractice, and reimbursement as principal barriers to telehealth sustainability. This session will highlight potential solutions and specific recommendations in support of disaster response telehealth solutions