Colorado Legislature Passes SJR 04-38
RE: Funding for Telehealth After
Surprise Committee Hearing Airs Benefits

HCAC Board Member and Legislative Council Chair Martha DeUlibarri, Visiting Nurse Corp. of Denver, and HCAC Staff Associate Fred Caruso, joined State Representative Gayle Berry in explaining and justifying legislative support of SJR 04-38 at a House Health, Education, Welfare and Institutions (HEWI) Committee hearing at the Capitol, Monday, May 3. The resolution sailed through the Senate without opposition but was challenged in the House. The resolution finally cleared the legislature on the next to the last day of the session.

By time the resolution reached the House, legislators realized that some 228 Senate and House resolutions had stacked up for consideration during the final three days of the session. These resolutions cover everything from acknowledging the importance of Western Civilization, to honoring individuals and clubs, to changing the names of mountains to urging a re-examination of our state tax structure. The HEWI Committee passed the bill to the House floor none-the-less by a vote of 7 to 4.

If passed, SJR 04-38 would demonstrate state support of federal agency and private foundation funding for research on the use of technology and electronic monitoring devices in the delivery of health care services in the home. The resolution urges all persons and agencies to consider using such technologies for the extension of services to the home, including rural areas. Much of Colorado is considered "frontier" as opposed to simply "rural" due to low population density and as such experiences greater difficulty in delivering home care services than more densely populated rural states.

DeUlibarri described the success her agency was having in controlling costs related to emergency admissions with its pilot telehealth project. The VNA's project  represents one of the few such pilot projects funded by the State of Colorado.

Caruso emphasized the growing numbers of elderly who want to stay at home and the growing shortage of RNs available to monitor their conditions. Telehealth (or telemedicine and monitoring devices) is one way some see as extending the effectiveness of RNs in dealing with remote patients. The issue of funding for telehealth at the federal level is critical to the aging due to the fact that most are covered by Medicare or Medicaid, neither of which fund telemonitoring equipment or reimburse telehealth professional services.

The following was presented at the hearing:

Testimony Presented to the House HEWI Committee
SJR04-38 – Resolution in Support of Telehealth
"Concerning the Use of Technology and Electronic Monitoring Devices
 (Telehealth Care) in the Delivery of Health Care Services in the Home."

 May 3, 2004 

Rep. Laurie Clapp, Chair
And Members of the Committee
House HEWI Committee
Colorado General Assembly

Dear Madam Chair and Members of the Committee:

My name is Fred Caruso and I am speaking on behalf of the Home Care Association of Colorado as one who has been involved in strategic planning for the home care industry in Colorado since 1982 (22 years) and one who has conducted numerous statistical surveys for home care and other health-related organizations in Colorado. I am also personally interested in the subject of telehealth and its relationship to our aging population as I am not too far behind in years of this growing segment of our society.

I ask your support of SJR04-38, sponsored by Senator Teck and Rep. Berry and your aid in getting this resolution out of committee and through the House.  It has already passed through the Senate without opposition. Here are a few key points to consider:

** SJR-38 has no fiscal impact on State general revenues. In fact, it may potentially generate substantial amounts of funding from private foundation grants as well as potential federal funding for projects that are presently being considered or developed.

** Telehealth research has been generating a great deal of interest because of its potential for extending the effectiveness of the ever-shrinking supply of health care professionals and especially registered nurses.

** Telehealth has been demonstrated as effective in controlling costs too often incurred with emergency treatment required of chronically ill patients whose conditions have gotten out of control due to insufficient monitoring of vital conditions (as with sudden weight gain due to water retention in those suffering from congestive heart failure).

** Colorado’s population is aging very rapidly. Home care has seen an increase in patients over 80 years of age as a percentage of their total client base from 32% in 1999 to 35% in 2001 to 38% in 2003 (source: HCAC benchmark surveys of client services and trends). Adding all client home care patients from age 60-79 to those over 80, you would find that home care patients over

age 60 accounted for 68% in 1999, 71% in 2001 and 72% in 2003, and that number continues to grow. The need for RNs to service these home-bound clients has grown accordingly while the supply of RNs continues to dwindle.

** Many patients prefer treatment at home and in nearly all cases, home care is less expensive than institutional care. Telehealth research and telemedicine will allow more people to stay in their own homes at less expense.

** Telehealth and telemedicine allows for more continuous monitoring of conditions and thus proves to be “safer” than reliance on an intermittent visit by a health professional, who may not be scheduled to visit until after conditions have turned for the worse.

** Telehealth equipment and intervention is not currently factored into funding and reimbursement formulas for state and federal programs, even where it may be far more cost effective. Encouraging research in this area will provide the data needed to establish the value of such funding and reimbursement.

** Colorado is in a unique position for certain pilot projects. Not only is Colorado mostly rural, but most of the state is considered “frontier” due to its extremely sparse population in many counties. Thousands of Colorado citizens could potentially benefit from telehealth projects that may allow them to remain in their homes between nursing visits 

** Colorado has several potential projects and a number of them already in progress, however, we currently have a very valuable project in the development stage in the Grand Junction. Home health agencies in the Grand Junction area have agreed to participate in a telehealth project in cooperation with a group of Cardiac Physicians who will work together on a project to test the value of telehealth in congestive heart failure monitoring and treatment. This resolution will be used as additional leverage in obtaining foundation and federal funding for the project.

Your support of SJR 38 is needed:

1)      to get the resolution out of committee and to the House Floor. And,

2)      to get the resolution adopted and out to the publics intended.

Thank you very much for your attention and your support.

Yours truly,
Fred Caruso
Fred Caruso
Staff Advisor and Researcher

Click to link to an Adobe PDF copy of SJR-38 - Concerning the Use of Technology and Electronic Monitoring Devices (Telehealth Care) in the Delivery of Health Care Services in the Home.

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