1. TeleMental Health
Brian J Grady, M.D. Director TeleMental Health Department of Psychiatry School of Medicine University of Maryland

2. Today’s Topics TMH Overview University Projects TMH Policy
Future Directions

3. TeleMental Health Overview
Beginnings Late 1950’s
Interactive “Television” 1960’s to 1990’s
“Affordable” VideoConferencing late 1990’s to mid 2000’s
Evidence Based TMH mid 2000’s to present

4. The Merger
Technology

5. The Merger
Technology
Clinical Needs

6. The Merger
Technology
Telemental
Health
Clinical Needs

7. The Merger
Technology
Access
Clinical Needs

11. UMB TMH Projects
Maryland Youth Practice Improvement Committee – Consortium of Psychiatry Department UMB, Psychiatry Department JHU, Mental Hygiene Administration, Regional Institutes for Children and Adolescents, State C&A Inpatient Units
School Based Mental Health Projects
Baltimore, Western High School (’04/’05)
Prince George Co, Suitland HS & Kettering MS
Health Resources and Services Administration Grant - Consortium of Mid-Shore MH CSA, Mental Hygiene Administration, Garrett Co Core Service Agency, St. Mary’s Co Core Service Agency, Psychiatry Department UMB

13. Required Resources Clinical Champion Distant Site
Site Champion Originating Site
Administrative Support
Technical Support
Financial Support

14. Financing Grants Health Services Resources Administration
Department of Agriculture
Maryland Community Health Resources Commission
Fee for Services
Medicare
Maryland Public Mental Health System
Third Party Reimbursements
Contractual Agreements

15. TMH Policy Regulations Board of Physicians Medicare Medicaid
Balanced Budget Act (BBA) of 1997
Benefits Improvement and Protection Act of 2000 (BIPA)
Medicaid
Draft Regulations

16. Medicare Originating Sites (additional Medicaid proposed)
Physicians or practitioner office
Hospital
Critical Access Hospital
Rural health clinic
Federally qualified health center
(Elementary, middle, high, or technical school with a supported nursing, counseling or medical office. A college or university student health or counseling office)
(County Health, Human and/or Social Service offices or clinics and other county offices appropriate for private clinical evaluations and services)

17. Qualified Geographical Areas
Medicare
Health Practice Shortage Areas (HPSAs)
Non-Metropolitan Statistical Area (MSA) counties
Entities that are Federal telemedicine demonstration projects
Medicaid
(proposed)
Garrett
Talbot
Allegany
Queen Anne’s
Worcester
Kent
Somerset
St. Mary’s
Wicomico
Calvert
Dorchester
Charles
Caroline

18. Technical Requirements
1. Minimum ISDN or IP bandwidth using H.264 video protocol > 256 kbps
2. Monitor: minimum, non-anamorphic, net display size of 16" diagonally
3. Minimum resolution of 1 Common Intermediate Format/Source Input Format
4. Switched Network or Encryption

19. Future Directions Vision: TeleMental Health Center of Excellence
Clinical Champion
Coordinator Resource
Technical Resource
Education, training & research

20. Comments, Questions