In this Jan. 14, 2019, photo, Caitlin Powers sits in the living room of her Brooklyn apartment in New York, and has a telemedicine video conference with physician, Dr. Deborah Mulligan. Widespread smartphone use, looser regulations and employer enthusiasm are helping to expand access to telemedicine, where patients interact with doctors and nurses from afar, often through a secure video connection. Credit: Mark Lennihan | AP

As of 11:30 a.m. Thursday, March 19, 42 Maine residents have been confirmed positive and 10 others are presumed positive for the coronavirus, according to the state. Click here for the latest coronavirus news, which the BDN has made free for the public. You can support this mission by purchasing a digital subscription.

More people across Maine will be able see their medical providers and other service professionals remotely after three main changes this week.

Medicare

More older people will be able to receive a range of services from their doctors without having to travel to a health care facility, under a change made by the federal government Tuesday.

People on Medicare throughout Maine, not just in more rural areas, will be able to stay at home and have their common office visits, mental health counseling and preventive health checks conducted through a computer screen with their provider, effective retroactively back to March 6.

Now that the U.S. Centers for Medicaid and Medicare Services has relaxed regulations, health care organizations such as Northern Light Acadia Hospital in Bangor will be able to provide more remote care to patients, said Jesse Higgins, director of integrated behavioral health for the hospital.

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She is now making sure a number of providers have the equipment, such as laptops and headsets, and confidential space they need to care for people staying at home. Next, providers will reach out to patients to prepare them to use a secure app on their phone, tablet or computer, to potentially have their mental health appointment remotely.

“What we’re focused on now is continuity of care for our patients — just keeping people safe in the community, so they don’t need a higher level of care. The hospital systems are likely to be overwhelmed with infectious disease concerns in the near future,” said Higgins, a psychiatric-mental health nurse practitioner.

Some people may be hesitant to try teletherapy, but patients usually get used to it after giving it a try, said Brent Scobie, vice president for clinician services and quality at Acadia.

“We have been providing the service regardless, but we’re looking to use more of it to supplement people’s care, so they don’t have to go without during this period of time,” Scobie said.

Prescriptions

People on MaineCare, the state’s version of Medicaid, are now able to talk to their doctor over the phone or through video to get a prescription.

On Monday, the state government made an emergency rule change to allow physicians, nurse practitioners and physician’s assistants to get reimbursed by MaineCare for prescribing medication remotely, such as over a video conferencing system. Previously, there was a blanket prohibition on telehealth prescribing.

[What we know about the Mainers who have tested positive for coronavirus]

Because it is an emergency measure, the rule is effective for 90 days. However, the Maine Department of Health and Human Services has begun the process to make the change permanent, according to Jackie Farwell, a department spokesperson.

Patients do not usually need to see a provider in person first to receive a prescription, unless the prescriptions are for controlled substances, Farwell said. Right now, however, people do not need to have an in-person assessment before they can get a prescription for controlled drugs, such as buprenorphine for the treatment of opioid use disorder.

“Under the current public health emergency, the Drug Enforcement Administration is allowing providers to conduct an audio-visual, real-time, two-way telehealth visit to take the place of the usual in-person requirement,” Farwell said.

Case management

People with behavioral or special developmental needs now have greater remote access to their case managers.

On Tuesday, the Maine Legislature approved an emergency bill, sponsored by Sen. Geoff Gratwick, D-Bangor, to allow MaineCare to reimburse for virtual case management services. Case managers are responsible for connecting their clients to resources in the community.

“Each Case Manager supports up to 35 people on their caseload. This is a lot of people when they have complex needs, are on waiting lists and are scattered throughout downeast Maine,” said Bonnie-Jean Brooks, the CEO of OHI, a Bangor-based nonprofit supporting more than 600 people with mental illness and intellectual disabilities, in written testimony to the Legislature.

Gov. Janet Mills signed LD 1974 on Wednesday, said her press secretary, Lindsay Crete. The governor’s signature put the bill into effect immediately.

Watch: What older adults need to know about COVID-19
https://www.youtube.com/watch?v=p6wEOCHdEu4

Erin Rhoda

Erin Rhoda

Erin Rhoda is editor of Maine Focus, a journalism and community engagement initiative by the Bangor Daily News.