TBI TARC is supported by contract number 

HHSP233201500119I from the U.S. Administration for 

Community Living, Department of Health and Human 

Services, Washington, D.C. 20201

Telehealth During a Pandemic: 

Maintaining Accessible Services

December 18, 2020
Welcome to Today’s Webinar

Terry

Camacho-Gonsalves

tcamacho@hsri.org

Project Director

Judy Dettmer

jdettmer@nashia.org

TA Lead/Sr. Policy 

Associate

Thank you for joining us to learn about 

Telehealth During a Pandemic: 

Maintaining Accessible Services.

This webinar is sponsored by the 

Traumatic Brain Injury Technical 

Assistance and Resource Center. 

TBI TARC is funded by the 

Administration for Community Living.

This webinar is free and open to the 

public.

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Webinar Logistics

• Participants will be muted during this webinar. You can 

use the chat feature in Zoom to post questions and 

communicate with the hosts. 

• Toward the end of the webinar, we will have an 

opportunity to respond to questions that have been 

entered into chat.

• The webinar will be live captioned in English.

• The webinar will also have an American Sign Language 

(ASL) interpreter.

• This live webinar includes polls and evaluation questions. 

Please be prepared to interact during polling times. 

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Feedback and Follow-Up

• After the webinar, you can send follow-up questions 

and feedback about the webinar to tbitarc@hsri.org

(Please note: This email address is not monitored 

during the webinar.)

• A recording, including a pdf version of the slides, will 

be available within two weeks at tbi.acl.gov

• We will also include questions and responses in the 

materials that are posted following the webinar.

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Opening Remarks

Dana Fink

Dana.Fink@acl.hhs.gov

Project Officer

• ACL’s Traumatic Brain Injury (TBI) State 

Partnership Program (SPP) provides support to 

state and local agencies nationwide to develop 

and promote accessible and person-centered 

services and supports for all members of the 

TBI community. 

• The ACL TBI TARC helps TBI SPP grantees 

promote access to integrated, coordinated 

services and supports for people who have 

sustained a TBI, their families, and their 

caregivers. 

• TBI TARC also provides a variety of resources 

to non-grantee states, people affected by brain 

injury, policymakers, and providers. 

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Who’s Here?

“In what role(s) do you selfidentify? Select all that apply.”

1. Person with a traumatic brain injury 

(TBI) or other disability

2. Family member or loved one of 

a person with a TBI or other disability 

3. Self-advocate / advocate

4. Peer-specialist / peer-mentor

5. Social worker, counselor, or care 

manager

6. Researcher/analyst

7. Service provider organization 

employee

8. Government employee 

(federal, state, tribal, or municipal)

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Meet Today’s Panelists

Terri Imus Edward 

Williams

Kimberly 

Lamb Vida 

Tolerson

Lisa 

Bothwell 

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What 

we will 

cover
Disclaimer

The images and examples of telehealth equipment 

used in this presentation are for illustrative and 

instructional purposes only and are not intended to 

endorse any specific product or service.

We have nothing to disclose.
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THE BASICS
Telehealth

“The use of technology to deliver 

health care, health information or 

health education at a distance.”

— Health Resources & Services Administration
Telemedicine

“The use of medical information exchanged 

from one site to another via electronic 

communications to improve a patient’s 

clinical health status.”

— American Telemedicine Association
Telehealth components
Telemedicine Delivery Methods

Live (synchronous)

Store and Forward (asynchronous)

Remote Patient Monitoring
Live (synchronous)

Originating Site

Location of Patient

Distant Site

Location of Clinician Can view images or 

x-rays 

(asynchronous)
Remote Patient Monitoring (RPM)
However, with Covid-19

• Relaxed rules and regulations 

• HIPAA rules were relaxed

• The telephone was an acceptable method of delivering care

• Text messaging and emails are being used to exchange 

information regarding care

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All 50 states and D.C. reimburse for some 

type of live video Telehealth Services

(slide 1 of 2)

Medicaid and private insurances in some states 

may allow for reimbursement for:

• Store and Forward

• Remote Patient Monitoring (RPM)

• Telephone check in

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All 50 states and D.C. reimburse for some 

type of live video Telehealth Services

(slide 2 of 2)

• Some states have parity laws with regard to

reimbursement

• Visit with your state representatives to move toward 

changes in telehealth and telemedicine laws

• Physicians should follow their state rules 

(State laws applied)

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During the public health emergency

• Physicians can be paid at the same rate as in-person 

visits for all diagnoses, if the services can be provided 

as if in person

• Patients can be in their home, or in any other nonmedical setting, to receive telehealth services

• Patients do not need to have an existing relationship 

with the physician who is providing telehealth 

assistance

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Providers need to be aware

• Review your state Medical Associations Rules and Regulations

• Ensure your devices are able to encrypt connection

• HIPAA rules have relaxed but patient privacy as well as financial 

transactions need to be protected

• Informed consent is required in some states; however, some states 

do not

• See: Working from home during the pandemic: What physicians 

need to know, from the American Medical Association, and the

AMA Telehealth Quick Guide

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Benefits to people living with TBI and 

other disabilities

• Patients should be informed of their choices for 

treatment methods

• Caregivers should ask for what is convenient for all 

parties

• Access should not be a barrier for treatment, 

education, or job training

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Equipment needed to provide care

• Most telemedicine equipment used for evaluation of 

well-being can be as simple as a personal cell phone 

with video capabilities

• More extensive exams may require other equipment and 

a person with knowledge to help with the assessment

• Many times, a family member can be instructed in 

providing assistance to the provider to provide the 

needed exam of the patient

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Home health can be the interface

• When the patient requires more extensive exam, the 

visiting nurse, physical therapist, or home health care 

person can assist the provider with instructions. 

• The exam can be carried out without traveling to the 

clinic.

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Where you live should not determine 

whether you live or whether you die. —U2, “Crumbs From Your Table”
The Tolerson Family

https://youtu.be/-IJH-IqI000

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American Medical Association states:

“Because of the coronavirus and temporary waivers on Medicare 

limitations, physicians saw between 50 to 175 times more patients”

Many health care providers were given a crash course in providing 

telemedicine to their patients.

The patients seemed to adapt more quickly than the providers in many 

cases.

Our institution had about 10 clinics seeing patients via telemedicine to 

every outpatient clinic using some form of telemedicine for follow-up visits.

— From “5 huge ways the pandemic has changed telemedicine”

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Telemedicine Health Policy

• The National Telehealth Policy Resource Center

• State Telehealth Laws and Reimbursement Policies

• Center for Connected Health Policy

• Telehealth Technology Assessment Resource Center

• South Central Telehealth Resource Center

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Resources 

Center for Connected Health Policy

National Telehealth Technology Assessment Resource Center (TeleHealth.org)

National Telehealth Technology Assessment Resource Center - Toolkits

South Central Telehealth Resource Center

AMA: "5 huge ways the pandemic has changed telemedicine"

Telehealth webpages from the Centers for Medicare & Medicaid Services

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Federal Government Resources on Telehealth

Lisa N. Bothwell

Administration for Community Living

December 18, 2020
Applicable Laws

Both Section 504 and the ADA state that no qualified 

individual with a disability shall, by reason of his or her 

disability, be excluded from the participation in, denied 

the benefits of, or subjected to discrimination under any 

services, programs, or activities of the covered entity.

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Effective Communication

In the context of [telehealth], a provider who takes 

appropriate steps to furnish individuals with disabilities 

auxiliary aids and services when scheduling or holding 

virtual telemedicine appointments helps to ensure that its 

patients are afforded effective communication.

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“Hacks” for Accessible Telehealth 

(slide 1 of 2)

• In the context of [telehealth], a provider who takes appropriate steps to 

furnish individuals with disabilities auxiliary aids and services when 

scheduling or holding virtual [telehealth] appointments helps to ensure that 

its patients are afforded effective communication.

• As you invest in permanent changes to include [telehealth] in your practice, 

consider using a [telehealth] platform that has capacity to add a third party, 

for example an interpreter for someone who is deaf, or a remote care 

provider for a patient with an intellectual disability.

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“Hacks” for Accessible Telehealth 

(slide 2 of 2)

• Consider reasonably modifying your pre-[telehealth] appointment practices 

to allow for additional time to provide a patient with a visual or intellectual 

disability extra assistance with using the video platform technology.

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LINKS

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Electronic Information Technology

Guidance and Resources for Electronic Information 

Technology: Ensuring Equal Access to All Health Services 

and Benefits Provided Through Electronic Means (12.21.26)

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telehealth.hhs.gov

“Telehealth for People with Disabilities” Section of 

“Increasing telehealth equity and access”

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WEBINARS

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Telehealth Webinar for 

Community-Based Organizations 

Series

Part 2: Promising Practices - Accessibility 

and Language Access (08.26.20) from 

PublicHealthEmergency.gov

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Telehealth Hack Series

Building Accessible Telehealth for Patients with Disabilities 

from the Ground Up (10.26.20), from the National 

Consortium of Telehealth Resource Centers

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QUESTIONS?
Real-Time Evaluation Questions

• Please take a moment to respond to these seven 

evaluation questions to help us deliver high-quality TBI 

TARC webinars.

• If you have suggestions on how we might improve TBI 

TARC webinars, or if you have ideas or requests for future 

webinar topics, please send us a note at tbitarc@hsri.org
The Traumatic Brain Injury Technical Assistance and Resources Center (TBI TARC) is 

an initiative from the Administration for Community Living that helps TBI State 

Partnership Program grantees promote access to integrated, coordinated services 

and supports for people who have sustained a TBI, their families, and their 

caregivers. The Center also provides a variety of resources to non-grantee states, 

people affected by brain injury, policymakers, and providers.

Thank You.

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