HIVTRG
COVID 19
DHS Update 20320
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HRSA HAB is working to keep Ryan White HIV/AIDS Program recipients, subrecipients, and partners updated on the latest information regarding COVID-19. As part of that effort, HAB is continuing to update our new Frequently Asked Question (FAQ) webpage on the HAB website as new information is made available.
Additional COVID-19 Resources
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Coronavirus.gov is the primary portal of information for the public regarding COVID-19.
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COVID-19 Resources for People with HIV from HIV.gov
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Up-to-date information on the status of the virus outbreak from the Centers for Disease Control and Prevention, including:
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Information on clinical evaluation criteria for providers
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Information about COVID-19 symptoms, prevention, and treatment
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COVID-19 Resources from HRSA
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Emergency preparedness and recovery resources for HRSA-funded health centers and Health Center Program partners
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Tele-Dentistry:
Currently, Tele-Dentistry is not allowed under Texas law. Tele-Dentistry cannot be covered by Ryan White and/or State Services funding.
COVID-19 Dental Resources:
Two Webinars About Surviving the Financial Storm Around COVID-19
Guidance on Dental Emergency and Non-Emergency Care
ADA Coronavirus Center for Dentists:
Telehealth and Telemedicine:
Governor Abbott approved the Texas Medical Board’s (TMA’s) request to temporarily suspend Texas Occupation Code 111.005 (a)-(b) and Title 22, Chapter 174.6 (a)(2)-(3) of the Texas Administrative Code (TAC). The Texas Medical Board asserts that strict compliance with these laws could prevent, hinder, or delay timely delivery of necessary medical services in relation to efforts to cope with the declared disaster; Texas Medical Board Press Release.
This suspension is in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires. Pursuant to this development, the following new procedures are in effect during the declared disaster period:
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Real-time (live streaming) is no longer required for a telehealth or telemedicine visit but may be used as you have it available
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A client does not need to be seen in person before a telehealth or telemedicine visit to establish a provider-client relationship
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Allowing the use of phone consults to treat clients but only for telemedicine to establish a physician-patient relationship
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This expanded use of telemedicine may be used for diagnosis, treatment, ordering of tests, and prescribing for all conditions
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The medical standard of care must be met in all instances
Telehealth/Telemedicine informed consent: An informed consent must be in place with all clients receiving a service via telehealth or telemedicine. Attached are two examples which can be customized for your agency/clinic.
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Informed consent form courtesy of Texas Medical Association in English Only: www.texmed.org Informed Consent
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Sample informed consent in English & Spanish courtesy of Texas Tech Telemedicine program
 
HIPAA compliant platforms: When choosing a platform for telemedicine and telehealth for future use by your agency/clinic it is recommended to ensure compliance with minimum Health Insurance Portability and Accountability Act (HIPAA) requirements
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National Consortium of Telehealth Resource Center’s Stepwise Guide to HIPAA Compliance for Telehealth: Telehealth Resource Center HIPAA Compliance
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Business Associate Agreements (BAA) guidance and sample BAA’s: HHS.gov HIPAA for covered entities BAA
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It is strongly encouraged that you develop your telehealth/telemedicine response to be sustainable. That means investing in HIPAA compliant platforms. HRSA, DSHS, nor TRG will recommend a HIPAA compliant platform. It is important that agency IT determine the best platform to supplement your electronic health record system.
 
During the COVID-19 national public health emergency the Office of Civil Rights (OOCR) at the Department of Health and Human Services (HHS) “will exercise their enforcement discretion and will not impose penalties for non-compliance with the regulatory requirements under the HIPAA Rules against covered health providers in connection with a good faith provision of telehealth” during this public health emergency. Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications. For a list of allowable platforms and disallowed platforms see: HHS.gov OCR announcement and platforms.
HIPAAA certified email messaging
All HIPAA compliant email providers must ensure their solution incorporates all of the safeguards required by the HIPAA Security Rule. The solutions need to have access controls 164.312(a)(1), audit controls 164.312(b), integrity controls 164.312(c)(1), authentication 164.312(d), and PHI must be secured in transit 164.312(e)(1) For a list of some possible HIPAA compliant email platforms see: HIPAA Journal Compliant email providers.
Allowable Ryan White Services
Texas RW Care Services allows the use of telehealth and telemedicine for the delivery of the following service categories:  Outpatient Ambulatory Health Services, Case Management (both Medical and Non-Medical), Mental Health Services, Medical Nutrition Therapy and pays for the associated costs (Equipment (lease), Consulting Firm, Internet, software licenses).
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For more information please contact:  Brian Rosemond, RN, DSHS Nurse Consultant at:  brian.rosemond@dshs.texas.gov
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The standards of care that allow the use of telemedicine and telehealth require that providers follow the guidelines in the Texas Medicaid Telecommunications Handbook, Volume 2, 2020.  Please contact DSHS regarding RW policy exceptions to the Medicaid guide.  http://www.tmhp.com/Manuals_PDF/TMPPM/TMPPM_Living_Manual_Current/2_Telecommunication_Srvs.pdf