Call to Order and Roll Call
The 4th meeting of the Interim Joint Committee on Veterans, Military Affairs, and Public Protection was held on Thursday, September 14, 2017, at 1:00 PM, in Room 154 of the Capitol Annex. Senator Albert Robinson, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Senator Albert Robinson, Co-Chair; Representative Tim Moore, Co-Chair; Senators Julian M. Carroll, C.B. Embry Jr., Denise Harper Angel, Ernie Harris, Jimmy Higdon, Dennis Parrett, Wil Schroder, Whitney Westerfield, Mike Wilson, and Max Wise; Representatives Tom Burch, Jeffery Donohue, Myron Dossett, Jim DuPlessis, Chris Fugate, Jeff Greer, Chris Harris, Mark Hart, Regina Huff, Dan Johnson, DJ Johnson, Donna Mayfield, Brandon Reed, Rob Rothenburger, and Walker Thomas.
Guests: Representative Marie Rader, Tuyen T. Tran MD, MBA, Lexington VA; Kelli Carter Hogan, Executive Advisor, KDVA; Dr. Brian Houillion, Special Assistant, Public Protection Cabinet; Robert (Bob) King, President, Kentucky Council on Postsecondary Education; and Col. Ret. Mike Jones, KDVA.
LRC Staff: Erica Warren, Jessica Zeh, Jonathan Philpot, and Rhonda Schierer.
Minutes
Representative Burch moved to adopt the August 13, 2017, meeting minutes. Representative DuPlessis seconded the motion. The minutes were adopted.
Distinguished Veteran
Col. Mike Jones gave a testimony of his combined 47 years of service in the military and as a state employee. He spoke of his father who was a WWII veteran and how he inspired him as a father and a soldier. Co-Chair Moore presented Col. Jones with a Distinguished Veteran’s Coin for his outstanding service in the military and to the Commonwealth.
Pledge of Allegiance
Co-Chair Moore led the committee in the Pledge of Allegiance.
Incorporating Telehealth in Veterans’ Medical Care
Representative Marie Rader shared information about an event that was held at the Jackson County public library to introduce a new public service called Veterans Telehealth. Several local agencies, representatives from the Veterans’ Administration, and local leaders in the county and surrounding communities participated. Over 50 local veterans were in attendance to hear about how to incorporate the idea of telehealth into the medical care of veterans. Rural broadband has a future in rural communities but it has to be affordable and is necessary for telehealth availability for veterans and others. Jackson county and surrounding communities have no veterans’ hospital or healthcare facility and the nearest veterans’ hospital is approximately 70 miles away.
Dr. Tuyen T. Tran, MD, MBA, and Chief of Staff at Virtual Care (Telehealth), said that he participated in a summit last year to talk about the possibilities of bringing health care into rural areas through broadband. The Veterans Health Administration is the largest integrated health care system in the U.S. The VA in Lexington serves about 35,484 veterans and is a five-star facility.
He gave the committee a brief history of telehealth dating back to 1879, where doctors used telephones to diagnose patients and to avoid unnecessary house visits. NASA had telemedicine capabilities placed in spacecraft and spacesuits. Dr. Tran described telemedicine as the traditional clinical diagnosis and monitoring delivered by technology.
Telehealth, also known as Connected Care, is a collection of modalities to enhance delivery of care and education. Telehealth makes it easier for veterans to take care of simple health-related tasks online and on their mobile devices. Information sharing makes it easier for patients to see their health care records, gives them control of their health data, and allows them to share health-related data with others. For the provider, it makes it easier for them to deliver care virtually and with seamless electronic health record integration. Dr. Tran stressed that Connected Care should be valued equal to face-to-face care.
Patient support makes it easy for the patient to get the help they need to access and use online and mobile tools. Through telehealth, the VA can access prescription refill and tracking requests, download health records, and schedule appointments, and have secure messaging with providers. VA Connected Care products and services include VA mobile which has apps for veterans and VA staff. These capabilities provide live “real-time” video, two-way interaction between a patient and provider using audiovisual telecommunications technology, and may serve as a substitute for an in-person encounter. There is the capability to transmit the recorded health history to a specialist who evaluates or renders service outside of a real-time or live interaction. It also allows for the personal health and medical data collection from an individual be stored electronically in one location and then transmitted to a provider in a different location for use. Applications include targeted text messages that promote healthy behavior and wide-scale alerts regarding disease outbreaks. Nationally, 12 percent of veterans enrolled in VA care are accessed through telehealth. 5,011 veterans are enrolled in the LEX VAMC telehealth program.
The barriers to adoption of telehealth include: cost for and access to quality broadband internet, privacy and data security, health system bureaucracy, training for patients to use new systems/technologies, attitude of patients to adopt new systems/technologies, trust in accuracy of data collected by monitoring devices, government health-related regulations/policy, and training for healthcare professionals.
Dr. Tran concluded that the rising cost of healthcare and the demand for Connect Care across a continuum have placed unprecedented pressures on healthcare systems. Telehealth offers tremendous hopes for enhancing the delivery of health care, but to achieve this aspiration it will require powerful technologies an efficient networks. The time is right to implement telehealth to make healthcare more efficient, more connected, and more affordable.
In response to a question from Representative Rothenburger, Dr. Tran explained that the costs associated with telehealth will drop significantly in the near future as most all people have some type of phone, tablet, or device to connect to telehealth.
Kentucky Veterans Employment, Training, and Support Program (KyVETS)
Kelli Carter Hogan, Executive Advisor, gave a PowerPoint presentation on KyVETS. Ms. Hogan explained that KyVETS provides resources and support to assist veterans in gainful employment and training services. KyVETS veteran services include workforce training, resume assistance, effective job search, networking, interviewing skills, and apprenticeship opportunities. Employer services include education on why hiring veterans is good business, matching veterans’ skills to their employment needs, free advertisement of positions, and top talent referrals. KyVETS has three key areas which are education, training, and retention. The number of employers and veterans joining the program increases weekly, the program has more job postings from employers than veterans to fill them. This creates choice and opportunity for our veterans. KDVA joined the Kentucky Chamber to network with employers and to create a new platform to share KyVETS story. Ms. Hogan shared KyVETS’ goals for 2017-2018. The grand opening of the program is scheduled for November 11, 2017. The program hopes to develop a tool to identify job seekers by partnering with the Kentucky National Guard.
Kentucky Veteran and Transitional Military Resource Team
Dr. Brian Houillion, Special Assistant with the Public Protection Cabinet, spoke on the Kentucky Veteran and Military Resource Team. The resource team is split into two subcommittees which are the Accelerated Licensing and the Bridge. The Bridge subcommittee looks into the facet of veteran’s employment and education.
Dr. Houillion is the chair of the subcommittee on Accelerated Licensing. HB 113 requests licensing boards to find ways to help veterans and military personnel receive professional licensing quicker. The Accelerated Licensing Subcommittee formed and includes several different organizations: the Kentucky Commission on Military Affairs, Workforce Innovation Board, Council on Postsecondary Education, Cabinet for Health and Family Services, KCTCS Where Opportunity Knocks, Employer Support of the Guard and Reserve, and West Kentucky Workforce. The subcommittee came up with the objectives to bridge military and civilian requirements for professional licensing. The goal is to provide fast and fair professional licenses to veterans, transitioning service personnel, active service personnel and their spouses. Several studies have been performed throughout the U.S., and the subcommittee hopes to see what other states are doing and adopt best practices. The subcommittee has designed a gap analysis to find out what separates the current requirements for licensing from the background and the education that the military may have. There are three areas where gaps can exist including education, regulations and legislation, and being lost in translation, that could hold back licensing. A meeting is set for September 15, 2017, to look into some identified industries of critical need. Some of the industries include an overall military medic into an EMT or a paramedic, license practicing nurses, nurse aides, licensed and certified social workers, HVAC and plumbers, physical therapist, and potentially respiratory therapists. The goal is to have a course of action arranged by the end of the year.
In response to a question to Representative Donahue, Dr. Houillion stated that whatever board is in charge of licensing will continue to be. The Transitional Military Resource Team’s responsibility is to help assist and look into ways to accelerate the process of licensing for the veterans.
Academic Credit for Military Experience
Robert King, President of the Kentucky Council on Postsecondary Education, gave a PowerPoint presentation on the importance of military students to higher education and state’s goals. Service members, veterans, and families can help Kentucky meet its attainment goals. The traditional enrollment age is declining and there is a need to focus on adult learners. Military students benefit from taking college courses in order to have increased earning power and lower unemployment. By 2020, 65 percent of all U.S. jobs and 63 percent of all Kentucky jobs will require some level of college coursework or degree. About 98 percent of all jobs created since the recession required some level of postsecondary education. Mr. King discussed the Multi-state Collaborative on Military Credit (MCMC). Kentucky joined the MCMC in 2014 and focuses on developing course equivalencies using the American Council on Education (ACE) credit recommendations, which helps universities create outreach strategies and increase support services and resources for military members. MCMC created a set of guiding principles related to translating military training into college credit and is working with KCTCS to create a crosswalk between military occupations training and the KCTCS appropriate courses. It is working with universities to accept certain common ACE college credit recommendations for general education college credit.
Mr. King explained how military-related credit is awarded and future plans for publicly creating an accessible website where veterans can input their military experience and compose the academic credits earned to different programs at KY schools. Implementation of a site modeled after the Minnesota Veterans Education Transfer System (VETS) will cost $2,000,000 and the ongoing operating costs would be approximately $100,000 annually.
Other Business
There being no further business, the meeting was adjourned.