Last updated 03/03/2025
Definitions
Crisis Intervention Program
Telehealth Services. Delivery of health care services, through the use of interactive real-time visual and audio or other electronic media for the purpose of consultation and education concerning diagnosis, treatment, care management and self-management of patient’s physical and mental health and includes real-time interaction between the patient and the telehealth provider, synchronous encounters, asynchronous encounters, store, and forward transfers and telemonitoring.
SOURCE: VI Code annotated 19 VIC Sec. 1020. (Accessed Mar. 2025).
Last updated 03/03/2025
Miscellaneous
Mobile Integrated Healthcare Programs
Mobile Integrated Healthcare (“MIH”) means patient-centered care delivered in a patient’s home or in a mobile environment that focuses on improving patient outcomes by integrating the larger spectrum of community healthcare and technology.
MIH components include traditional emergency medical services (“EMS”) response, community paramedics, physician assistants, nurse practitioners, community health workers, social workers, mental health providers, 911 nurse triage lines, public safety, telemedicine, and alternate destination or emergency room diversion.
A Department-approved MIH program, including MIH programs with an emergency department avoidance component, that utilizes healthcare personnel to deliver healthcare services to patients in an out-of-hospital environment in coordination with healthcare facilities or healthcare providers may provide healthcare services such as chronic disease management, dental care, behavioral health, maternal and infant health, preventative care, post-discharge follow-up visits, or transport or referral to facilities other than a hospital emergency department.
The Virgin Islands Department of Health (“Department”) shall develop and approve mobile integrated healthcare programs consistent with its role as the territorial lead agency for healthcare-related services. In so doing, the Department shall consider the following:
- the type of healthcare that can be provided under the program;
- the training, educational, and certification requirements for community paramedics and other healthcare personnel in providing services under the program;
- the degree of oversight, reporting, and enforcement needed for the program; r
- elevant standards and criteria developed or adopted by nationally recognized agencies or organizations; and
- the recommendations of interested stakeholders.
The Department, pursuant to its mandate under 3 V.I.C. § 418(a) and its responsibility under 3 V.I.C. § 418(a)(11), and its licensing and certification authority under chapter 15 of this title, shall establish or approve MIH programs that meet the following criteria:
- provide pre-hospital and post-hospital services as a coordinated continuum of care that fully supports the patient’s medical needs;
- address gaps in service delivery and prevent unnecessary hospitalizations, or other harmful and wasteful resource delivery;
- focus on partnerships through contracts or otherwise between healthcare providers and healthcare facilities, as defined in this chapter, respectively, that promote coordination and utilization of existing personnel and resources without duplication of services;
- adhere to clinical standards and protocols adopted by the Department to ensure that MIH healthcare providers employed by healthcare facilities provide healthcare services or treatment within their scope of practice;
- dispatch only those community paramedics or other healthcare providers employed by a healthcare facility who have—received appropriate training and demonstrate competency in the MIH clinical protocols;
- meet appropriate standards related to capacity, location, personnel, and equipment;
- provide access to qualified medical control and medical direction;
- provide a secure and effective medical communication subsystem linkage for online medical direction;
- have an activated 911 system to ensure that if an MIH program patient experiences a medical emergency during an MIH visit there will be a rapid response by emergency services;
- ensure compliance with all territorial and federal privacy requirements regarding patient medical records and other individually identified patient health information; and
- ensure that healthcare providers operating MIH programs collect and maintain data of mobile integrated health services, including statistics on mortality and morbidity; the information needed to review access, availability, quality, cost, and third-party reimbursement for the services; and coordinate and perform the data collection in conjunction with other data-collection activities.
In addition, the Department shall examine how 911 triage assessment tools may be incorporated into MIH, with the objective of enhancing the efficiency and effectiveness of MIH programs.
Crisis Intervention Program
The Director with the approval of the Commissioner shall establish Crisis Intervention and Prevention Services. This is a community-based program shall provide counseling, consultation, evaluation, treatment and referral, education, and training services, delivered by a crisis intervention team. The program must be designed for persons with behavioral challenges, mental health disorders or substance use disorders who experience a behavioral crisis that threatens their ability to live a full, productive life due to hospitalizations, law enforcement involvement, or placement in restrictive settings. The Department of Health, Division of Behavioral Health shall support persons in the development of behavioral assessments, individualized behavior treatment plans, and intensive intervention with a focus on family coaching.
The program shall provide the following services:
- Emergency room services. Crisis intervention and psychiatric emergency services based in a hospital emergency room;
- Outreach services. Outreach services and crisis intervention beyond the hospital setting;
- Telephone hot-line services. A community-based telephone crisis intervention hot-line offering 24-hour, 7-days-a-week counseling, consultation, evaluation, treatment and referral services;
- Telehealth Services. Delivery of health care services, through the use of interactive real-time visual and audio or other electronic media for the purpose of consultation and education concerning diagnosis, treatment, care management and self-management of patient’s physical and mental health and includes real-time interaction between the patient and the telehealth provider, synchronous encounters, asynchronous encounters, store, and forward transfers and telemonitoring;
- Transportation of persons in crisis to and from the hospital or institution; and
- Suicide Prevention and School Counseling Program: a program in cooperation and coordination with the Department of Education, Department of Human Services, and the Police shall develop a suicide prevention strategy and an evidence-based model suicide prevention program, counseling for bullying, cyberbullying, and peer pressure counseling to be presented in the elementary, junior, middle, and high schools in the Territory which must include the preparation of relevant educational materials that must be distributed in the schools.
SOURCE: VI Code annotated 19 VIC Sec. 1020. (Accessed Mar. 2025).
Last updated 03/03/2025
Overview
Currently there is no explicit permanent policy regarding telehealth and the Medicaid program, however, legislation was passed for the establishment of a Crisis Intervention and Prevention Services program, which includes providing telehealth services within the Medicaid program as well as for a Mobile Integrated Healthcare program – see Medicaid Miscellaneous section for more information. However, aside from these mentions in legislation, there is no Departmental documentation that we found that these programs have been implemented.
Additionally, USVI COVID-19 documents refer to telehealth as a Medicaid covered benefit – see COVID-19 Telehealth Information Beneficiary Flyer and Virgin Islands Medical Assistance Program (VIMAP) Telemedicine and Telehealth Policy Statement for more information. However, it is unclear if this documentation continues to be active and applicable outside of the COVID-19 Public Health Emergency.
