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UHLC health legislation and advocacy students get help from leading disability expert

Lex Frieden, a preeminent voice for the disabled in the U.S. and an architect of the Americans with Disabilities Act, meets with students of the UHLC's Health Legislation & Advocacy Class.


Dec. 2, 2014 -- Students in the University of Houston Law Center’s “Health Legislation & Advocacy” class are drafting bills for the upcoming legislative session to expand access to telemedicine. And they’re getting help from one of the preeminent voices for the disabled in the United States.

Allison Winnike, a UHLC research professor who has worked on health care policy issues since her graduation from Rice University in 2001, teaches the class along with fellow research professor Patricia Gray. The two-semester course is designed to teach students how to develop legislation at the state level and then work to have it introduced and voted on in the legislature.

This year, the “client” for the class is the Institute for Rehabilitation and Research (TIRR) Memorial Hermann, the world-renowned center for the treatment of people with disabilities based in the Texas Medical Center in Houston. For the 2015 legislative session, TIRR was particularly interested in introducing bills that would expand telemedicine options for their patients to receive high-quality care, which is especially important for those living in remote rural areas or people with limited mobility or transportation options.

Lex Frieden, one of the people credited as leading the charge for the enactment of the original Americans with Disabilities Act in 1990 (and its subsequent amendments in 2008), is the director of the Independent Living Research Utilization (ILRU) program at TIRR. As such, he has been advising Winnike and Gray’s students on their ideas for proposed legislation. He is also a member of the Law Center’s Health Law & Policy Institute Advisory Board.

On Nov. 20, Frieden – who suffered a spinal cord injury in an automobile accident while a college freshman in Oklahoma – met with the small class to hear students’ legislative proposals and offer some pointed advice on the best practical and political approaches.

Among the ideas students presented:

  • Giving physicians and health care providers discretion to determine whether telemedicine treatment in a patient’s home is appropriate, increasing access for patients who cannot visit an established medical site for telemedicine treatment.
  • Having Texas adopt the  “Interstate Medical Licensure Compact” which would allow licensed physicians in one of the member states to receive expedited licensure applications in the others, which may increase the number of physicians offering telemedicine services in Texas.
  • Expanding the limited list of Medicaid patients eligible for “home telemonitoring” to include coverage for elderly patients and those with chronic medical conditions.
  • Creating a pilot program and cost-effectiveness study to see how telemedicine services could function within the Medicaid system.

After each presentation by the students, Frieden offered feedback, much of it harkening back to the extensive work he did in advocating the ADA.

“I think that definition of telemonitoring is going to become key at some point. It’s vital to get it established in law somewhere,” he told one student.

“Wearing my advocacy act, if you start with something that looks straightforward, it’s going to seem apparent that it’s less expensive for the system,” he told another.

Frieden also told the students that after watching Texas politics over several decades, he’d advise them to craft policy solutions customized for Texas, and not present their ideas as being based on ones already implemented in “Eastern states.” He also quizzed them on which legislators they had identified as candidates for introducing their legislation.

The students will continue to work with Frieden and TIRR throughout the spring semester as the Texas Legislature holds its biennial session.  They will work to get their legislation introduced by a State Representative or Senator, draft committee testimony and amendments, and develop the advocacy skills needed to turn their proposed policy solution into law.

Guiding them through the complicated legislative process are their professors, who have extensive legislative and health policy experience.  Gray was elected six times to the Texas House of Representatives where she chaired the Committee on Public Health. 

Winnike served as a health staffer for U.S. Senator Bill Frist, M.D., on both the Senate Subcommittee on Public Health and in the Office of the Majority Leader. She said Frist, a physician who served two terms in the Senate from Tennessee (including a term as Majority Leader) and now sits on the board of a major telemedicine company, has agreed to hold a conference by Skype with her students in the spring to discuss telemedicine and the process of health policymaking.

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