On Thursday, December 29, 2022, President Joe Biden signed into law the Consolidated Appropriations Act, 2023 (H.R. 2617). Most importantly, the government funding package, which includes all 12 fiscal year 2023 appropriations bills, keeps the federal government running through September 30, 2023. But the legislation also includes some interesting broadband provisions that will impact Infrastructure Investment and Jobs Act funding, rural broadband projects, the device side of the digital divide, telehealth, and researching the effects of media on children. 

I. Using ARPA Funds for BEAD Match Requirements

The Coronavirus State and Local Fiscal Recovery Funds (SLFRF) program, a part of the American Rescue Plan Act, delivered $350 billion to state, local, and Tribal governments across the country to support their response to and recovery from the COVID-19 public health emergency. One allowable use of SLFRF funds is to make necessary investments to expand affordable access to broadband internet.

H.R. 2617 includes the State, Local, Tribal, and Territorial Fiscal Recovery, Infrastructure, and Disaster Relief Flexibility Act, providing additional flexibility for states, tribes, and units of local government to spend their SLFRF allocations. The National Telecommunications and Information Administration's Broadband Equity, Access, and Deployment (BEAD) Program requires states or subgrantees to provide matching funds of not less than 25 percent of project costs. H.R. 2617 allows these government entities to use their SLFRF allocations to fulfill the match requirement.

Under this legislation, the cap on how much of the COVID money can be spent on these new purposes would be the greater of $10 million or 30 percent of the SLFRF funds. This bill does not place spending mandates on recipients of COVID funding and does not reclaim any distributed funding.  Furthermore, the bill allows recipients to expend SLFRF funds on these types of infrastructure projects until September 30, 2026. 

II. More Money for Rural Broadband Projects

H.R. 2617 allocates $363,512,317 for the U.S. Department of Agriculture's (USDA) ReConnect Loan and Grant Program, $15,512,317 of which has been earmarked for "Congressionally Directed Spending." For the ReConnect spending, Congress further stipulates that:

• At least 90 percent of the households to be served by a project will be in a rural area without sufficient access to broadband (defined as 25 megabits per second downstream and three megabits per second upstream),
• To the extent possible, projects must build out service to at least 100 megabits per second downstream, and 20 megabits per second upstream,
• Supported projects will not use the loan or grant to overbuild or duplicate broadband service in a service area by any entity that has received a broadband loan from the USDA's Rural Utilities Service unless such service is not provided sufficient access to broadband at the minimum service threshold,
• To the maximum extent feasible, at least 10 percent of the funds shall be allocated for assistance in persistent poverty counties (any county that has had 20 percent or more of its population living in poverty over the past 30 years),
• Not more than four percent of the funds can be used for administrative costs and up to three percent of funds may be available for technical assistance and pre-development planning activities to support the most rural communities,  and
• The Rural Utilities Service is directed to expedite program delivery.

The legislation also sets aside nearly $65 million USDA grants for telemedicine and distance learning services in rural areas—nearly $5 million of these funds have been earmarked for Congressionally Directed Spending.

H.R. 2617 allocates $35 million for the USDA's Community Connect Grant Program provides financial assistance to eligible applicants that will provide broadband service in rural, economically-challenged communities where service does not exist.

As for the Congressionally Directed Spending, here's what we know.

ReConnect Earmarks

Rep. Jefferson Van Drew (R-NJ) requested $3.75 million for Cumberland County/Salem County Broadband Connectivity. The funding will facilitate a shared services agreement between the two counties, building out fiber connectivity to existing county operations and Infrastructure. Even though H.R. 2617 includes this earmark, Rep. Van Drew voted against the bill saying it "will lead to even more inflation, even higher interest rates, and an even larger national debt."

Rep Kurt Schrader (D-OR) and Sens. Ron Wyden (D-OR) and Jeff Merkley (D-OR) requested $3 million for the Tillamook County Fiber Network.

Rep. Elise Stefanik (R-NY) requested $1 million each ($2 million total) for Franklin County Broadband Expansion and Washington County Broadband Expansion. The funding will be used to: 1) accelerate the broadband network buildout to communities in the rural and agricultural parts of Franklin County that lack access to high-speed broadband, connecting over two thousand unserved locations and 2) facilitate new broadband connections for hundreds of unserved households in rural communities across Washington County. Rep. Stefanik voted against H.R. 2617 saying, "House Republicans will rein in reckless spending."

Rep. Robert Aderholt (R-AL) requested $1,704,200 go to the Cullman Electric Cooperative for its Sprout Fiber Internet Project. 

Rep. Jim Costa (D-CA) and Sen. Dianne Feinstein (D-CA) requested $1.35 million for the City of Gustine to improve internet access and bridge the digital divide by connecting low-income residents to affordable, reliable high-speed internet, including 5G access for businesses throughout the community. 

Rep. Blaine Luetkemeyer (R-MO) requested $960,112 for the Co-Mo Electric Cooperative's Co-Mo Connect in Central Missouri.

Rep. Carol Miller (R-WV) requested $925,069 for the Downtown Beckley Broadband Project. The funding would be used for providing broadband in the historic downtown to promote and build viable economic development. 

Rep. Sanford Bishop, Jr. (D-GA) requested $562,490 go to the City of Donalsonville for broadband internet infrastructure improvement and expanding service to over 1,200 households.

Rep. Pete Stauber (R-MN) requested $455,977 go to the City of Cromwell Broadband Project which will connect over 100 residential locations and nearly 25 businesses in the city.

Rep. Sam Graves (R-MO) requested $375,000 for the Ralls County Electric Cooperative. The funding will help connect 45 households in rural Ralls County. 

Rep. Ashley Hinson (R-IA) requested $330,200 for the Osage Municipal Utilities Orchard Fiber Project.

Rep. Elaine Luria (D-VA) requested $196,269 for Mt. Nebo and Bailey Neck Broadband Expansion through the Eastern Shore of Virginia Broadband Authority, a public authority, formed by the Counties of Northampton and Accomack, to provide broadband services. 

Telemedicine and Distance Learning

Sen. Cindy Hyde-Smith (R-MS) requested $1 million each ($3 million total) go to Covington County Hospital, Magee General Hospital, and Simpson General Hospital for support to purchase telehealth equipment.

Sen Dick Durbin (D-IL) requested:

• $710,000 go to Blessing Health System (Quincy, IL) to expand an established telemedicine program with a mobile clinic containing diagnostic and telemedicine equipment. This mobile clinic would provide physical exams and diagnostic tests such as EKG's, X-rays, ultrasounds and lab services, in communities in which such services are not available.
• $218,000 go to Saint Anthony Medical Center to expand telehealth services to additional rural hospitals and clinics surrounding Rockford (IL). Funding would allow the hospital to procure the necessary equipment to establish telehealth programs in small, rural hospitals and utilize scarce resources across a rural service area.
• $163,000 go to Carle Eureka Hospital (Eureka, IL) to expand its rural telemedicine program covering a town of 5,000 people. The acquisition of mobile telemedicine carts, telemedicine provider workstations, and other related equipment will allow this rural hospital to expand access to specialty care, mental health care, and support services to members of the community and reduce the need to travel in order to obtain such services.

Sen. Martin Heinrich (D-NM) requested $500,000 got to Western New Mexico University to purchase distance learning hardware to expand its online learning programs.  

Sen. Bill Cassidy (R-LA) requested $400,000 go to the Acadiana Planning Commission to expand telehealth services in Evangeline Parish, Louisiana.

III. Refurbishing Computers to Close the Digital Divide

In H.R. 2617, Congress finds:

• Access to computers and computer technology is indispensable for success in the 21st century. Millions of Americans do not regularly use a computer and research shows that substantial disparities remain in both internet use and the quality of access, with the digital divide concentrated among older, less educated, less affluent populations, especially veterans, low-income students, and senior citizens.
• The COVID–19 pandemic has highlighted the gap between those with computer access and those without. Millions of students, their families, and workers from across the economy were unable to do schoolwork, work remotely from home, or connect to loved ones and their communities because of the digital divide.
• Any Federal program that distributes surplus, repairable Federal computers or technology equipment would benefit from a partnership with a nonprofit organization whose mission is bridging the digital divide.

Currently, the General Services Administration (GSA) operates the Computers for Learning Program, which distributes surplus computers and related technology from federal agencies to schools and educational nonprofits, but the program does not allow property to be transferred directly to refurbishers.

With this in mind, the Consolidated Appropriations Act, 2023 includes the Computers for Veterans and Students Act of 2022 (or the COVS Act) which amends current law on the donation of personal property through state agencies. The COVS Act requires the General Services Administration (GSA) to transfer certain surplus computers and technology equipment to nonprofit computer refurbishers for repair and eventual distribution to 1) schools (including home schools), veterans, seniors, and other specified populations in need; and 2) state and local agencies for donation to nonprofit and public entities.

A nonprofit computer refurbisher that receives surplus computer or technology equipment under this law will:

• make necessary repairs to restore the surplus computer or technology equipment to working order;
• distribute the repaired surplus computer or technology equipment to eligible recipients at no cost (except to the extent necessary to facilitate shipping and handling, and that such cost is consistent with any GSA regulations);
• offer training programs on the use of the repaired computers and technology equipment for the recipients of the equipment;
• use recyclers to the maximum extent practicable in the event that surplus computer or technology equipment transferred under this section cannot be repaired or reused; and
• report to GSA on the distribution of equipment, especially to educational institutions, individuals with disabilities, low-income individuals, students, seniors in need, and veterans.

GSA will submit a report on these efforts annually to Congress.

IV. A Strategic Plan for Connected Care

H.R. 2617 says that it is the sense of Congress that the telehealth services offered by the Department of Veterans Affairs (VA) should be routinely measured and evaluated to ensure the telehealth technologies and modalities delivered to veteran patients to treat a wide variety of health conditions are as effective as in-person treatment for primary care, mental health care, and other forms of specialty care.

Congress finds that:

• The COVID–19 pandemic caused the VA to exponentially increase telehealth and virtual care modalities, including VA Video Connect, to deliver health care services to veteran patients.
• Between January 2020 and January 2021, the number of telehealth appointments offered by the VA increased by 1,831 percent.
• The VA maintains strategic partnerships, such as the Digital Divide Consult, with a goal of ensuring veterans who reside in rural, highly rural, or medically underserved areas have access to high-quality telehealth services offered by the Department.
• As of 2019, veterans who reside in rural and highly rural areas make up approximately 1⁄3 of veteran enrollees in the patient enrollment system, and are on average, older than their veteran peers in urban areas, experience higher degrees of financial instability, and live with a greater number of complex health needs and comorbidities.
• The Federal Communications Commission estimated in 2020 that 15 percent of veteran households do not have an internet connection.
• Under the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116–136, if you're scoring at home), Congress granted the VA additional authority to enter into short-term agreements or contracts with private sector telecommunications companies to provide certain broadband services for the purposes of providing expanded mental health services to isolated veterans through telehealth or VA Video Connect during a public health emergency.
• The VA did not utilize that authority to the fullest extent.
• Though the VA has made significant progress in expanding telehealth services offered to veterans who are enrolled in the patient enrollment system, significant gaps still exist to ensure all veterans receive equal and high-quality access to virtual care.
• Questions regarding the efficacy of using telehealth for certain health care services and specialties remain, and should be further studied.
• The VA continues to expand telehealth and virtual care offerings for primary care, mental health care, specialty care, urgent care, and even remote intensive care units.

With all this in mind, Congress is requiring the VA's Office of Connected Care to develop—an update no less than once every three years—a strategic plan to ensure the effectiveness of the telehealth technologies and modalities delivered by the VA to veterans who are enrolled in the patient enrollment system. The plan will include:

1. A comprehensive list of all health care specialties the VA is currently delivering by telehealth or virtual care.
2. An assessment of the effectiveness and patient outcomes for each type of health care specialty delivered by telehealth or virtual care by the VA.
3. An assessment of satisfaction of veterans in receiving care through telehealth or virtual care disaggregated by age group and by Veterans Integrated Service Network.
4. An assessment of the percentage of virtual visits delivered by the VA through each modality including standard telephone telehealth, VA Video Connect, and the Accessing Telehealth through Local Area Stations (ATLAS) program.
5. An outline of all current partnerships maintained by the VA to bolster telehealth or virtual care services for veterans.
6. An assessment of the barriers faced by the VA in delivering telehealth or virtual care services to veterans residing in rural and highly rural areas, and the strategies the Department is deploying beyond purchasing hardware for veterans who are enrolled in the patient enrollment system.
7. A detailed plan illustrating how the Department is working with other Federal agencies, including the Department of Health and Human Services, the Department of Agriculture, the Federal Communications Commission, and the National Telecommunications and Information Administration, to enhance connectivity in rural, highly rural, and medically underserved areas to better reach all veterans.
8. The feasibility and advisability of partnering with Federally qualified health centers, rural health clinics, and critical access hospitals to fill the gap for health care services that exists for veterans who reside in rural and highly rural areas.
9. An evaluation of the number of veterans who are enrolled in the patient enrollment system who have previously received care under the Veterans Community Care Program.

Within six months of developing (or updating) the plan, the VA will submit a report to Congress including the complete strategic plan and an n identification of areas of improvement by the VA in the delivery of telehealth and virtual care services to veterans who are enrolled in the patient enrollment system, with a timeline for improvements to be implemented.

V. The Impact of Media on Kids

The Secretary of Health and Human Services will conduct or support research related to the health and developmental effects, including long-term effects, of media and related technology use on infants, children, and adolescents. The research may include the effects of exposure to, and use of, media and related technology, such as social media, applications, websites, television, motion pictures, artificial intelligence, mobile devices, computers, video games, virtual and augmented reality, and other content, networks, or platforms disseminated through the internet, broadcasted, or other media technologies.

The Director of the National Institutes of Health will develop a research agenda to assess the effects of media and related technologies on infants, children, and adolescents, which may include consideration of the following:

• The cognitive development of infants, children, and adolescents, which may include effects related to language development, learning abilities, and other areas of cognitive development.
• The physical health of infants, children, and adolescents, which may include effects related to diet, exercise, sleeping and eating routines, and other areas of physical development.
• The mental health of infants, children, and adolescents, which may include effects related to self-awareness, social awareness, relationship skills, decision-making, violence, bullying, privacy, mental disorders, and other areas related to mental health.

By the end of December 2024, the Director of the National Institutes of Health will submit a report to Congress 1) on the progress made in improving data and expanding research on the health and developmental effects of media and 2) that summarizes the grants and research funded by this law.

The Benton Institute for Broadband & Society is a non-profit organization dedicated to ensuring that all people in the U.S. have access to competitive, High-Performance Broadband regardless of where they live or who they are. We believe communication policy - rooted in the values of access, equity, and diversity - has the power to deliver new opportunities and strengthen communities.

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