Rural Health Care

“We should construct broadband policy based on the ways people use broadband, and that has changed drastically,” writes Benton Senior Fellow Jonathan Sallet in “Broadband for America Now.” He’s absolutely right. Everything has changed since the coronavirus pandemic began – including the ways we use broadband. SHLB has long argued that community anchor institutions (CAIs) require high-quality broadband to serve their communities in the 21st century.

In October 2019, the Benton Institute for Broadband & Society issued Broadband for America’s Future: A Vision for the 2020s. The agenda was comprehensive, constructed upon achievements in communities and insights from experts across the nation. The report outlined the key building blocks of broadband policy—deployment, competition, community anchor institutions, and digital equity (including affordability and adoption).

We already know that the Federal Communication Commission’s current broadband maps are flawed – they overstate broadband availability, they don’t contain pricing information, and they rely too heavily on industry-provided data. The FCC is now seeking additional funding from Congress to improve its mapping efforts.

From the outset of the pandemic, it was clear that we needed to do everything we could to connect patients with their health care providers. So back in March, the Federal Communications Commission immediately made an additional $42 million available through our Rural Health Care Program. We also waived socalled “gift rules” so that participants in the Rural Health Care Program could solicit and accept better services or additional equipment for telemedicine from their broadband providers. And thanks to Congress, we were able to do much, much more.

There are almost three times as many Americans without a broadband subscription in blue urban areas than in red state rural areas. The Trump Federal Communications Commission, by focusing its attention on rural areas with a lack of access (i.e., those unable to get broadband) is dealing with only part of the digital divide. The larger part of the digital divide is adoption; those Americans who may have broadband available, but don’t or can’t use it. Here are three solutions the Trump FCC could pursue if they really were dedicated to making the digital divide their “number one priority.”

The Federal Communications Commission released a Public Notice providing additional information and guidance for potential applicants interested in applying for its Connected Care Pilot Program. The Pilot Program will provide up to $100 million from the Universal Service Fund over a three-year period to support the provision of connected care services, with an emphasis on supporting these services for lowincome Americans and veterans. The FCC will release a subsequent Public Notice with details regarding application procedures, including the timing of the application window. 

The Federal Communications Commission (FCC), US Department of Health and Human Services (HHS), and US Department of Agriculture (USDA) announced that they have signed a Memorandum of Understanding to work together on the Rural Telehealth Initiative, a joint effort to collaborate and share information to address health disparities, resolve service provider challenges, and promote broadband services and technology to rural areas in America. This action delivers on President Donald Trump’s recently signed Executive Order on Improving Rural Health and Telehealth Access.

Federal Communications Commission Chairman Ajit Pai is pushing Congress to make “more funding available for connectivity during the COVID-19 pandemic — including at least $430 million in funding for the highly successful but underfunded COVID-19 Telehealth Program,” a spokesperson said, noting that the FCC has conveyed these requests for months. Congress in March slated $200 million for the Covid-19 Telehealth Program, and the FCC has since awarded that cash to subsidize connectivity for 539 health care entities across the country.

Senator Brian Schatz (D-HI) led a group of 15 senators in urging Federal Communications Commission Chairman Ajit Pai to increase funding for and improve the operations of the Rural Health Care (RHC) program, which helps expand access to telehealth services in hard-to-reach and economically depressed communities. “Cash-strapped health care providers are looking to the RHC Program for help to defray these costs, but you have so far not taken steps that would allow health care providers to receive additional support through the program,” they wrote.

Nearly 12 million urban household have no access to telehealth, but Federal agencies earmark billions for broadband and telehealth grants targeted to 3.8 million disconnected rural households. Urban communities demand parity with rural community for these grants that their tax dollars and telephone bills support. COVID-19’s disproportionate killing of Black people has thrown into stark relief the many health issues afflicting this population, afflictions that telehealth can mitigate.