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Senators to FCC: Better Rural Connectivity Means More Telehealth

The Senate is lobbying the FCC on several fronts to improve broadband and cellular connectivity in rural America, saying a more connected population will be better able to access needed telehealth services.

Source: ThinkStock

By Eric Wicklund

- The Senate is challenging the Federal Communications Commission on two fronts in an effort to improve broadband and cellphone connectivity in rural areas – key ingredients to expanding telehealth and telemedicine programs to reach underserved populations.

One letter signed by 30 Senators from both sides of the aisle urges FCC Chairman Ajit Pai to increase the funding cap for the Rural Health Care (RHC) Program to address the shortage of broadband connectivity for rural healthcare providers.

A second letter to Pai, meanwhile, questions whether a map used by the FCC to determine funding for preserving and expanding mobile coverage in rural areas is accurate.

“Having consistently traveled throughout rural areas in our states, it appears that there are significant gaps in mobile coverage beyond what is represented by the map’s initial presentation of ‘eligible areas,’” the letter, dated March 8 and signed by nine Senators, stated. “To accurately target support to communities truly in need of broadband service, it is critical we collect standardized and accurate data.”

The Mobility Fund Phase II (MF II) map is designed to identify rural regions of the country where broadband and cellphone coverage is weak, and will be used by federal regulators to disperse $4.53 billion from the Universal Service Fund over the next 10 years “to preserve and expand mobile coverage to rural areas.”

READ MORE: Tying Telehealth to Better Rural Health Outcomes

But the Senators – Roger Wicker (R-Miss.), Maggie Hassan (D-N.H.), Jerry Moran (R-Kan.), Angus King (I-Maine), Cory Gardner (R-Colo.), Amy Klobuchar (D-Minn.), Pat Roberts (R-Kan.), Roy Blunt (R-Mo.), Gary Peters (D-Mich.) and Thom Tillis (R-N.C.) – say the map “was developed based on a preliminary assessment from a one-time data collection effort” and is inaccurate.

“For too long, millions of rural Americans have been living without consistent and reliable mobile broadband service,” they wrote. “Identifying rural areas as not eligible for support will exacerbate the digital divide, denying fundamental economic opportunities to these rural communities. We strongly urge the Commission to accurately and consistently identify areas that do not have unsubsidized 4G LTE service and provide Congress with an update on final eligible areas before auctioning $4.53 billion of MF II support.”

FCC officials unveiled the map earlier this year as an update to one crafted in 2012 and used in the first round of mobility grants. The agency uses the map to identify areas identified as having inadequate or non-existent coverage, the only areas to qualify for federal funding.

But at a March hearing before the Senate Communications, Technology, Innovation and the Internet subcommittee, several senators cried foul. Those representing New Hampshire, Mississippi and Kansas pointed out that the map shows each state as being fully covered with mobile broadband service.

“(T)hat map is utterly worthless of giving us good information,” argued Wicker, the subcommittee’s chairman.

READ MORE: New Group Lobbies to Use ‘TV White Space’ for Rural Telehealth

Separately, 61 Senators crafted a letter to Pai this week asking for “more predictable and long-term efficiencies in the FCC’s High-Cost Universal Service Fund, which is responsible for helping meet the Commission’s goal to provide reliable and affordable communications to all Americans.” A similar letter was signed by 130 members of the House of Representatives.

Meanwhile, a group of 30 Senators sent a letter to Pai this past week urging the FCC to increase funding through the RHC Program for rural communities.

Congress established the RHC Program in the Telecommunications Act of 1996, and set a $400 million cap on RHC’s Telecom Program “to subsidize the difference between urban and rural rates for telecommunications services.” A second part of RHC, the HCF Program, was established in 2012 to allow telecoms to provide a flat 65 percent discount on a variety of communications services “to promote the use of broadband services and facilitate the formation of healthcare provider consortia.”

But driven by a strong interest in telemedicine and telehealth services, as well as educational outreach programs, the RHC Program exceeded the cap by $20 million in FY 2017; the agency expects the cap will be surpassed by increases in both funding requests and the number of projects in FY 2017, which runs through June 20, 2018.

In December, the FCC voted to carry forward unused funds from past years to cover additional FY 2017 expenditures on a one-time-only basis. The agency is now looking for a formula, as noted in a proposed rule published on January 3 in the Federal Register, to adjust the cap each year. One suggestion is to adjust the cap annually for inflation.

READ MORE: Broadband Offers a Telehealth Lifeline to Rural Hospitals

“In 2016, for the first time ever, the demand for RHC funding exceeded the cap and funding to recipients was reduced by 7.5 percent,” the letter stated. “Further, it was recently announced that RHC applicants will suffer a devastating cutback in funding of 16 (percent) to 26 percent in funding year 2017 because of continued growth in demand. Unless the spending cap is raised appropriately to account for current needs and future growth, healthcare providers in rural areas will encounter severe rate increases for their broadband services, making it even harder for rural health care practitioners to engage in life-saving telemedicine.”

The Senate isn’t the only group pressuring the FCC to take action. In recent months the American Association of Family Physicians, American Hospital Association, American Telemedicine Association, Healthcare Information and Management Systems Society (HIMSS), College of Health Information Management Executives (CHIME) and several other organizations have issued similar pleas.

“The AHA appreciates the FCC’s attempts to soften the blow this year by making unused funds from prior years available and allowing companies to lower prices for requested services, but these steps clearly were not sufficient,” the AHA said in its letter. “Now more than ever, innovations in health care demand connectivity for telehealth, remote monitoring, patient engagement and daily operations.”

“The Commission has expressed a strong commitment to meeting the broadband connectivity needs of rural health care providers and thereby improving the lives of rural Americans,” the letter concludes. “Reversing the large and unexpected cuts to FY 2017 funding under the RHC program and putting the program on a path to provide sufficient and predictable funding in FY2018 and beyond would be consistent with that commitment.”

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