FCC Proposes Health Care Fund Changes to Encourage More Participation
A revamped rural health care telecom subsidy program should help more health facilities use broadband to connect to the outside world, FCC Chairman Julius Genachowski said. The commission initiated a rulemaking Thursday to change the rules of the USF program based on lessons learned from the Rural Health Care Pilot Program. The original program failed to live up to its potential, Commissioner Michael Copps said. In most years it disbursed less than 20 percent of the $400 million that could be spent.
Sign up for a free preview to unlock the rest of this article
Timely, relevant coverage of court proceedings and agency rulings involving tariffs, classification, valuation, origin and antidumping and countervailing duties. Each day, Trade Law Daily subscribers receive a daily headline email, in-depth PDF edition and access to all relevant documents via our trade law source document library and website.
The proposed program would retain the $400 million cap, which Commissioner Robert McDowell supported. The changes are likely to increase demand, he said, but the commission must be careful to identify savings in other areas of the fund to check “runaway growth,” he said. He also cautioned against expanding the health care program beyond its Congressional mandate to bring broadband to rural areas.
It’s too early to know if or when applications to the program would actually exceed the dollar cap, Genachowski said. But demand is good, he said, because it would bring a more competitive aspect to the program, similar to the Department of Education’s Race to the Top grant-making initiative.
The proposed changes include creating a new program that would support 85 percent of the construction costs for bringing new or upgraded broadband to a public or non-profit health facility where broadband is unavailable or insufficient.; supporting 50 percent, rather than 25 percent, of the monthly recurring costs for broadband; and increasing the types of facilities eligible for funding. Skilled nursing facilities, renal dialysis centers and administrative centers that aren’t physically attached to the health facilities they serve would become eligible for funding, which would bring the nationwide total of eligible facilities to 12,000 from 9,800.
Wireline Bureau Chief Sharon Gillett said the bureau realized the fund rules hadn’t kept pace with technological and legal developments. The old Internet Access Fund read so that it would reimburse the costs of accessing the public Internet via older technologies, but “they're not dialing up AOL to do their health record exchange,” she said. Because of privacy laws, health providers must exchange records over dedicated lines, something the fund didn’t account for before, she said. The 25 percent reimbursement for monthly costs probably wasn’t enticing enough for centers that had to go through the effort of applying for government funds, she said.
AT&T said the proposal could remove some of the challenges to achieving the National Broadband Plan goals, challenges it saw firsthand through its experience with the California Telehealth Network. Telecommunications Industry Association President Grant Seiffert said the proposal would “promote the deployment of critical communications infrastructure” while also improving health care outcomes and injecting “much-needed capital into the flagging economy.” Verizon also applauded the proposal. “Broadband technology has the potential to provide advanced medical care to patients no matter where they live,” said Kathleen Grillo, senior vice president for federal regulatory affairs.
The American Telemedicine Association was happy to see action being taken but said “re-branding and taking baby steps with a deeply flawed program are not a solution.” Less than 10 percent of promised funds from the pilot program have been disbursed and applicants have received “arbitrary, conflicting and changing” guidance, the group said. It suggested streamlining the project approval process, not requiring quarterly reports until a project has started, removing the cash-only requirement for matches and providing additional support for project administration and management.
Genachowski said he’s “very enthusiastic” about the program. “This program has the potential to do for rural health care providers and patients what the enormously successful E-Rate program has done for schools and students,” he said. He said 30 percent of federally funded rural health clinics don’t have access to broadband and only 8 percent of Indian Health Service centers do. Copps also expressed strong support: “I truly do believe our rural health care initiative can be the signature item of this commission.” However, an FCC official said there had been internal debate about the extent to which the program could be expanded. Concerns were raised that attempting to include suburban or urban health centers in the funding would violate Section 254 of the Telecommunications Act, he said. The NPRM, though, says Section 254 “is not limited to health care providers in rural areas.” Instead, the commission wants to know whether it should focus first on rural areas.