We’ve all seen lots of reports from a variety of source documenting how telemedicine use has skyrocketed during the COVID public health emergency. There have also been many subsequent reports on the significant disparities in access to and use of telemedicine that were revealed and/or exacerbated by COVID. A simple search of Google Scholar brings up thousands of articles from around the world summarizing digital divide and related challenges that have been exposed, and many of them highlight some very creative strategies to help address and reduce barriers to telemedicine care. How can we offer a telemedicine option to someone who does not own a digital device? To someone who does but must choose between using their minutes to support their child’s remote school classes or see their doctor? Or someone who has access to the Internet but at limited bandwidth?
The Federal Communications Commission to the rescue! See our December 15, 2021 blog by Mike Holcomb “Recent Telehealth and Broadband Funding and Funding Opportunities for the Southwest Region” for details about the first two rounds of funding aimed at helping providers/programs expand telehealth and broadband availability. Each state has a long list of providers that can be contacted directly for the services that they offer as part of the program. Perhaps even more importantly, the Consolidated Appropriations Act of 2021 appropriated $3.2 billion to help low-income households pay for connected internet devices and broadband service. The Affordable Connectivity Program (originally called the Emergency Broadband Benefit Program) initially provided discounts of up to $50 per month for broadband services and that is now $30. There is also a one-time discount of up to $100 for a desktop computer, laptop, or tablet. There are of course eligibility requirements and the latter requires a co-payment of at least $10 but no more than $50. The former provides enhanced support of up to $75 for consumers living on qualifying Tribal lands.
Like all good things, this does not last forever. It will expire when the funds run out or when the Department of Health and Human Services declares that the Public Health Emergency is over. There is only one monthly service discount available per household, but the program does acknowledge that there may be more than one eligible household residing at the same address. The definition of household is rather liberal. It is a group of people who live together and share income and expenses. They do not have to be related to one another. Thus, if there are 3 people who share an apartment but do not share any money – that’s 3 households!
Has anyone benefited from this program? Definitely! There is a Program Enrollment and Claims Tracker with a variety of search tools, but here are a few facts and figures we found. As of December 31, 2021 there were 9,048,536 households enrolled with $1,836,345,751 claimed! That is split $1,676,318,041 for monthly broadband support and $160,027,710 for the one-time connected device support. That still leaves $1,299,654,249 remaining in the appropriation. In the Southwest there have been 212,283 households enrolled in Arizona, 100,492 in Colorado, 105,175 in Nevada and 85,516 in New Mexico. In Arizona the top five counties have been Maricopa, Pima, Navajo, Apache, and Yuma. In Colorado the top five counties have been Denver, El Paso, Pueblo, Adams, and Arapahoe. In Nevada the top five counties have been Clark, Washoe, Carson City, Lyon, and Churchill. In New Mexico it has been Bernalillo, McKinley, San Juan, Dona Ana, and Chaves.
On the program and provider side, on January 26, 2022 the FCC has approved even more COVID-19 Telehealth Program applications. This represents the sixth and final round of funding and awarded $48 million to 100 providers to enhance their telehealth capabilities. Nine organizations in the Southwest received funding.
Canyonlands Community Health Care in Page, Arizona: $506,702 for laptops, tablets, servers, web cameras, computers, patient telehealth platforms, and privacy and communication licenses to improve patient care, expand their telehealth services, and enhance remote monitoring.
Cobre Valley Regional Medical Center in Globe, Arizona: $449,201 to purchase video conferencing subscriptions, tablets, and network hardware to connect providers directly with patients for COVID-19 follow-up care, as well as to maintain consistent communication for patients with chronic care needs.
Community Health Center of Yavapai in Prescott, Arizona: $915,985 to purchase remote patient monitoring devices, telemedicine carts, internet connectivity, and Wi-Fi infrastructure upgrades to enable mobile provider care, maintain telehealth monitoring for patients with high-risk medical conditions, handle a greater volume of telehealth visits to promote social distancing, and increase access to low-income, uninsured patients without smart phones or internet service.
Creek Valley Health Clinic in Colorado City, Arizona: $241,586 to purchase remote patient monitoring devices, such as pulse oximeters, blood pressure devices, thermometers, and to provide loaner tablets to patients who may lack access to the devices needed to utilize telehealth care.
Arkansas Valley Regional Medical Center in La Junta, Colorado: $339,501 to purchase infrastructure upgrades, including upgraded network capabilities, to support growing telehealth needs.
University of Colorado School of Medicine in Aurora, Colorado: $691,230 to purchase computers, phones, and networking devices to improve access, remotely manage care for patients, reduce patient and provider exposure, and conserve vital personal protective equipment for caregivers.
Summit Community Care Clinic in Frisco, Colorado: $143,495 to purchase laptops and other equipment necessary to provide secure and efficient medical, dental, and behavioral health care remotely.
Cibola General Hospital in Grants, New Mexico: $152,398 to purchase remote patient health monitoring equipment, which will be provided to providers and patients and provide consistent care and access to patient information.
New Frontier in Fallon, Nevada: $134,353 to purchase computers, tablets, and telemedicine clinical assistant carts, which will provide secure videoconferencing and transmission of diagnostic information for primary care and mental health services.
Lesson learned – there is funding out there for providers and patients to help reduce the digital divide and get healthcare services to those who really need it through telemedicine. There are of course forms and eligibility requirements, but help is available! For example, in Arizona there is Connect Arizona, an initiative led by Arizona State Library, Archives and Public Records that providers Digital Navigators to help with finding internet offers in your area and helping learn about digital devices in general. If you need to talk to someone about your eligibility or application status, call the Affordable Connectivity Program Support Center at (877) 384-2575. If you think you qualify or would just like to learn more don’t wait – the time to apply is now!