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FCC Proposal to Expand Rural Broadband Too Limiting

Cheryl Clark, for HealthLeaders Media, August 18, 2010

As background, FCC officials admit that they are trying to correct the follies that have crippled, and some say doomed to failure, most of the 62 Rural Health Care Pilot projects that were approved in 2007, which would have spent $417 million by June of this year, the deadline for completion. Only recently were the stymied projects given another year to comply with all the requirements.

These 62 grants funded demonstration or pilot projects from Puerto Rico to Western New York to the mountains of Utah and Alaska.

An FCC spokesman said, "The Rural Health Care Pilot Program has provided the FCC with valuable insight on how to provide much-needed connectivity for broadband-enabled health care technology in areas where it is lacking. Over half of the 62 projects have received sign-off from the FCC to link hundreds of hospitals in 30 states, and 20 projects have submitted invoices for work already performed. As we seek comment on designing a new Rural Health Care Program, we are using lessons learned in the Pilot to create a flexible program that will provide rural health providers the networks and support they need, where they need them, while still protecting the universal service fund from waste, fraud and abuse."

Unfortunately, most of them have yet to get off the ground for a variety of complicated reasons.

Massive amounts of paperwork were required to be submitted quarterly and in some cases monthly by the grantees, who in many cases didn't have the resources or the acumen to accomplish the task.  As of last week, only $24.9 million of the money has been spent, and only $69.2 million, or about 15%, has been committed for only 32 of the 62 projects.

A major part of the problem is that the federal funds required a 15% match, which the applying entities can't come up with, said Dale Alverson, MD, full time medical director for the Center for Telehealth in Albuquerque, NM, a region that is still waiting to receive the first penny of its $15,931,111 award for the Southwest Telehealth Access Grid, which was to receive one of the top 10 highest amounts.

The money was supposed to support a network of networks that would distribute telemedicine clinical services to about 60 healthcare facilities in Arizona, and New Mexico, said Alverson, who also is the newly elected president of the American Telemedicine Association.

Alverson describes a series of paperwork bottlenecks of lengthy forms, formulas that kept changing. "It was like filling out a complex tax return."
And a lot of the sites that might have benefitted didn't have the infrastructure in place—to use an analogy, the on and off ramps from the main networks to the provider's clinics and hospitals—that was needed to even start the projects.

Rural Native American tribes, as strange as it might sound, Alverson explained, "had to confirm that they really existed. And it proved to be much more complicated for these rural smaller clinics."

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