Thursday, March 9, 2023
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Digital healthcare equity in primary care: implementing an integrated digital health navigator
The Affordable Connectivity Program: Time Is of the Essence for Congress to Act
Digital Equity


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Digitial Equity

The 21st Century Cures Act and the rise of telemedicine led to a renewed focus on patient portals. However, portal use disparities persist and are in part driven by limited digital literacy. To address digital disparities in primary care, we implemented an integrated digital health navigator program supporting portal use among patients with type II diabetes. During our pilot, we were able to enroll 121 (30.9%) patients in the portal. Of newly enrolled or trained patients, 75 (62.0%) were Black, 13 (10.7%) were White, 23 (19.0%) were Hispanic/Latinx, 4 (3.3%) were Asian, 3 (2.5%) were of another race or ethnicity, and 3 (2.5%) had missing data. Our overall portal enrollment for clinic patients with type II diabetes increased for Hispanic/Latinx patients from 30% to 42% and for Black patients from 49% to 61%. We used the Consolidated Framework for Implementation Research to understand key implementation components. Using our approach, other clinics can implement an integrated digital health navigator to support patient portal use.

Congress should extend the worthwhile Affordability Connectivity Program (ACP) promptly by appropriating additional funding. At the same time, it can consider revising the program to better target the ACP benefit to those lower-income households most truly in need and adopting measures to minimize, to the extent possible, any waste, fraud, and abuse in the program. The ACP represents one-half of the federal government's push to make it possible for every American to access a high-speed Internet connection. The other side of the equation, of course, is the many – potentially too many – programs making massive amounts of money available for the construction of broadband infrastructure, specifically in those limited areas that remain unserved despite the trillions in private investment that have brought broadband to the vast majority of households. The ACP incorporates features that recommend it over other affordability approaches. One, it promotes the efficient use of taxpayer dollars by empowering recipients to exercise relatively unfettered choice in the competitive marketplace for broadband service. And two, it promotes political accountability because it is funded by a direct congressional appropriation, unlike Universal Service Fund (USF) programs, such as Lifeline, that unsustainably rely upon an anachronistic regressive tax that targets an arbitrary subset of communications services. Accordingly, it's worth repeating my call for Congress to act without further delay to extend and revise the ACP. Specifically, lawmakers should pass legislation that provides another one-time appropriation, sufficient to expand the ACP's lifespan over several years.

While I think that fixed wireless technology can efficiently serve all communities, this is especially true for rural communities, because fixed wireless is high-speed, reliable, and perhaps most importantly, can be deployed quickly. Rural America needs access to high-speed and reliable technologies today, not years from now, in order to remain competitive in our nation’s economy. Despite the important role fixed wireless has played in achieving this goal, our policymakers have failed to realize the true potential of fixed wireless and other wireless technologies, among them satellite, and have, in doing so, disadvantaged wireless technology providers’ ability to compete in the marketplace by gaining access to the funds available in government programs aimed at serving rural America. I fully agree with WISPA’s recent statements about the lack of technological neutrality in the BEAD program. The definitions adopted by NTIA have, unfortunately, stacked the deck in favor of fiber deployments—in places where fiber will likely take years to build-out, if it’s even possible, whether because of the difficulties presented by the terrain in specific areas, the lack of infrastructure for supporting fiber, or competition for limited fiber supplies from more densely populated markets. We must reconsider this approach if we wish for rural America to keep pace with the rest of the US and the US with the rest of the world.

SpaceX has offered a public explanation for why Starlink's actual service availability falls far short of what it claimed on the Federal Communications Commission's national broadband map. SpaceX's FCC filings indicate it offers fixed broadband at virtually every address in the US even though the Starlink website's service map shows it has a waitlist in huge portions of the country. SpaceX removed some homes from the FCC database when residents filed challenges because they were unable to order Starlink at addresses listed as served on the FCC map. SpaceX tried to clear up the confusion in an FCC filing. The company says it followed FCC rules when submitting data and blamed the FCC system for not allowing it to report data more precisely. Under the map system rules, SpaceX argues that it is allowed to report an address as "served" even if the resident can only order Starlink's RV service. Whether someone can order residential Starlink service at their address depends on "available capacity," which is "driven by local subscription levels," SpaceX wrote.
State/Local
Pennsylvania Broadband Development Authority Seeking Public Input on Community Engagement Efforts

Pennsylvania Broadband Development Authority Executive Director Brandon Carson is asking Pennsylvanians to provide input on the stakeholder engagement process for developing two plans: the State Digital Equity Plan and the Commonwealth’s Broadband Equity, Access, and Deployment (BEAD) Five-Year Action Plan. The two-week public comment period began on February 27 and ends Friday, March 10, 2023. The State Digital Equity Stakeholder Engagement Plan will focus on engaging eight primary populations required through federal guidance – aging individuals, incarcerated individuals, veterans, individuals with disabilities, English learners, individuals with low levels of literacy, individuals who are members of an ethnic or racial minority, or individuals living in rural areas – to offer achievable objectives, and measurable outcomes. The plan can be viewed on the Authority’s website and includes:
- Two digital equity roundtable discussions,
- Community surveys,
- Participation by the Authority in community events,
- In-person community conversations held around the Commonwealth,
- Measurable outcomes.
In addition to the plan, the Authority will identify a specific number of stakeholders to form a Digital Equity Stakeholder Engagement Panel to help inform and guide the implementation of the plan. Digital equity is also a core component of the BEAD program and the Authority’s Five-Year Action Plan will incorporate digital equity and inclusion needs, goals, and implementation strategy.
[02/27/2023]
Colorado goes analog to boost affordable internet program after just 23% of eligible households join

An effort to boost awareness of the year-old Affordable Connectivity Program (ACP) is getting more local after earlier attempts to promote it statewide resulted in just 23% of eligible Colorado households signing up to get up to $30 off their internet bills. To get the rest of the 77% signed up, state officials feel that the campaign needs to go analog and provide help right in local libraries, schools, and community centers. Lt Governor Dianne Primavera (D-CO) announced the new Colorado ACP Act Now, an initiative that includes partnering with the nonprofit EducationSuperHighway and 71 public libraries, city governments, internet providers, and others statewide to help their neighbors get connected in person. The organization is providing training and tools at no charge to Colorado. 181,867 households in Colorado had enrolled. State officials estimate that 800,000 are eligible, which means 23% have signed up. Evan Maxwell, CEO and founder of EducationSuperHighway, said his company's task is more or less accomplished, with 99.7% of schools served. The company has since turned to increase ACP awareness and adoption to help states find those eligible households who really could use faster internet.
[02/22/2023]
AARP Arkansas and ARConnect, the state’s broadband office, are teaming up to bridge the digital divide in the Natural State. Glen Howie, state broadband director, attended AARP Arkansas’ Advocacy Team meeting to provide a deeper dive into broadband infrastructure deployment and how it will benefit Arkansans. Howie said, “AARP Arkansas’ support and engagement, specific to the Federal Communications Commission’s Affordable Connectivity Program (ACP), is critical in spreading awareness that retirees may receive assistance with the cost of internet services.” AARP Arkansas made broadband a key issue during the 94th General Assembly. The organization supports legislation and efforts to expand digital equity via accessible and affordable high-speed internet across the state, especially in rural and underserved areas. Ashley McBride, AARP Arkansas state director, cites survey data from AARP’s Older Adults Technology Services (OATS) which confirms that over 21 million people in the US, ages 65 and older, lack residential broadband access. OATS survey results also highlight the disparity for seniors in rural areas who are 1.6 times more likely to have deficient broadband access.
[02/22/2023]
Office of Broadband Access and Expansion Announces Third Wave of Connect New Mexico Pilot Program Funding

The New Mexico Office of Broadband Access and Expansion (OBAE) has extended the deadline for Wave Three of the Connect New Mexico Pilot Program (“Pilot Program”). The application period will close on April 3, 2023. The Pilot Program aims to bridge the digital divide and foster socioeconomic progress by providing infrastructure grants for broadband deployment to unserved and underserved communities across New Mexico. The $123 million pilot program is funded by the American Rescue Plan Act’s (ARPA) Coronavirus Capital Projects Fund (CPF). OBAE launched the program in August 2022 and announced Wave One awards in November 2022. An initial set of Wave 2 awards will be announced later in March and April 2023. OBAE invites existing and emerging Internet providers to participate and encourages partnerships between local and tribal governments. According to OBAE Director Kelly Schlegel, “The strongest proposals to date directly serve qualifying residential, business, and community premises with future-proof networks backed by “skin in the game,” and offer a range of affordably-priced services while fostering adoption through targeted programs.”

Consolidated Communications will provide access to high-speed Internet for thousands of people in New Hampshire as soon as 2024 after the New Hampshire Executive Council approved giving it $40 million in federal funding. The panel unanimously authorized using American Rescue Plan Act (ARPA) money for a three-year contract to make fiber-optic broadband available to nearly 25,000 homes, including almost 3,100 in Cheshire County. Consolidated has also pledged to add another 32,000 homes in the project area using its own money, but it didn’t have a county-by-county breakdown for these additional locations. Consumers can expect to pay $70 per month, increasing to $95 after one year, if they buy the company’s most popular level of service. The cheapest introductory rate is $35, increasing to $55 after a year.
[02/23/2023]
Legislation
Senators Introduce Bipartisan Bill to Tackle National Security Threats from Foreign Tech

Senators Mark Warner (D-VA) and John Thune (R-SD) led a group of 12 bipartisan senators to introduce the Restricting the Emergence of Security Threats that Risk Information and Communications Technology (RESTRICT) Act, legislation that will comprehensively address the ongoing threat posed by technology from foreign adversaries by better empowering the Department of Commerce to review, prevent, and mitigate information communications and technology transactions that pose undue risk to our national security. The Act would:
- Require the Secretary of Commerce to establish procedures to identify, deter, disrupt, prevent, prohibit, and mitigate transactions involving information and communications technology products in which any foreign adversary has any interest and poses undue or unacceptable risk to national security;
- Prioritize evaluation of information communications and technology products used in critical infrastructure, integral to telecommunications products, or pertaining to a range of defined emerging, foundational, and disruptive technologies with serious national security implications;
- Ensure comprehensive actions to address risks of untrusted foreign information communications and technology products by requiring the Secretary to take up consideration of concerning activity identified by other government entities;
- Educate the public and business community about the threat by requiring the Secretary of Commerce to coordinate with the Director of National Intelligence to provide declassified information on how transactions denied or otherwise mitigated posed undue or unacceptable risk.
The legislation is co-sponsored by Sens. Tammy Baldwin (D-WI), Deb Fischer (R-NE), Joe Manchin (D-WV), Jerry Moran (R-KS), Michael Bennet (D-CO), Dan Sullivan (R-AK), Kirsten Gillibrand (D-NY), Susan Collins (R-ME), Martin Heinrich (D-NM), and Mitt Romney (R-UT).
Benton (www.benton.org) provides the only free, reliable, and non-partisan daily digest that curates and distributes news related to universal broadband, while connecting communications, democracy, and public interest issues. Posted Monday through Friday, this service provides updates on important industry developments, policy issues, and other related news events. While the summaries are factually accurate, their sometimes informal tone may not always represent the tone of the original articles. Headlines are compiled by Kevin Taglang (headlines AT benton DOT org), Grace Tepper (grace AT benton DOT org), and David L. Clay II (dclay AT benton DOT org) — we welcome your comments.
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