Minnesota ranks top state to raise a family

This news was too good not to share. WalletHub was just named Minnesota the best place to raise a family. No surprise to me with three girls! To be fair they don’t mention broadband or internet but reading through their categories, it was easy for me to see the impact broadband would have on each:

Family Fun – OK we only ranked 13. I have a family blog that alone should rank us higher than that. (To be fair, we were more obviously fun when the girls were little.) But especially when the girls were little, broadband helped us find fun. I scanned local calendars for fun things on a regular basis – from Winter Carnivals to art openings to pumpkin carvings. You name it, if we had an afternoon off, we could find fun. Also we used the internet to see things we’d never go see. Question about the Sphinx? We’ll look it up. For some families, gaming may be an issue or feature – and Paul Bunyan has shown us how fun and profitable that can be with their annual Gaming Contest. Not for us – but it has been a ticket into finding unusual activities.

Health & Safety – Access to remote healthcare – be it doctor emails or actual video visits has been a game changer, especially as a parent. And I’m a parent in a city. I can’t imagine the time savings not bundling up kids for every sneeze when the doctor is 10 miles away. Also portals make it easy to manage regular visits and payments. Telehealth use increased seven-fold in Minnesota between 2010-2015, and use continues to grow. But it also helps with healthier lifestyles. Many of us use devices (fitbits and others) to maintain healthy habits. And of course using the internet for quick fixes for getting out splinters or getting gum out of hair is a day saver too.

Education and Child Care – My kids have used broadband for assignments starting almost in kindergarten. In Kindergarten we used it to extend learning. But by second grade one was using Khan Academy for extra math support. They have all created and uploaded videos for class assignments. All have been required to access, complete and turn in assignments online. The youngest has created (on her own) online quizlets to help her with mock trial. Broadband is all but required for basic education but it is key for extending a student’s reach beyond formal education. (Last year, Blandin hosted a webinar on broadband and the homework gap.)

Affordability – Studies show that homes with broadband see an annual economic benefit between $1,850 and $10,500. And home buyers will pay seven percent more for a home with gigabit service; people wouldn’t pay that if they didn’t think there was a return on investment in education, healthcare or fun for their families.

Laws and Policies Affecting Broadband Access in Minnesota

The Network for Public Health recently posted a report on State Laws and Policies Affecting Broadband Access in Eight Northern Region States – including Minnesota.

Here is what they say specifically about Minnesota. Because tables don’t always transfer well here, I’ve manipulated the format a little but not the content…

Minnesota

Broadband Definition

  • “Broadband” or “broadband service” means any service providing advanced telecommunications capability and Internet access with transmission speeds that, at a minimum, meet the Federal Communications Commission definition for broadband. MINN. STAT. § 116J.39

State Leadership Body/Initiative

  • The Office of Broadband Development
    The Office of Broadband Development is established to serve as the central broadband planning body for the state and shall remain in existence until the commissioner of the Minnesota Department of Employment and Economic Development certifies that the state has met the broadband goals established in MINN. STAT. § 237.012. MINN. STAT. § 116J.39
  • State Statutory Goals
    It is a state goal that all Minnesota businesses and homes have access to highspeed broadband by 2022, among other goals. MINN. STAT. § 237.012

Statutory Funding
Border-to-Border Broadband Fund

  • Administration. The border-to-border broadband fund is administered by the Department of Employment and Economic Development. MINN. STAT. § 116J.396
  • Eligible Expenditures. Grants may be awarded under this section to fund the acquisition and installation of middle-mile and last-mile infrastructure that support broadband service scalable to speeds of at least 100 megabits per second download and 100 megabits per second upload. MINN. STAT. § 116J.395
  • Eligible Applicants. Eligible applications for grants include: (1) an incorporated business or a partnership; (2) a political subdivision; (3) an Indian tribe; (4) a Minnesota nonprofit organization; (5) a Minnesota cooperative association; and (6) a Minnesota limited liability corporation. MINN. STAT. § 116J.395

Preemptive/Restrictive Laws Regarding Municipal Broadband

Procedural Barriers

  • A municipality seeking to construct a new exchange where an exchange already exists shall not be authorized to do so unless 65 percent of those voting thereon vote in favor of the undertaking. MINN. STAT. § 237.19
  • The council of a municipality shall have the power to improve, construct, extend, and maintain facilities for Internet access and other communications purposes, if the council finds that: (i) the facilities are necessary to make available Internet access or other communications services that are not and will not be available through other providers or the private market in the reasonably foreseeable future; and (ii) the service to be provided by the facilities will not compete with service provided by private entities. MINN. STAT. § 429.021

Other

“Dig Once” Efforts

  • The Office of Broadband Development shall, in collaboration with the Department of Transportation and private entities, encourage and coordinate “dig once” efforts for the planning, relocation, installation, or improvement of broadband conduit within the right-of-way in conjunction with any current or planned construction, including, but not limited to, trunk highways and bridges. MINN. STAT. § 116J.391

Fiber Collaboration Database

  • The purpose of the fiber collaboration database is to provide broadband providers with advance notice of upcoming Department of Transportation construction projects so that they may notify the department of their interest in installing broadband infrastructure within the right-of-way during construction in order to minimize installation costs. MINN. STAT. § 161.462

Creation of Broadband Deployment Maps

  • The Office of Broadband Development shall oversee the creation of state and county maps showing the availability of broadband service at various upload and download speeds throughout Minnesota. MINN. STAT. § 116J.397

I see that they have the 2022 state speed goals but have missed the 2026, which are 100 Mbps down and 20 up.

The report also provides some easy ways to compare us with our neighbors; we’re not number one.

Also they frame broadband from a healthcare perspective, which is helpful in making the case that broadband is a solution to other problems – not a problem in and of itself…

Lack of broadband access at home can serve to exacerbate disparities in other social determinants of health, such as by limiting educational and employment opportunities. Lack of broadband access can limit online educational opportunities for students living in rural and underserved areas. With online curricula and resources being increasingly part of the educational experience, this puts many rural students at a significant disadvantage. Lack of broadband access can also limit employment opportunities. It may be difficult to draw businesses to communities lacking broadband access, and job-seekers also face logistical challenges in looking for work or applying for jobs online.

Connectivity also plays an important role in healthcare. In addition to accessing clinical services online via telemedicine, individuals can learn about health topics online, access their electronic health records, and learn about programs and opportunities to improve their health. Individuals without broadband access at home may not be able to take full advantage of these opportunities for remote care and health promotion.

 

Telehealth increases sevenfold in MN between 2010 and 2015

Minneapolis Star Tribune reports…

The popularity of telemedicine has soared among Minnesotans in the past decade, with urban dwellers seeking the convenience of routine care online and rural residents videochatting with distant doctors for everything from prescription refills to psychiatric sessions to cancer consults.

A first-of-its-kind report used a Minnesota database of health insurance claims and found that the number of telemedicine visits increased sevenfold from 2010 to 2015. The study is part of a special edition of the influential journal Health Affairs that assesses the national impact of telemedicine — a broad term to describe billable patient care that isn’t provided face to face, including online queries and videoconferencing.

There is a difference in how telehealth is happening in rural and urban areas…

Most of the increase was in virtual visits by privately insured patients in metro areas, who used online portals such as VirtuWell to receive routine care for sore throats and skin rashes.

Such visits accounted for only 20 percent of the 11,113 telemedicine visits in Minnesota in 2010, but 60 percent of the 86,238 visits in 2015.

Patients in rural areas used telemedicine more to connect with doctors in other communities — either to avoid long drives for routine checkups or to get second opinions from specialists, the data showed.

Duluth-based Essentia Health has videoconferencing in every one of its clinics in northern Minnesota. Patients in International Falls, for example, can connect remotely with doctors in seven different specialties, including psychiatry and cardiology.

And there’s room for growth…

Telemedicine accounts for less than 1 percent of all patient care visits, but the local study suggests continued growth. Abraham noted that her research did not assess the effectiveness of virtual vs. in-person visits, just the numbers of them.

Why are adults using health care devices?

Just a fun look at how people are using connected health devices from Internet Innovation Alliance…

It doesn’t actually say how many (or what percentage of) adults use a device for heath reasons but I think we could conservatively say a third do. I wore a Fitbit for years and I have to say for myself it did get me thinking about how to sneak in extra steps. So now I walk outside whenever I have a conference call. I’m getting exercise and I’m not distracted with my email. When I’m in a waiting room, I tend to pace. I park at the back of the lot.

It’s a little way that being online can make life a little better – for those who have access.

Digital equity stands in the way of Medicaid in Arkansas

I know this story is about Arkansas, not Minnesota but I know Minnesota was looking at a similar law last year. And sometimes it’s nice to learn from the sidelines. The Washington Post reports…

This summer, Arkansas became the first state to require poor people to prove they’re employed to receive Medicaid.

Specifically, recipients need to work 80 hours a month to get Medicaid…

More than 12,000 have been purged from the state Medicaid rolls since September — and not necessarily because they’re actually failing to work 80 hours a month, as the state requires.

The article tells the story of two recipients who lost their insurance because they didn’t have access and/or understanding of technology required to report hours and the rules behind the measure…

The state made reporting online-only to avoid hiring more staff. (It also didn’t allocate any additional dollars to help enrollees find work.) Officials did this even though Arkansas has the lowest level of household Internet access in the country, and the online portal doesn’t work well on smartphones. Once, when I tried it, I got an error message saying my phone’s browser was “not compatible.” The next day, it was mysteriously compatible again.

Most indefensibly, the website shuts down every single night  between 9 p.m. and 7 a.m. for “scheduled maintenance.”

No wonder 80 percent of those required to report work hours or exemptions each month are reporting nothing at all.

It reminds me of working on the library reference desk when Government Docs moved most of their documents online. It saved a lot of money in terms of printing for Government Docs but it suddenly meant most people had to go to the library to access these documents. It made a lot more work for the library and even more so the users of users of the info.

Broadband and technology can be a great way to cut costs but only when everyone has access to it and skills to use it.

Medical Licensure Compacts makes Telehealth easier in Minnesota

MHealth Intelligence reports on policies that will smooth the path to more telehealth usage…

More than 3,000 US physicians have received permission to practice in multiple states through the Interstate Medical Licensure Compact, giving them the opportunity to expand their practice through telehealth and telemedicine.

According to the Interstate Medical Licensure Compact Commission, a branch of the Federation of State Medical Boards, 3,426 medical licenses have been by medical boards in member states since the launch of the Compact in April 2017. The IMLCC, meanwhile, has processed 1,867 applications and 497 licenses have been renewed through the compact.

Minnesota part of the compact…

Launched as a means of expediting the licensure process for physicians looking to practice in more than one state, the compact has been approved in the District of Colombia, Guam and 24 states: Alabama, Arizona, Colorado, Idaho, Illinois, Iowa, Kansas, Maine, Maryland, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, Pennsylvania, South Dakota, Tennessee, Utah, Vermont, Washington, West Virginia, Wisconsin and Wyoming.

Telehealth & Broadband – tips for partnerships

Craig Settles has a new report on telehealth and broadband. Here’s the briefest description…

The bulk of the report gives three categories innovative and effective telemedicine applications: 1) general medical services, 2) mental health services, and 3) home health care. The summaries present how or why these are ideal to offer community broadband subscribers. The report concludes with highlights on developing a telemedicinenpilot project, and helpful recommendations.

He discusses affordability…

The digital divide’s impact is that many low-­‐income and lower middle class residents do not have internet access available, and so by extension they will have a hard time getting telehealth. Significant numbers of these individuals can’t afford access even if broadband reaches their neighborhoods. And if the infrastructure is poor, even well to-­‐do folks cannot get good broadband.

He discusses how partnerships are built between broadband providers and telehealth services…

Bottom line – both the vendors,  particularly start-­‐ups and medium size companies, and broadband owners share a mission – the need for plenty of customers and marketing clout. In addition, many of these organizations and committed to serving committed to serving communities’ disadvantaged and the low-come income residents,                so there’s a shared social as well as marketing mission.

And how partnerships can improve digital inclusion efforts…

To design the most effective digital literacy program, Seifer advises broadband and telehealth teams to consult with those community nonprofits most familiar wit the audiences that will use the telehealth programs. “If you’re trying to reach veterans with a telemedicine app, contact local or state organizations that service veterans that service veterans. If you are selling to seniors, talk to groups that deal with that population.”