Doctor in Duluth asks policymakers to make COVID telehealth changes permanent

The Duluth News Tribune runs a letter to the editor from Dr. Sarah Manney is the chief medical information officer at Essentia Health in Duluth…

We didn’t conduct our first virtual visit until mid-March 2020. Within weeks, we were performing thousands per day, peaking at more than 3,500. One year later, we have surpassed 400,000 virtual visits. Further, 80% of our mental health encounters were done via virtual visits this last year. For those patients, when one of the biggest hurdles is simply getting out of the house to seek help, that initial obstacle was rendered obsolete by the accessibility of virtual visits.

We’ve also done more than 100,000 e-visits, which are targeted at 20 of the most common conditions, pushing Essentia’s telehealth encounters in a single year well north of half a million. And this was only the first year; imagine how many more people will benefit from these innovative offerings as they become more prevalent.

Right now in Minnesota, we have a tremendous opportunity to increase that access. We can make permanent some of the temporary advances that occurred because of COVID-19 through bipartisan legislation — specifically, Senate File 1160 and House File 1412. The bills are sponsored by Republican Sen. Julie Rosen and DFL Rep. Kelly Morrison, one of two physicians in the Legislature.

While previous law required patients to visit a health care provider site to access telehealth, this bill would continue to allow providers to deliver telehealth services directly to a patient’s home setting via audio-only telephone calls or secure two-way audio-video services on a tablet or computer. The legislation would allow scheduled visits to be conducted by phone when a patient does not have internet access or the appropriate electronic device.

These care-delivery practices are currently in effect due to COVID-19. But we feel strongly that they should become a staple of 21st century health care, even after the pandemic. They let patients receive treatment that may prevent the worsening of chronic health issues and may reduce potentially avoidable emergency-room visits.

Kandiyohi County is poising to use American Rescue Plan funding for broadband

West Central Tribune reports…

Kandiyohi County is gearing up to complete broadband projects in the county, with the hope it will be able to use money from the American Rescue Plan to help fund those projects.

The County Commissioners are poising to take advantage of any opportunity…

With the passage of the American Rescue Plan, the $1.9 trillion economic stimulus package enacted by the federal government in March, the county could find itself with an influx of federal funding, an estimated $8.38 million, which early guidance says can be used for broadband projects.

The County Board work session was scheduled Tuesday to make sure the commissioners were up to date on county broadband challenges and opportunities.

“So when we get the federal American Rescue dollars, hopefully we can use some of those dollars for broadband, we can hit the ground running,” Kleindl said. “We want to be ready. Today we are at the starting blocks. We are putting our foot on the race and we are going to kick it off.”

They are already working…

Officials are now working on a new project with Federated Telephone Cooperative, to bring high-speed broadband access to Arctander, Dovre, Mamre and St. Johns townships. The project is estimated to cost between $6,818,656 and $7,626,906 depending on the size of the service area to be included in the new project. The plan would provide broadband to nearly 600 properties.

The county has already approved a $25,000 grant to each of the townships for broadband expansion and Federated has said it will provide 25 percent of the project costs. All four of the townships are also on board, estimating to pay around $1,945,597 in total.

“Everybody will need to have some skin in the game,” said Commissioner Corky Berg.

The EDC is also applying for a state Border-to-Border broadband grant for about 50 percent of the project costs. Without the state grant, which is very competitive, the project will not be possible, Schmoll said.

They are asking residents to take the speed test to help the State recognize the need…

We know how important it is to get broadband out. We need citizens’help to do that,” Kleindl said.

This could mean writing letters to legislators, providing letters of support to the EDC and participating in the state internet speed test. In 2020, residents were urged to take the speed test. And while some did, more is needed.

“It is important for us to know where the underserved, unserved people are,” Kleindl said. “Do your part.”

MN Senate Ag Committee (Chair Den Westrom) pass omnibus with $40 million for broadband

Minnesota State Senate Republicans report

Senator Torrey Westrom (R-Elbow Lake), Chair of the Senate Agriculture Committee, passed the committee’s omnibus bill on Wednesday to fund agriculture, rural development, and rural COVID recovery.

The bill includes some funding for broadband…

Further, this bill funds the Border-to-Border Broadband Grant program at $40 million over the next two fiscal years. Rural Minnesota has faced the brunt of lack of Internet access, and this funding will develop permanent broadband infrastructure in unserved and underserved areas. Minnesota contains large segments of the state that fall into the categories of unserved and underserved. This significant funding from the legislature matches the critical need that has become apparent this year.

“Broadband is essential to our way of life. This has become even more clear over the past year as Minnesotans have struggled to work remotely and navigate Covid-19. If students can only access school online, it is imperative that accessibility to an internet connection is widely available. Funding broadband is addressing the issue head-on and will help rural Minnesotans flourish,” Westrom remarked.

Aitkin County interested in extending waivers that support telehealth

Aitkin Age reports

Last March, Gov. Tim Walz declared a peacetime state of emergency, issuing waivers to health care providers that temporarily granted them increased flexibility in responding to the COVID-19 pandemic. Across Minnesota, standard regulations for treatment location, telehealth services, and administrative activities were relaxed.

The state of emergency is set to expire on April 14. It is not known whether Walz will extend it beyond that date.

Cynthia Bennett, the director of Aitkin County Health and Human Services, said that a number of the waivers, such as more flexibility in terms of remote work, should stay in place.

“We had to make all these adjustments because we were not supposed to be face-to-face and we needed to comply with the governor’s executive orders for social distancing,” she said. “And it worked out well, so we would like to continue that, because we found cost savings for taxpayers.”

The waiver are what made telehealth possible and affordable during the pandemic. The increase in use is one of the silver linings of the pandemic allowing more patients to be seen and reducing drive times for patients and often for family or friends who would drive them to appointments out of town.

Sen Klobuchar hears that some students may want to continue online post-pandemic

West Central Tribune reports…

The mental health of students and teachers, free and reduced lunches, and the possibility of distance learning into the next school year were at the top of local school leaders’ concerns in a conversation with Sen. Amy Klobuchar on Wednesday, March 31.

Klobuchar met in a conference call with the superintendents of four northwest Minnesota school districts — East Grand Forks Public Schools, Stephen/Argyle Central School District, Park Rapids Area Schools and Greenbush Middle River School District — to discuss how the districts have fared during the pandemic, as well as their concerns going forward. The intent was to help guide Klobuchar’s legislative priorities in Washington.

They discussed topics I expected…

The superintendents also brought up the issues of rural internet access, which is still limited in many areas of northwest Minnesota, and of mental health, which impacted every level of the school communities during the pandemic.

And one that I did not…

The discussion was expected to cover distance learning, high-speed internet, nutrition and mental health, according to a media advisory. But other topics arose and seemed to take the senator by surprise, particularly a concern raised by East Grand Forks Superintendent Mike Kolness, who worries some students who have found they thrive in a virtual setting may depart from the district next year in favor of a virtual academy.

“I get asked this question probably daily about are we going to have to continue with distance learning next year,” Kolness said. “And that’s a big question for families and educators and, whether it be mandated by state or federal government or just by the loss of students, if we don’t provide that service and we have 100 students still want to participate in distance learning, we’re going to lose those students to a virtual academy somewhere. That’s concerning.”

There are approximately 2,000 students in the East Grand Forks district, Kolness said, and the district transitioned back to full-time in-person learning for all students after middle and high school students spent the first semester in a hybrid learning model. However, he estimates there are still about 150 students who have opted to remain in a full-time distance learning program.

A decline in the student population could bring financial impacts to the school district, as some state and federal funding is based on student enrollment. This semester, East Grand Forks schools already reported their lowest enrollment numbers in several years.

I am envious of a family that likes distance education but I understand the conundrum. It is a reminder that “going back to normal” post-pandemic is going to look at lot different and opportunities are going to look more similar in urban and rural locations – as long as there’s adequate, affordable broadband.

OpenVault finds big increase in upload broadband traffic in 2020

OpenVault optimizes networks. The just releases their Q4 2020 broadband network report. A lot of what they deal with is a deep dive for non-broadband providers and much of what they look at is volume, not speed but there are some interesting points. At a high level here are some of the high level observations:

  • The pandemic driven year of 2020 saw dramatic increases in both bandwidth usage and new subscriber growth. The combination has driven as much as 51% of additional on-net traffic on networks observed by OpenVault.
  • The continued growth in upstream bandwidth, up 63% year-over-year at the end of 2020, is particularly noteworthy for network operators who are challenged with managing upstream bandwidth on their network.
  • For the first time, over half (50.6%) of all subscribers are now provisioned for the 100 – 200 Mbps speed tier. Lower speed tiers of less than 100 Mbps are now seeing penetration of only 21.5%.
  • Growth in median usage, up 54% year-over-year at the end of 2020, demonstrates that bandwidth usage growth defined by the pandemic is distributed evenly across most users and not driven by outliers or extreme users.

The growth in upload speed is especially interesting to me. Open Vault talks about the strain that increased upload has had on the network

FCC Creates Consumer FAQ for Emergency Broadband Benefit

Yesterday the FCC updated their site with more info on the Emergency Broadband Benefit. Here are the questions…

When can I sign up for the Emergency Broadband Benefit?

The program has been authorized by the FCC, but the start date has not yet been established.  The FCC is working to make the benefit available as quickly as possible, and you should be able to sign up by the end of April, 2021.  Please check our website, www.fcc.gov/broadbandbenefit, regularly for the latest information.

Do I receive the funds directly each month?

No, the Emergency Broadband Benefit provides a monthly discount on broadband service of up to $50 per eligible household (or up to $75 per eligible household on Tribal lands).  The participating broadband service provider will receive the funds directly from the Emergency Broadband Benefit program.

Which broadband providers are participating in the Emergency Broadband Benefit?

Various broadband providers, including those offering landline and wireless broadband, will be participating in the Emergency Broadband Benefit.  Depending on where you live, you may have a choice of providers.  Check with the broadband providers in your area to learn about their plans for program participation and eligible service offerings.  You can also use the Companies Near Me tool found here.

sort byWhat is the enhanced benefit amount for residents of Tribal Lands?

Eligible households on Tribal lands can receive a total monthly discount of up to $75.  You can find out more about which areas are eligible Tribal lands by visiting this site: www.lifelinesupport.org/additional-support-for-tribal-land.

Ramsey County TechPak initiative: Tech for folks who needed it see $2.40 return for every $1 spent

TechPak was a program that helped get technology into the hands that needed it during the pandemic. Read below for details or watch the video but know that they report a great ROI…

The projected SROI for the TechPak initiative is $2.40 for every $1 dollar spent.

TechPak, a partnership between Tech DumpLiteracy MinnesotaSaint Paul Public Library and Ramsey County, is a new initiative bringing computers, internet and digital literacy training into the homes of Ramsey County residents who have experienced economic impacts due to COVID-19. The packs include a refurbished laptop, a hotspot for internet access and quick start guides.

During the upcoming enrollment period, Aug. 31-Sept. 2, TechPaks will be awarded to eligible Ramsey County residents who have experienced job loss, reduced hours, change of household income or have other barriers due to COVID-19. Additional application periods will be offered from September through December 2020. An anticipated 500 TechPaks will be distributed by the end of the year.

Laptop donations for this program are being accepted by Tech Dump. Laptops will be securely wiped of all data, updated and repaired, and then assessed for use. Donations can be made by contacting Tech Dump at techdump.org or calling 763-432-3117.

Additional information about TeckPaks can be found at ramseycounty.us/TechPak.

COVID19 opens the doors for continued legislative support for telehealth

Minneapolis Star Tribune reports

The use of electronic devices in patient care, known as telehealth, has long held promise as the next big thing in the industry, but not until the coronavirus hit, raising a host of safety concerns, did it become commonplace.

Nearly 30% of health care visits are now conducted electronically, much of it made possible because federal and state regulators, as well as insurance providers, responding to the pandemic emergency, relaxed some of the rules and requirements that made it more difficult to use telehealth.

For example, under Minnesota law, some patients had to drive to a clinic or hospital to use that facility’s secure telecommunications equipment if they wanted to talk with a doctor located at another site. In the past year, that rule has been waived.

As the number of COVID-19 cases begins to rise once again in Minnesota, there is bipartisan support at the Legislature to make permanent many of the changes that have driven the increase in telehealth, with both chambers advancing bills to rewrite the state’s telehealth laws.

That’s quite an increase…

Before the pandemic, telehealth accounted for 3% of patient visits, according to a Minnesota Medical Association survey.

And there are benefits…

“The addition of virtual care clearly was a benefit to the patient, their satisfaction went up, quality went up and overall costs went down because we really architected our system to take advantage of virtual care,” he said.

The virtual visits worked best with patients who already had an established relationship with the physician and clinic and where hands-on care, such physical exams or blood draws, were not needed.

Telehealth also has been extremely popular in mental health and substance use treatment, with many health care systems reporting high volumes of therapy visits.

But providers need the reimbursement to make it happen…

Providers say it is important that they get the same insurance reimbursement payments as in-person visits because overhead costs are the same for virtual visits.

“It is not bricks and mortar costs as much as the infrastructure and all the people behind it to do that work,” said Ingham. “You can’t have virtual visits without those foundational costs.”

MN to get $5 billion for COVID relief – broadband would be a good fit

Minneapolis Star Tribune reports…

Billions of dollars for public construction projects would come raining down on Minnesota in the coming years if President Joe Biden’s push for a massive infrastructure package is successful.

Fresh off passing $1.9 trillion in COVID relief, the new Democratic White House is turning next to an even more ambitious spending proposal. The Biden administration is briefing congressional allies and interest groups on hopes for at least $3 trillion in new federal money for a range of domestic priorities, including $1 trillion for roads, bridges and other transportation projects nationwide.

Minnesota will get a slide of it…

Almost $5 billion is now bound for Minnesota state and local governments from the COVID relief bill, intended to ease a pandemic-driven strain on public services. The administration has not yet detailed an infrastructure plan, but the size of spending under discussion carries the potential to transform the state’s economy and physical landscape.

Broadband is a part of it…

An expansive definition of infrastructure is likely in whatever Biden proposes, encompassing not just transportation systems but also power grids, broadband networks, wastewater treatment facilities and affordable housing projects. Progressive policy goals will influence project lists and construction standards.

EVENT Mar 29: NDIA Hosts Emergency Broadband Benefit Webinar

From the NDIA (National Digital Inclusion Alliance)...

The FCC has confirmed and released the rules on the Emergency Broadband Benefit (EBB) program. The EBB program will provide eligible households with subsidies up to $50 a month for internet service ($75 a month for tribal households) and up to $100 for devices.

With the rules on the Emergency Broadband Benefit confirmed by the FCC, NDIA is creating a list of FAQs to assist our affiliates with understanding how to navigate the program and what to expect before sign-ups are opened to the public.

We will review these FAQs and other resources during an EBB Webinar on Monday, March 29th at 4 PM ET.

American Rescue Plan Commits Billions to Broadband

CTC Technology and Energy report

resident Biden signed the American Rescue Plan Act into law on March 11, 2021. Included in the $1.9 trillion package is significant funding that can be used to support expansion of broadband infrastructure and initiatives. We’ll provide updates and analysis in this space as we learn more. Based on our initial review of the new law, here are some of the key broadband-related funding provisions:
  • Economic Development Administration (Department of Commerce): $3 billion in additional funding to the Public Works and Economic Adjustment Assistance (PWEAA) program through September 2022
  • Coronavirus Capital Projects Fund (Department of the Treasury): $10 billion for “capital projects directly enabling work, education, and health monitoring, including remote options, in response to the public health emergency”; in addition to capital projects, eligible efforts include ancillary services (such as broadband mapping) to increase efficiencies of capital projects, and cost support efforts (such as subsidies)
  • Emergency Connectivity Fund (FCC): $7.2 billion for E-Rate support to reimburse schools and libraries for provision of eligible equipment and advanced telecommunications and information services during the pandemic, including for locations other than schools and libraries
  • Coronavirus State Fiscal Recovery Fund: $219.8 billion for investments in water, sewer, or broadband infrastructure
  • Coronavirus Local Fiscal Recovery Fund: $130.2 billion for rural community development block grants (CDBG) ($45.6 billion), rural areas ($19.5 billion), and counties ($65.1 billion, population-based), including for investments in water, sewer, or broadband infrastructure
  • Local Assistance and Tribal Consistency Fund: $500 million ($250 million per year for 2022 and 2023) for Tribal use only “for any governmental purpose other than a lobbying activity”

Wisconsin is using drones to bring broadband to students in Northwoods

People are so clever. I love the innovation here. It’s not a permanent fix but what a great way to reach people who currently don’t even have enough cell coverage to support students or workers trying to get online at home. I know there are areas in Minnesota that are in the same boat! Wisconsin Public Radio reports

Rural Northwoods students who lack reliable internet at home will soon be able to connect to their school networks via a drone-powered cellular signal.

A Wisconsin startup will be part of a state-funded pilot program in the Eagle River area that will test the use of drones as a way to expand internet connectivity into rural areas.

It’s a partnership between the new company Wisconsin Telelift and the Northland Pines School District. The drones will be fitted with cellphone towers, allowing students throughout the sprawling Northwoods district to get online, even in rural areas where cellphone service and broadband access are unavailable or unreliable.

It’s a real need in a district that is among the state’s largest geographically, spreading over 435 square miles in Vilas and Oneida counties.

As many as 15 percent of the district’s 1,340 students have no internet access at home, said Northland Pines administrator Scott Foster, and half of its students have unreliable connections that don’t always allow for streaming video and other tools used in educational software. The district provides Chromebooks to its students and portable hotspots to those who need them — but the hotspots can only work where there is a strong cellular signal. In much of the district, that’s just not the case.

Senator Klobuchar and Hon Clyburn introduce Accessible, Affordable Internet for All Act

The Hill reports

House Majority Whip James Clyburn (D-S.C.) and Sen. Amy Klobuchar (D-Minn.) are reintroducing legislation Thursday aimed at improving internet access in impoverished communities.

The Accessible, Affordable Internet for All Act would invest $94 billion in expanding broadband infrastructure and connecting Americans.

“Access to broadband today will have the same dramatic impact on rural communities as the rural electrification efforts in the last century,” Clyburn said in a statement.

Beyond building necessary infrastructure, the legislation requires internet providers that use the funding to offer affordable service plans.

It also authorizes an additional $6 billion for the Emergency Broadband Benefit, which gives qualifying Americans a discount on internet plans.

The legislation would also add an extra $2 billion to the $7 billion in funding for the E-Rate program that was included in the coronavirus relief package expected to be signed by President Biden later this week.

Study of Libraries in pandemic indicate need to focus on home internet access

New America released a report on libraries and COVID. I’m sure no readers will be surprised, but it turns out that the pandemic highlighted disparities between folks who could get online at home and those who couldn’t…

The pandemic has laid bare the extent of social and educational disparities by racial group, income, and education level. It has particularly affected those without high-speed home internet access, a group in which people of color, low-income Americans, and rural communities are over-represented. These disparities are the legacies of systems that were not built with everyone’s welfare in mind—such as library systems that were originally segregated and educational systems and technology networks designed by and for those able to afford and connect to the internet. The disparities are affecting the way people become aware of, connect to, and use their public libraries, and they need to be addressed head-on by libraries, education leaders, and policymakers both during and after the pandemic.

Our findings highlight the need for more inclusivity, more focus on providing internet access, and more awareness-raising initiatives with local organizations and schools. The stories in this report—of libraries developing mobile Wi-Fi options, creating digital navigator programs to support digital literacy, launching more online programs, and making use of outdoor spaces—show the possibilities of transformation and partnership. The report concludes with eight recommendations for investment in library transformations, expansion of policies such as E-Rate and the Emergency Broadband Benefit to provide better internet access at home, and more collaboration with local schools and organizations. With these changes, libraries can leverage the lessons of the pandemic to help launch more equitable ecosystems of learning across communities, providing access to knowledge, resources, and training, online and off.

The prevalence of broadband in the recommendations highlights the importance of broadband…

For policymakers:

  • Invest in efforts by libraries and schools to bring internet access, online resources, and other tools to underserved households and communities.
    • Expand the E-Rate Program so that libraries and schools can get discounts on the technology services that patrons and students need to get online from home.
    • Support schools, libraries, and community-based organizations in distributing devices such as tablets, laptops, and hotspots.
  • Improve broadband access to low-income households.
    • Make the new $50-per-month Emergency Broadband Benefit permanent and integrate it into the Lifeline program.
    • Require internet service providers to be more transparent about internet costs and hidden fees.
    • Enable municipalities to provide internet service.
  • Encourage collaboration by developing grant programs and other incentives for community-based organizations, libraries, and schools to work together in raising awareness and jointly delivering library services.
  • Provide funding for the expansion of tech-support programs such as Digital Navigators and other programs that enable on-demand, one-on-one troubleshooting, mentorship, and guidance.
  • Provide funding for needs assessments and other research to take stock of how public libraries are used within communities that are marginalized or underserved.

For libraries:

  • Increase outreach and communications efforts to make more residents aware of offerings both online and off.
    • Target outreach so that low-income households; Black, Hispanic, and Asian households; and patrons whose first language is not English are welcomed and connected to the library.
    • Experiment with mobile offerings that bring the library to underserved communities.
    • Establish Digital Navigator programs and similar mentoring initiatives that help patrons build technological fluency, digital literacy, and media literacy skills.

For educators and leaders of community-based organizations:

  • Develop deeper partnerships with libraries to build awareness of resources for clients and students.

  • Include library leaders in strategic planning for programs and services.