Expanding Broadband for Healthcare Presentation to National Conference of State Legislatures Kerry McDermott Director, Healthcare Federal Communications Commission April 14, 2011 Discussion Topics FCC 101 National Broadband Map Universal Service Fund Reform Wireless as National Priority 2 1
Federal Communications Commission Established by Communications Act of 1934 Charged with regulating interstate and international communications by radio, television, wire, satellite and cable www.fcc.gov FCC Chairman: Julius Genachowski 3 National Broadband Map (www.broadbandmap.gov) 4 2
Universal Service Fund Supports Four Programs Schools and Libraries Total Disbursements, 2010 100% = $7.9 Billion Low Income Source: USAC data $2.2B $1.3B Rural Health Care $0.1B $4.3B High Cost High Cost focuses on service to all consumers (both residential and business) in high cost, rural and insular areas Low Income (Lifeline/Link Up) makes basic, local telephone service affordable for low-income consumers (vouchers) Schools and Libraries (E-rate) enables schools and libraries to connect to the Internet (discounts/matching funds) Rural Health Care provides reduced rates to rural health care providers (discounts/matching funds) 5 FCC Universal Service Proceedings Since The National Broadband Plan (March 2010) Schools and Libraries E-rate Community Use Waiver (February 2010), FY 2011 NPRM (May 2010) and Order (September 2010) EDU2011 Wireless Pilot Selected Applicants (March 2011) Rural Health Care Reform NPRM (July 2010) Low Income USF Joint Board Referral (June 2010), Recommended Decision (November 2010) Lifeline/LinkUp Reform and Modernization NPRM (March 2011) High Cost Universal Service NOI and NPRM (April 2010) Mobility Fund NPRM (October 2010) Universal Service/Intercarrier Compensation Transformation NPRM (February 2011) Broadband Data NPRM and release of National Broadband Map (February 2011) 6 3
Current Rural Health Care Program Rural Health Care Program Primary Program* Authorized up to $400M/yr FY 2009 = $72.3M Pilot Program Up to $417M over 3 years Initial period 2007 2010 62 projects Telecommunications Fund FY 2009 = $70.1M Alaska receives over half Internet Access Fund FY 2009 = $2.2M *Funding Year (FY) is July 1 June 30 7 Rural Health Care Program: Implementing NBP recommendations July 15, 2010 NPRM Seeks comment on: o Pilot Program -> Health Infrastructure Fund o Internet Access -> Health Broadband Services Fund o More flexible definition of health care provider to expand eligibility o Telecom fund would continue in current form o Clear program goals and performance measures es 8 4
Current High Cost Program Provides per-line support to carriers (wireline and wireless) for high-cost areas, mostly rural Support is for last mile infrastructure (network and switching), not middle mile infrastructure Support provided to Eligible Telecommunications Carriers (ETCs) Does not directly support broadband, although current rules have enabled some companies to use high-cost support to extend broadband But existing support is not targeted effectively High Cost program must be reformed in order to effectively promote broadband deployment 9 Pillars of Reform 1. Reform USF and ICC to Focus on Modern Networks - Explicitly support universal availability of bb and voice service - Target funds to areas otherwise uneconomic to serve - Accelerate transition to IP networks 2. Fiscal Responsibility - Eliminate waste, inefficiency, and redundancy - Create incentives for efficient operations and prudent investment - Constrain size of fund 3. Demand Accountability - Improved performance metrics and obligations 4. Market-driven and Incentive-based Policies - Facilitate deployment of technologies/services providing maximum value to consumers at lowest possible cost Predictable transition mechanisms no flash cuts 10 5
Connect America Fund (CAF) Transition portions of existing funding to support broadband - Phase down outdated programs - Modernize rules that lead to waste and inefficiency - Use savings to establish CAF Phase 1 8Identify unserved areas based on National Broadband Map 8Hold reverse auction - Many details to work out we seek comment Long-term CAF options - Competitive bidding process in all areas of country - Right of first refusal to incumbent, with support level based on model - Continue rate of return system in some areas, but with modifications 11 Healthcare Concerns in Connect America Fund Para. 149 Supporting anchor institutions (including healthcare facilities) Para. 291 Defining unserved areas Para. 395 Supporting middle mile networks Para. 408 Potential impact of limiting support to a single provider in a given area Para. 416 Size and role of CAF compared to other USF programs 12 6
Wireless devices can help improve health outcomes Source: AirStrip Technologies, VECTOR Project, Medtronic, CardioNet, Corventis 13 Spectrum is the oxygen that fuels wireless broadband 450X Hungry Devices Unit Sales in the US (millions) Smartphone sales to overtake standard phones by 2011 120 100 80 60 40 20 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Consumer Apps 30X Smartphones Standard Wireless Telephones Source: TIA, Wilkofsky Gruen Associates from TIA s 2009 ICT Market Review and Forecast. Standard Smartphone Mobile PC Source: Cisco National Purposes Civic Engagement Telemedicine Public Safety Smart Grid 14 7
Demand & supply trends suggest looming spectrum gap Forecasted mobile data traffic in North America Mobile broadband spectrum pipeline Need to transform spectrum policy to meet wireless broadband demands *In 2004 MDS/ITFS was rebanded to create the EBS/BRS band 15 Implications for States Better understanding of broadband gaps Targeted federal resources to solve broadband d challenges Improved connectivity for rural communities Expanded ongoing support for rural healthcare providers 16 8
To continue the dialogue Kerry McDermott, MPH Director, Healthcare Federal Communications Commission 202.418.1021 kerry.mcdermott@fcc.gov Thank you 9