tinitrd ~terrs ~rnatr WASHINGTON, DC 20510 410 May 25, 2018 The Honorable Ajit Pai Chairman Federal Communications Commission 445 12th Street SW Washington, D.C. 20554 Dear Chairman Pai, We write today in regards to the Federal Communications Commission's (FCC) intention to review the Rural Health Care (RHC) Program through a Notice of Proposed Rulemaking and Order and its solicitation for comment on the appropriate budget level. We strongly encourage the FCC to increase funding above the annual cap to ensure that all Americans have access to advanced telehealth services regardless of where they live. For over 20 years, the Rural Health Care Program (RHC) has provided subsidies to eligible health care providers for telecommunications and broadband services in order to improve the quality of care for patients in rural communities. The program encourages the formation of state and regional broadband networks, and Oregon has operated one of the largest and most innovative networks, OCHIN, since 2007. 1 Through this network, providers in Oregon received over $4 million in Rural Health Care Program funding in 2016, and have benefitted from over $35 million in support between 1998 and 2016.2 Though the program has grown considerably, funding has remained static: The program's $400 million annual cap has remained unchanged since its inception 20 years ago. In 2016, the program received $521 million in subsidy requests, surpassing the annual cap. It was recently announced that individual program participants will face a 15 percent cut in subsidies in fiscal year 201 7 and consortia members will face a 25 percent reduction. In Oregon, such a cut would be devastating. St. Charles Health System, headquartered in Bend, Oregon, would lose $120,000 in subsidies if the cuts were to take effect, according to recent coverage in the Bend Bulletin newspaper. 3 1 Rural Health Care Pilot Program. (2015, October 08). Retrieved from https://www.fcc.gov/general/rural-health­ care-pilot-program 2 (Rep.). (2016). Retrieved 2018, from https://www.usac.org/_res/documents/about/pdf/annual-reports/usac-annual­ report-interactive-2016.pdf 3 Hawryluk, M. (2018, May 21). Cuts threaten subsidies for rural health broadband. Retrieved from http://www. bendbulletin. com/localstate/6248 82 5-151 I cuts-threaten-subsidies-for-rural-health-broadband Rural health care providers face numerous and well-documented challenges in providing access to high quality health care. As technology, and specifically telecommunications, become increasingly central to the practice of medicine, improved broadband speed presents an opportunity to make strides in narrowing the urban-rural divide. The FCC's Rural Health Care Program has supported this effort for over two decades, and we commend the Commission for seeking comment on how to strengthen the program and keep up with growing demand. To this end, we urge the FCC to increase the current funding cap to match the growth of the program and support current recipients in rural communities across the country. Sincerely, R'::;dev:~ United States Senator Cc: Commissioner Mike O'Rielly Commissioner Mignon Clyburn Commissioner Jessica Rosenworcel Commissioner Brendan Carr