*Pages 1--1 from Microsoft Word - 44804.doc* SEPARATE STATEMENT OF COMMISSIONER JONATHAN S. ADELSTEIN Re: Rural Health Care Support Mechanism, Second Report and Order, Order on Reconsideration, and Further Notice of Proposed Rulemaking I’m pleased to support this Order which updates and strengthens the Rural Health Care program established by Congress in Section 254 of the Act. During my time as an FCC Commissioner, I have seen first hand the positive effects that telemedicine programs can have on rural communities. Telemedicine programs enable rural residents to bridge distances that might otherwise be unaffordable or physically impracticable to cross. The funding provided by the Rural Health Care program is crucial to the sustainability of many telemedicine programs. Our work on this program is what makes our jobs as public servants rewarding and should help the program fulfill its enormous potential to improve the quality of health care in Rural America. In this Order, we take an important step by updating the definition of “rural areas” that are eligible for funding under the Rural Health Care program. Many parties argued persuasively that our prior definition of “rural areas” was overly restrictive and obsolete. I am hopeful that the definition adopted here will facilitate access to health care services for greater numbers of our underserved Americans who reside in rural areas, but understand that none of the proposed definitions was perfect. To that end, I am pleased that this Order grandfathers existing funding recipients for three years. This will give the Commission ample opportunity to gauge the effectiveness of our new definition. The Commission takes other notable steps to improve the effectiveness of the Rural Health Care program in this Order. In particular, I am pleased that we expand funding for mobile rural health care services in this Order. The ability of mobile rural health care providers to reach hard- to- serve customers is increasingly important. For example, these services are being used to deliver high quality, real- time digital mammography services to Native American tribes in my home state of South Dakota. The Commission appropriately recognizes that satellite services may be the most cost- effective and efficient way of delivering advanced telemedicine services to mobile rural health care providers and revises the funding mechanism for these services. In addition, the Commission permits rural health care providers in entirely rural states to receive support under the program. This decision is particularly important to address the unique circumstances of health care providers serving geographically isolated areas. Finally, I am pleased that we are continuing to look for ways to improve this program through a Further Notice. In this item, we seek comment on whether to increase the percentage discount that rural health care providers receive for Internet access and whether infrastructure development should be funded. I eagerly await the ideas that health care and service providers will offer in response to our request for more information. My commitment to universal service is based on the fundamental belief that a chain is only as strong as its weakest link. Today we further fortify the links in our communications network and, in so doing, we strengthen our nation as a whole. That effort is worthy of the strong support we are giving this initiative today. 1