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 Federal  Communications  Commission  FCC  06-  144 
 STATEMENT  OF  COMMISSIONER  JONATHAN  S.  ADELSTEIN 


 Re:  In  the  Matter  of  Rural  Health  Care  Support  Mechanism,  WC  Docket  No.  02-  60 
 In  this  Order,  we  expand  the  Federal  Universal  Service  Rural  Health  Care  program  to  include  a  pilot  program  to  fund  the  construction  of  broadband  infrastructure  to  connect  rural 
 health  care  providers.  The  telemedicine  programs  funded  through  the  Rural  Health  Care  program  can  have  dramatic  benefits  for  rural  communities,  and  I  have  repeatedly  supported  efforts  to 
 improve  the  connectivity  of  rural  health  care  providers. 
 I  have  been  privileged  during  my  time  as  an  FCC  Commissioner  to  have  seen  first  hand  the  way  that  telemedicine  programs  enable  rural  residents  to  bridge  distances  that  might 
 otherwise  be  unaffordable  or  physically  impractical  to  cross.  The  telemedicine  applications  funded  through  the  Rural  Health  Care  program  may  be  the  only  viable  link  to  vital  diagnostic 
 services  and  specialized  care  for  many  patients.  With  advances  in  digital  imaging,  rural  health  care  providers  are  increasingly  able  to  send  medical  records,  CAT  scans,  and  other  lab  results  to 
 specialists  in  distant  locations.  Connecting  our  health  care  providers  can  also  play  a  critical  role  in  promoting  continuing  education  through  distance  learning  for  our  health  care  professionals. 


 More  than  ever  it  is  critical  that  we  expand  the  connectivity  of  our  health  care  providers  to  improve  our  ability  to  respond  to  disasters,  natural  and  man-  made.  As  we  have  seen  repeatedly 
 in  the  past  few  years,  our  communications  systems  are  a  critical  factor  in  our  ability  to  respond  quickly  and  in  a  coordinated  fashion. 


 The  funding  provided  by  the  Rural  Health  Care  program  is  crucial  to  the  sustainability  of  many  telemedicine  programs.  Without  universal  service,  the  high  cost  of  telemedicine  services 
 might  put  them  out  of  reach  of  many  small  communities.  Yet,  the  Rural  Health  Care  program  has  consistently  been  underutilized  despite  widely-  varying  levels  of  connectivity  among  rural  health 
 care  providers.  So,  I  was  pleased  to  support  our  2004  Notice  of  Proposed  Rulemaking  in  which  we  sought  comment  on  whether  to  fund  infrastructure  development  for  rural  health  care 
 providers,  and  I  am  pleased  that  we  take  a  step  in  that  direction  today.  A  well-  tailored  pilot  program  has  the  potential  to  give  us  critical  information  about  the  needs  of  health  care  providers 
 and  the  resources  required  to  establish  connectivity. 
 While  I  support  our  efforts  to  make  additional  funds  available  for  telemedicine  uses,  I  have  had  some  concerns  about  the  specific  implementation  of  this  program  –  some  of  which  have 
 been  addressed,  while  others  still  give  me  pause.  One  area  where  the  item  could  be  improved  is  in  its  articulation  of  criteria  for  selecting  program  participants  among  the  potentially  myriad  well-qualified 
 applicants  who  may  seek  funding.  While  I  appreciate  my  colleagues’  willingness  to  amend  the  criteria  to  give  weight  to  applications  that  serve  rural  areas,  this  Order  could  do  more 
 to  explicitly  prioritize  projects  that  target  services  to  rural  areas.  Nor  does  the  Order  assign  any  apparent  weight  to  the  selection  of  applicants  willing  to  deploy  facilities  to  unserved  areas,  or 
 applicants  targeting  service  to  the  most  needy  or  hardest-  to-  serve  areas.  Had  we  sought  comment  on  whether  to  create  a  pilot  program  and  how  to  tailor  it,  we  likely  would  have  greater  clarity  and 
 transparency  here  but,  unfortunately,  that  is  not  the  case. 
 With  an  entirely  new  program,  and  given  the  importance  of  this  effort,  I  also  would  have  preferred  a  longer  application  window.  Even  in  a  more  established  program  like  our  Schools  and 
 Libraries  program  we  give  applicants  sixty  days  to  file  their  funding  requests  from  our  publication  of  the  Eligible  Services  List.  But  I  appreciate  the  Chairman’s  commitment  to  extend 
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 the  application  deadline  for  interested  parties  who  would  like  to  participate  but  may  require  additional  time.  It  will  also  be  critical  for  us  to  do  as  much  outreach  as  possible  to  solicit  a  wide 
 variety  of  applicants.  We  all  want  to  improve  the  connectivity  of  our  health  care  providers  as  quickly  as  possible,  but  if  we  are  trying  to  create  a  program  that  is  above  reproach  and  that  truly 
 is  open  to  all  --  including  small  communities  and  Tribal  providers  who  may  not  have  the  resources  to  assemble  proposals  on  a  moment’s  notice  --  we  must  give  health  care  providers  a 
 meaningful  opportunity  to  participate  and  the  Commission’s  selection  processes  should  be  as  transparent  as  possible. 


 This  program  is  so  important,  we’ve  got  to  get  the  details  right.  So,  I  thank  my  colleagues  for  their  willingness  to  accommodate  some  of  my  concerns  and  look  forward  to 
 working  together  to  further  Congress’  goal  of  connectivity  for  rural  health  care  providers. 
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