Rural Health Support Mechanism
The Rural Healthcare Support Mechanism (RHCSM) is vital to the implementation and sustainability of telehealth programs throughout the nation. Since the inception of this program, rural broadband deployment has increased dramatically, thereby facilitating the expansion of telehealth networks designed to provide locally unavailable healthcare services to rural Americans. Despite recent regulatory changes implemented by the Federal Communications Commission (FCC), statutory and regulatory barriers still preclude the fullest deployment of telehealth services nationwide.
Issues
1. Currently only telecommunications providers contribute to the fund.
2. Only telecommunications services are eligible for the broadest discounts as regulated by the Federal Communications Commission (FCC). Currently, internet services only are eligible for discounts of 25%.
3. Changes in technologies have blurred the distinction between telecommunications services and information services, such that the type of bandwidth ("communications services") selected for most telehealth applications is generally transparent to the user.
4. If the collective "communications services" are to be discounted equitably based on bandwidth, equitable contributions to the fund should be made by any current and future provider of bandwidth to include long distance carriers, local carriers, cable companies, satellite companies, wireless providers, electric cooperatives, etc.
5. The new FCC definition of rural will eliminate many previously eligible telehealth providers located in underserved areas. Even if a previously eligible rural site is "grandfathered" that exemption will expire after Funding Year 2007.
6. The Act limits eligibility of rural healthcare providers to six categories, and fails to include bonafide providers of healthcare that include and are not limited to nursing homes, skilled nursing facilities, community mental health centers, and hospice providers.
7. The Anti-Deficiency Act prohibits the FCC from issuing funding commitments before the Universal Service Administrative Company (USAC) has collected sufficient funds to cover those commitments. A one year exemption has been granted and has now been extended for another year.
8. In 2004, President Bush established the position of National Coordinator, Health Information Technology (ONC) so as to develop a nationwide interoperable health information technology infrastructure. Such an infrastructure must reside on a platform of a broadband communications network.
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