COVID-19: CARES Act Telecom Initiatives and Telehealth Program

COVID-19: CARES Act Telecom Initiatives and Telehealth Program

Rural Utility Service (RUS) Distance Learning, Telemedicine and Broadband Program

The CARES Act (“the Act”) appropriates $25 million, or an additional one-third, to the budget for the RUS Distance Learning, Telemedicine and Broadband Program to be used for telemedicine and distance learning in rural areas. State and local governmental entities, federally recognized tribes, nonprofits and businesses are eligible to receive funds under RUS. While the first window for applications runs through April 10, 2020, the United States Department of Agriculture recently opened a second window – during which only online applications will be accepted – that will run from April 14, 2020 through July 13, 2020. Additional information on how to apply for the second window will be available on grants.gov on April 14, 2020.

Under the Act, the term “telehealth” means the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration. Such telecommunications technologies include:

• Videoconferencing;
• Internet;
• Streaming media; and
• Terrestrial and wireless communications.

Federal Communications Commission COVID-19 Telehealth Program Funding

The Act allocates $200 million to the Federal Communications Commission (FCC) to provide funds to support “efforts of health care providers” to address the COVID-19 pandemic by providing telecommunications services, information services, and devices and equipment necessary to enable the provision of telehealth services during an emergency period¹.

According to the FCC, this $200 million allocation will immediately support health care providers responding to the pandemic by assisting eligible health care providers in purchasing telecommunications services, information services, and devices. The FCC has developed a streamlined application process for health care providers, and the FCC will award funds to selected applicants on a rolling basis until the funds are exhausted or until the current pandemic has ended. The FCC does not anticipate awarding more than $1 million to any one applicant but applicants that exhaust initial funding may reapply.

The FCC limits its definition of an eligible health care providers to not-for-profit and public eligible health care providers that fall within the categories of health care providers in section 254(h)(7)(B) of the Telecommunications Act of 1996. The categories for a public eligible health care provider are:

1. Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools;
2. Community health centers or health centers providing health care to migrants;
3. Local health departments or agencies;
4. Community mental health centers;
5. Not-for-profit hospitals;
6. Rural health clinics;
7. Skilled nursing facilities; and
8. Consortia of health care providers consisting of one or more entities falling into the first seven categories.

To be considered for participation in the COVID-19 Telehealth Program, interested eligible health care providers must submit applications that, at a minimum, contain the following information:

• Names, addresses, counties and health care provider numbers (if available) for health care providers who seek funding through the COVID-19 Telehealth Program application and the lead health care provider for applications involving multiple health care providers.
• Contact information for the individual that will be responsible for the application (telephone number, mailing address and e-mail address).
• Description of the anticipated connected care services to be provided, the conditions to be treated, and the goals and objectives.
  • This should include a brief description of how COVID-19 has impacted the area, the area’s patient population and the approximate number of patients that could be treated by the health care provider’s connected care services during the COVID-19 pandemic.
  • If a health care provider intends to use the COVID-19 Telehealth Program funding to treat patients without COVID-19, they should describe how this would free up resources to be used to treat COVID-19 and/or how this would otherwise prevent, prepare for or respond to the disease by, for example, facilitating social distancing.
• The estimated number of patients to be treated.
• Description of the telecommunications services, information services, or “devices necessary to enable the provision of telehealth services” requested and the total amount of funding requested, as well as the total monthly amount of funding requested for each eligible item.
  • If requesting funding for devices, description of all types of devices for which funding is requested, how the devices are integral to patient care, and whether the devices are for patient use or for the health care provider’s use. As noted above, monitoring devices (e.g., pulse-ox, BP monitoring devices) will only be funded if they are themselves connected.
• Supporting documentation for the costs indicated in the application, such as a vendor or service provider quote, invoice or similar information.
• A timeline for deployment of the proposed service(s) and a summary of the factors the applicant intends to track that can help measure the real impact of supported services and devices.

Additionally, at the time of submission of their application, the FCC is requiring COVID-19 Telehealth Program applicants to certify, among other things, that they will comply with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable privacy laws, reimbursement laws and regulations, and applicable medical licensing laws and regulations, as waived or modified in connection with the COVID-19 pandemic. Applicants must retain their records to demonstrate compliance with the COVID-19 Telehealth Program requirements and procedures for three years following the last date of service.

Applications for the COVID-19 Telehealth Program must be submitted through the FCC’s Electronic Comment Filing System under WC Docket No. 20-89. The Commission will begin accepting applications for the COVID-19 Telehealth Program after publication of the Report and Order and notice of the Office of Management and Budget’s approval of the COVID-19 Telehealth Program information collection requirements in the Federal Register.

The Wireline Competition Bureau, in consultation with the FCC’s Connect2Health Task Force, will evaluate the COVID-19 Telehealth Program applications and will select participants based on applicants’ responses to the criteria listed above.

Interested health care providers that do not already have an eligibility determination can obtain one by filing an FCC Form 460 with the Universal Service Administrative Company. Information for the FCC’s Form 460 can be found at the FCC website. Applications may be filed while eligibility determinations are pending.

The FCC also established a Connected Care Pilot Program within the Universal Service Fund as a separate longer-term initiative.

RUS Pilot Program

The Act provides $100 million for additional grants to service providers under the RUS broadband deployment pilot program, ReConnect, for infrastructure projects. Applications are due April 15, 2020. An entity is eligible to apply for grants, provided that:

• At least 90 percent of the households to be served by a project receiving a grant shall be in a rural area without sufficient access to broadband;
• For purposes of such pilot program, a rural area without sufficient access to broadband shall be defined as 10 Mbps downstream and 1 Mbps upstream, and such definition shall be reevaluated and redefined, as necessary, on an annual basis by the Secretary of Agriculture;
• An entity to which a grant is made under the pilot program shall not use a grant to overbuild or duplicate broadband expansion efforts made by any entity that has received a broadband loan from RUS; and
• Priority consideration for grants shall be given to previous applicants now eligible as a result of adjusted eligibility requirements.

Veterans Affairs Program

The U.S. Secretary of Veterans Affairs may enter into short-term agreements or contracts with telecommunications companies to provide temporary, complimentary or subsidized fixed and mobile broadband services for the purposes of providing expanded mental health services to isolated veterans through telehealth or VA Video Connect² during a public health emergency.

The U.S. Secretary of Veterans Affairs is authorized to expand eligibility for telehealth services from the Department of Veterans Affairs (“the Department”). This includes veterans already receiving care from the Department who may not be eligible for mental health services or other health care services delivered through telehealth or VA Video Connect.

The Act prioritizes expanded mental health services eligibility for:

• Veterans who are in unserved and underserved areas;
• Veterans who reside in rural and highly rural areas, as defined in the rural-urban commuting areas coding system of the Department of Agriculture;
• Low-income veterans; and
• Any other veterans that the Secretary considers to be at a higher risk for suicide and mental health concerns during isolation periods due to a public health emergency.

Museum and Library Digital Network Funding

The Act appropriates $50 million to the Institute of Museum and Library Services (IMLS) for response to COVID-19, which can be used for grants to states, territories and tribes to expand digital network access and to purchase equipment. Any matching funds requirements for states, tribes, libraries and museums are waived for grants provided with funds made available under the Act.

Additional Assistance

For further assistance, please contact a member of the Telecommunications Practice Team, the Coronavirus (COVID-19) Response Team, or the Phillips Lytle attorney with whom you have a relationship.

1. Emergency period defined in Section 1135(g)(1) of the Social Security Act. 42 U.S.C. 1320b–5(g)(1).
2. The term “VA Video Connect” means the program of the Department of Veterans Affairs to connect veterans with their health care team from anywhere, using encryption to ensure a secure and private session.