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Digital Inclusion

Craig Settles: Libraries and Telehealth on the Vanguard for Broadband

Libraries can do for telehealth what they did for broadband: Provide low-income folks with access to digital and healthcare literacy.



The author of this Expert Opinion in Craig Settles, director of Communities United for Broadband

Libraries are the vanguard of a forces working to close the “healthcare gap.” The FCC’s E-rate broadband grant program for libraries and schools, and the Emergency Broadband Benefit broadband subsidy, collectively are providing over $10 billion immediately. Libraries can leverage these funds to deploy telehealth and broadband to attack the heathcare gap.

Many libraries are moving toward telehealth. Three libraries in Delaware have recently installed telehealth kiosks, Seaford, Milford and Laurel. The Pottsboro, TX public library rolled out their telehealth center in January this year. Several library’s around the country are developing  digital navigators programs to facilitate telehealth.

Lucinda Nord, Executive Director of the Indiana Library Federation says, “In 2020, many courts required virtual online attendance. To help patrons, librarians learned effective virtual meeting skills that will help us expedite telehealth. We partnered with state agencies to train over 1,000 library employees to help residents apply for unemployment, SNAP, and health coverage.” In the process, these libraries acquired resources critical for telehealth.

The healthcare as well as the broadband gap exists in the rural areas, but the media, policymakers, and politicians have selective myopia when it comes to urban broadband and by default, telehealth. 

Libraries and telehealth attack the healthcare gap

There are over 12 million homes in urban America that cannot get neither broadband nor telehealth. 75 percent of those are homes of African-Americans or other people of color. Countless millions of others homes technically have broadband, but in reality it is a pathetic attempt at coverage that lacks the strength to carry telehealth into enough homes.                           

Libraries can do for telehealth what they did for broadband: provide low-income folks with access to the technology, drive adoption, and facilitate digital and healthcare literacy. With FCC funding plus the Institute of Museums and Library Services’ $200 million, libraries get a running start on making a difference. Urban libraries have to push hard for grant equity!      

Telehealth isn’t just chats with physicians, it’s using intranets and Internet networks to do everything medical that gets you and keeps you healed. Telehealth brings digital equity to the healthcare gap. This gap is abundantly prevalent in among people of color.

Analysis by the Kaiser Family Foundation show 33 percent of Hispanic women and 31 percent of African-American men don’t have a regular doctor. According to the CDC, six out of 10 people in the U.S. suffer from a chronic disease, four out of 10 people suffer from two. Diabetes is 60 percent more common in African Americans and the men are 50 percent more likely to get lung cancer. Twice as many African Americans would die as all the other ethnic groups combined.

Libraries exist to help

FCC started the Emergency Broadband Benefit of $3.2 billion, which will be available until expended or until six months after the COVID-19 emergency declaration expires. The EBB provides eligible low-income households with a monthly $50 discount for broadband service from participating providers, as well as a one-time $100 discount on an internet-enabled device. 

EBB recipients are potential telehealth users and patrons needing training and digital literacy. “At a minimum, we know libraries will want to have the information handy to respond to any requests,” says Larra Clark, Deputy Director of the Office for Information Technology Policy at the American Library Association.

Digital navigators are a major force in moving people over the digital literacy hurdle, and often they are hired from the disadvantaged neighborhood that the libraries serve. Shauna Edson, Digital Inclusion Coordinator Salt Lake City Public Library, And she is partnering with the National Digital Inclusion Alliance shaping a national digital navigator program.

“Locally, our digital navigators problem solve and help connect people to the appropriate free or low-cost resources such a Chromebook or a laptop,” she says. “We have mostly beginner computer users wanting to use Zoom for workshops and communicating with friends and families. There are some organizations focusing on this navigator model just for telehealth support.”

Decide navigators, expect quite a few large libraries will seek funding to convert study rooms into telehealth rooms at least for part of the week, and small libraries are considering buying telehealth kiosks to compensate for the limited spaces. Wi-Fi hotspots became particularly popular during the pandemic and telehealth will make them even more so. 

Quite a few libraries will want to tap into these grant programs to build out their physical space to support telehealth, and also boost their broadband capabilities. Micheal McKerley, CTO at ENA says, “Libraries need that data traffic to be segmented and not be sniffable by hackers. That segmentation may or may not require new broadband infrastructure, but it may need a network assessment. Even you don’t need new equipment, you might need a re-design.”

“A lot of libraries right now are struggling to keep up with everything that’s going on,” says Henry Stokes, Library Technology Consultant at Texas State Library and Archives. “But as libraries move forward and they see their peers push out telehealth initiatives, we’ll see healthcare become even prominently featured in libraries. Telehealth is such a great fit!” And telehealth will drive broadband like there’s no tomorrow.

Craig Settles conducts needs analyses with community stakeholders who want broadband networks to improve economic development, healthcare, education and local government. He hosts the radio talk show Gigabit Nation, and is Director of Communities United for Broadband, a national grass roots effort to assist communities launching their networks. He recently created a guide to help librarians uncover patrons’ healthcare needs, create community health milestones and effectively market telehealth. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

Craig Settles conducts needs analyses with community stakeholders who want broadband networks to improve economic development, healthcare, education and local government. He hosts the radio talk show Gigabit Nation, and is Director of Communities United for Broadband, a national grass roots effort to assist communities launching their networks. He recently created a guide to help librarians uncover patrons’ healthcare needs, create community health milestones and effectively market telehealth.

Digital Inclusion

Sean Gonsalves: National Digital Inclusion Alliance Hosts Largest Net Inclusion Gathering

NDIA Executive Director Angela Siefer zeroed in on the need for good data.



Selfie of NDIA Executive Director Angela Seifer and Net Inclusions audience from Twitter

With nearly 1,000 in attendance at the Henry B. Gonzalez Convention Center in downtown San Antonio for the National Digital Inclusion Alliance (NDIA) marquee gathering, those on the front lines of bridging the digital divide across the nation came to the three-day conference (Feb 28  to March 2) to network, share lessons, best-practices, and learn from experts as the largest ever federal investment in expanding broadband access is heading to state broadband offices this summer.

Mayor addresses attendees, acknowledges open secret of segregation

San Antonio Mayor Ron Nirenberg welcomed attendees, noting how his city was a fitting venue for the event.

“It’s no secret San Antonio is one of the most socio-economically segregated cities in the United States,” he said. “And that’s why we have zeroed-in on equity – in our budget, in who gets invited to the table.”

DeAnne Cuellar with Mayor Ron Nirenberg

Nirenberg congratulated NDIA for its work and the attendance record set by this year’s gathering. He also singled out our own outreach coordinator and San Antonio resident DeAnne Cuellar, not only lauding her work with ILSR’s Community Broadband Networks team but for her role in bringing city officials together with Older Adults Technology Services as the city commits to connecting 100,000 older adults in the city.

(ILSR’s Community Broadband Networks team, which has long worked with NDIA participated conducted a workshop, participated in several panels discussions, and hosted a special Connect This! live stream at a social mixer at The Friendly Spot Icehouse.)

“Broadband is a basic human right and is a public utility. That’s why digital inclusion is a pillar of our recovery program,” Nirenberg said, noting how that is reflected in line items in the city’s budget.

Mayor Nirenberg also spoke candidly about injustices that had been baked-in to city and state policies in the past and, whether intentional or not, excluded vulnerable communities across the city, putting them at a socio-economic disadvantage. He said that closing the digital divide was central to correcting those injustices.

He concluded his welcoming remarks encouraging attendees to “use technology to live, learn, work and thrive.”

Texas broadband office announces new network funding opportunity

Also on hand for the conference was Greg Conte, Director of the Texas Broadband Development Office. Conte announced a Notice of Funding Opportunity for $120 million in grants for the construction of new high-speed Internet infrastructure across the Lone Star State.

As projects are funded to build new infrastructure, the state can’t assume people will automatically subscribe for Internet service, as efforts to tackle affordability and adoption are equally important undertakings.

“We want to make sure communities can get online and use it,” he said. “We ask all Texans to help in this process.”

He also briefly touched on something numerous other state broadband offices are in the process of doing: beefing up staff as each state is set to receive an historic amount of federal funds from the bipartisan infrastructure bill’s BEAD program.

Conte was a guest on our Community Broadband Bits podcast last summer in which he discussed the challenges of staffing up his office and addressing the dearth of data about precisely where broadband is and isn’t available across the state.

Engaging other sectors in the work of advocating for more ACP funding

Batting clean-up was NDIA Executive Director Angela Siefer, who first zeroed in on the need for good data that shows and measures how local digital equity programs are working, and how those efforts can be improved.

Angela Siefer speaking at Net Inclusion

And while quality robust data is vital, she said, it is also worth thinking about who benefits from expanded broadband access (beyond individual end-users) and how data and stories about digital inclusion initiatives can be used to engage industries and sectors of society who may not see bridging the digital divide as an urgent concern.

That includes the necessity of getting more than just Internet service providers at the table. Buy-in from healthcare providers, educational leaders, captains of retail and commerce, as well as transportation planners and housing officials should be engaged in helping to make broadband available especially for residents who struggle with affordability.

Specifically as it relates to commerce, Siefer noted, “the savings that can come from conducting certain business online can be invested into access.”

Siefer also emphasized the value of digital equity advocates sharing the stories they encounter of the lives impacted by their work with those who may not be tuned into the connectivity crisis that still plagues even such a technologically-sophisticated nation as the U.S.

Lastly, Siefer reminded the attendees that the federal funding that supports the Affordable Connectivity Program will run in the next year or so without additional appropriation from Congress.

“We need more money for the ACP,” she said, adding that it was important for state and local leaders to be pushing their Congressional representatives to replenish the ACP’s coffers.

“The long term plan is that the Universal Service Fund needs to be fixed but that is going to take time. The ACP will run out of funds before the USF is fixed,” she said.

Before the general assembly dispersed to a variety of focused workshops and breakout groups, Siefer ended with a note of encouragement: “Remember you guys are the heroes. You do the work on the ground. But NDIA has your back.”

Watch the plenary sessions below. Also, stay tuned for our new podcast series Building for Digital Equity, which will debut soon and feature interviews with dozens of frontline digital inclusion practitioners discussing the work they are doing in their local communities.

This article originally appeared on the Institute for Local Self Reliance’s Community Broadband Networks project on March 2, 2023, and is reprinted with permission.

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Digital Inclusion

NTIA Seeks Comment on How to Spend $2.5 Billion in Digital Equity Act

National Telecommunications and Information Administration is seeking comment on how to structure the programs.



Photo of Veneeth Iyengar of ConnectLA

WASHINGTON, March 1, 2023 – The National Telecommunications and Information Administration announced Wednesday that it is seeking comment on how to structure the $2.5 billion that the Digital Equity Act provides to promote digital equity and inclusion. 

As part of the Infrastructure Investment and Jobs Act, the Digital Equity Act consists of two sub-programs, the State Digital Equity Capacity grant and the Digital Equity Competitive grant. Comments will guide how the NTIA will design, regulate, and evaluate criteria for both programs. 

“We need to hear directly from those who are most impacted by the systemic barriers that prevent some from fully utilizing the Internet,” Secretary of Commerce Gina Raimondo said Wednesday at the National Digital Inclusion Alliance’s Net Inclusion event in San Antonio. 

See Commerce Secretary Raimondo’s remarks at Net Inclusion:

The request for comment is part of NTIA’s strategy to hear diverse perspectives in implementing its goal to ensure every American has the skills and capacity needed to reap the benefits of the digital economy, stated a press release. 

The $1.44 billion State Digital Equity Capacity grant will fund implementation of state digital equity plans which will strategically plan how to overcome barriers faced by communities seeking to achieve digital equity.  

Simply making investments in broadband builds is not enough, said Veneeth Iyengar, executive director of ConnectLA, speaking at a Brookings Insitution event in December. Bringing digital equity means “driving adoption, digital skills, and doing the kinds of things that we need to do to tackle the digital divide.” 

The $1.25 billion Digital Equity Competitive grant program will fund anchor institutions, such as schools, libraries, and nonprofits, in offering digital inclusion activities that promote internet adoption. 

“Community-anchor institutions have been and are the connective tissue that make delivering high-speed internet access possible,” said Alan Davidson, head of the NTIA at AnchorNets 2022 conference. 

This announcement follows dissent on the definition of digital discrimination. Commenters to the Federal Communications Commission disagree on whether the intent of a provider should be considered when determining if the provider participated in digital discrimination. There has been no response from the FCC. 

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Digital Inclusion

Does Digital Discrimination Require Intent? In FCC Proceeding, Commenters Disagree

FCC laws should not include unintentional acts of discrimination, say industry voices.



Illustration about fixing discrimination online from Harvard Business Review

WASHINGTON, February 23, 2023 – The Federal Communications Commission should adopt an intent-based definition of digital discrimination, say internet service providers in comments to the FCC. 

In December, the FCC issued a Notice of Proposed Rulemaking to implement provisions of the Infrastructure Investment and Jobs Act to prevent and eliminate digital discrimination. The Infrastructure Act of 2021 requires the agency to enable “equal access” for all Americans, which is defined as the “equal opportunity to subscribe to an offered service that provides comparable speeds.” 

As part of its Notice, the FCC requested comment on adopting a definition of digital discrimination that includes actions by a provider that intentionally or non-intentionally impact consumers’ access to broadband interest access without justification on grounds of technical or economic infeasibility. 

Intentional discrimination 

Imposing liability on broadband internet service providers by including non-intentional discrimination would harm investment and deployment in hard-to-reach areas of the country, said the Free State Foundation, a nonpartisan think tank, in its comment. 

“Rules imposing unintentional disparate impact liability would result in penalizing a broadband ISP that made good faith efforts to ensure equal access for all subscribers in a given area, but came up short,” read the Free State Foundation’s comment. 

Service provider AT&T added that “because no broadband provider can deploy everywhere at once, any broadband provider would inevitably engage in ‘discrimination’ under this standard.” Employing this definition would impose massive unfunded deployment mandates and regulation of broadband rates and terms, said the company.  

Furthermore, new regulatory burdens would undermine incentives for broadband deployment, said AT&T. No provider would sink money to overbuild existing networks if doing so would expose it to liability for failing to do so everywhere at the same time, continued its comments. 

Careful reading through the IIJA would suggest that Congress intended for the Commission to ban intentional discrimination, argued comment from service provider T-Mobile.  

In fact, said T-Mobile, a disparate impact framework would put the Commission on a “collision course” with the overall structure of the IIJA which allocates billions of dollars to connect unserved and underserved locations through a competitive bidding process. The process limits a provider’s ability to control its deployment ratio, which would prove to be a liability and may deter the company from participating, said T-Mobile. 

“Deployment is an incremental process that varies in pace based on a wide range of variables, none of which are related to discriminatory animus,” argued trade association USTelecom in its comment.  

Internet advocacy group Public Knowledge disagrees. Service providers “urge the Commission to adopt the most toothless, least effective regulations possible,” read its comment.  

“Congress does not care about motives or accept excuses,” said Public Knowledge, arguing that providers should be held accountable for discriminatory actions regardless of intent. 

Adopting a definition of digital discrimination that included non-intentional grievances is appropriate, agreed advocacy group Free Press, as it fulfills Congress’ requirement to adopt rules that would facilitate equal access by preventing and identifying discriminatory actions. 

Carriers who profess certainty that they do not discriminate should have nothing to fear, read Free Press’ comments. 

Service providers argue that the agency should instead target its rules on digital discrimination only where it can be unmistakably proven to exist and cannot be excused by financial, geographical, technological, or other limitations. 

Safe harbors and feasibility 

Indeed, the Infrastructure Act urges the FCC to consider the issues of technical and economic feasibility facing providers. However, there is considerable debate regarding what constitutes an economic or technical limitation. 

In its notice, the FCC asked for comment on whether technical infeasibility should “require a showing that providing service was technically impossible.”  

T-Mobile in its comment answered that the FCC should not require proof of impossibility but should consider a “totality of circumstances” according for regulatory and other barriers to deployment. 

Instead, service providers urged the FCC to adopt safe harbors to ensure that discrimination complaints recognize Congress’s technical and economic feasibility limitation. The safe harbors outlined in T-Mobiles’ comments would provide liability protection for providers that: met or exceeded any applicable build-out requirements in the terms of its wireless license; or is otherwise subject to an enforceable commitment to deploy service to a given population. 

These suggested safe harbors, however, would be “inconsistent” with the purpose of the IIJA, read comments by Public Knowledge. The Act directs the FCC to counter digital discrimination and safe harbors could allow “broadband providers who engaged in digital discrimination to avoid having to take remedial steps,” it argued. 

Furthermore, Public Knowledge continued, projects that are technologically possible should be considered both economically and technically feasible unless a provider can present evidence to the contrary.  

Efforts to diminish discrimination 

The FCC’s tool for eliminating digital discrimination include its Universal Service Fund programs, including the Affordable Connectivity Program established in 2021, which provides $35 per monthly discounts for broadband services to most qualifying homes.

Also, in June 2021, the commission chartered the Communications Equity and Diversity Council to present recommendations to the FCC on advancing digital equity for all Americans.

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