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Craig Settles: Libraries, Barbershops and Salons Tackle TeleHealthcare Gap

Craig Settles describes the important role that community institutions have played in promoting connectivity during the COVID-19 pandemic.

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Photo of Urban Kutz Barbershops owner Waverly Willis getting his blood pressure checked used with permission

Today, Senator Ed Markey, D-Mass., Senator Chris Van Hollen,D-Maryland, and Representative Grace Meng, D-N.Y., led 40 members of Congress to introduce the Securing Universal Communications Connectivity to Ensure Students Succeed (SUCCESS) Act. The bill would extend the Emergency Connectivity Fund by five years and provide $8 billion a year to schools and libraries for student connectivity off-campus.

Barbershops and hair salons are long-time anchor institutions in African-American communities that have shown promise for advancing telehealth. Their partnering with libraries (a broadband anchor institution), and the Biden Administration’s enlisting of 1,000 shops and salons to help combat COVID-19, telehealth and public health in these communities could go into overdrive.

Missing their July 4 COVID-19 vaccination goals, the Biden Administration raised money to transform the shops into mini-medical centers. This success is motivating shop owners to do more. As one of the targets for $7 billion in broadband funds, libraries are idea partners that can provide broadband services, digital content, and digital and health literacy shops’ customers. 

Mike Brown manages a barbershop in Hyattsville, Maryland, and participated in the vaccination program. Brown and others owners talks with their customer about how the vaccines have been proven to work. “I use my platform to advocate for truth and dispel myths,” said Mr. Brown in an Wall Street Journal article, who has also held a vaccination clinic in his shop. “I’ve gotten about 60% of my clients to get vaccinated.”

The program has opened shop owners’ eyes to the power they have to make a difference in the healthcare of their communities. It’s a logical transition from the vaccination program to hypertension screening. Urban Kutz Barbershops in Cleveland have been screening customers for 12 years, recently with telehealth assistance from the famed Cleveland Clinic’s. 

Owner Waverley Willis says “Barbers and hairdressers are part-time marriage counselors, psychiatrists, spiritual advisers, and expert listeners. So many customers listen to our medical advice.” He has made a noticeable impact on many of his customers’ healthy eating habits as well.

Think differently about broadband, public health and telehealth

On July 1, the Federal Communications Commission began a 45-day Emergency Connectivity Fund of $7.1 billion in broadband and digital technology funding to support libraries and schools. By August 13, libraries interested in grants from the program must present a proposal on how they plan to spend money for libraries laptops, hotspots, Internet services, and other resources to advance education and remote learning. 

A generous interpretation of “education“ enables libraries to serve any patrons with broadband. If libraries are situated in areas in which there are no ISP services, they can request money from ECF to build their own broadband infrastructure for unserved patrons. Unlike traditional E-rate proposals, ECF doesn’t require a competitive bid for services, meaning libraries can present a quote from the first vender they contact.

Libraries partnering with shops and healthcare organization could give shops laptops, telehealth software, and portable hotspots to provide hypertension screening and other healthcare services that are suited to their customers’ needs up to three years. Shop owners often don’t have computing devices or Internet access in their shops. Telehealth devices such as portable digital blood pressure monitors and digital scales will have to be provided separately and possibly through funds from another government agency such as Health & Human Services.

For hypertension screening, for example, shops can take customers’ blood pressures digitally. The healthcare provider takes that data through telehealth and recommends treatment when necessary or advisable. The partner likely would have established rates for their healthcare services. Shops can then decide on additional telehealth services they want to provide.

The shops could work with libraries to develop health information and interactive Web content to reduce hypertension and other medical issues through healthier living, plus the libraries can provide telehealth services beyond what the shops can do.  

Libraries and shops can also designate customers who need a laptop, hotspots and telehealth software for chronic illnesses such as severe hypertension, diabetes, heart disease, mental health treatments, and so forth. However, these devices in this scenario would need to be given out for longer periods then just a couple of weeks. For occasional medical appointments, libraries can loan out laptops and hotspots for limited times such as two or three weeks. Libraries are good at delivering digital training and literacy programs.

Why barbershops, hair salons and libraries? 

Facilitating telehealth and healthcare does have an educational element for barbershop and hair salon customers as well as for general library patrons. These health services and information help both groups of people learn more about their own health, enables them to react effectively to medical issues, and be more proactive in taking care of their health.  

The ability for shops and salons to reach and impact African-American communities is legendary. “This type of barbershop health initiative has been shown to be effective,” said Cameron Webb, a senior White House health equity adviser on the coronavirus. Willis adds, “On more than one occasion, a guy’s blood pressure would be so high we would urge him to skip the haircut and go straight to the emergency room.”

The author of this opinion is municipal broadband expert and industry analyst Craig Settles.

Libraries have years of experience introducing new technology such as broadband to underserved populations. Matt McLain, Associate Director for Community Engagement at Salt Lake County Library, said, “We’ve had a pretty good amount of success reaching Hispanic populations at their markets. We have Asian markets out here too. And our health initiatives are quite important with the church leadership in these communities.”

The healthcare and broadband gaps are real and they are deadly! So many elements of the COVID pandemic reiterates the deadliness of those gaps. According to the Centers for Disease Control, of the data collected as of June 14 nearly two-thirds of people who got at least one dose of the vaccine were White. Only 9% were African-Americans. 14 million urban household cannot get any broadband, without which you cannot get telehealth, and 75% are Black or other people of color. 

There may never be as many federal broadband and health-related grant programs as we are seeing now. Partnership potential between libraries and haircare shops are many. Will public health practitioners and advocates, broadband builders, and community leaders step up?

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 commentary@breakfast.media. 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

Debra Berlyn: What’s New in 2022 for Aging and Tech?

Older adults continue at a rapid pace to adopt tech that assists the aging process.

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The author of this Expert Opinion is Debra Berlyn, executive director of GOAL

It’s the start of a new year and time to view what’s on the horizon for the latest technology innovations. To our great anticipation, the most significant technology event of the year, the Consumer Electronics Show, returned in-person to Las Vegas!

CES 2022 literally rolled in with some eye-catching innovations and gadgets unveiled at CES, notably with a BMW that can change its color and patterns with the use of a phone app. CES also unveiled the usual army of robots to clean the house, provide learning skills, and entertain. The Ameca robot is “human-like” and can be programmed with software using artificial intelligence, offering both speech and facial/object recognition. Ameca will engage in conversation and complement you on your lovely red hat.

The more important technology story for consumers for 2022, isn’t just the “wow” innovations that may or may not make it to market this year, it is the tech that will enhance and improve all of our lives. This is particularly important for the aging community, who increasingly rely on tech to stay connected to family and community, and as an important component of healthcare.

Those 65 and older continue to adopt tech at a rapid pace, narrowing the gap with their age 18-29 younger counterparts. Now, over 65% of older adults have broadband at home, 44% have tablets, and 61% have a smartphone. These “basics” form the foundation for layering the more sophisticated health and wellness and smart home innovations available today, and on the horizon.

The pandemic has emphasized the importance of tech for the aging community. A recent AARP study has confirmed that technology is a “habit” that is here to stay for older adults. The past couple of years has led to an emphasis on tech devices to monitor our health, help us stay fit and get connected to our health care professionals.  We are spending more time at home for work and leisure, and while at home we want to be able to manage our energy use, home security, appliances and more.

According to the chief technology officer at Amazon, Werner Vogels, one of his primary predictions for tech this year is, “In 2022, our homes and buildings will become better assistants and more attentive companions to truly help with our most human needs. The greatest impact in the next few years will be with the elderly.”

Technology can provide solutions to make life easier for older individuals

A critical opportunity that technology provides is to solve tough problems such as how to make life just a bit easier for older individuals and address their greatest challenges as they age.  Voice assistive tech continues to be a popular device for older adults. One-third (35%) of those 50-plus now own a home assistant, up from 17% just two years ago, with the voice assistant serving as a significant tool to reduce isolation for older adults.

While the AARP study found that growth of ownership of voice assistants, such as the Amazon Echo and Google Home, may have slowed for younger demographic groups, ownership continues to be on the rise for older adults.

Here are several examples of innovations for the aging community:

  • The Labrador Retriever is an assistive “robot” that empowers individuals to live more independently by providing practical, physical assistance with everyday activities. The robot is a rolling container with trays that can be “commanded” to go to different locations in the home to retrieve objects and carry them to various locations. It maps the home and “learns” how to navigate the space to operate wirelessly.
  • Tech devices that enable older individuals to track several critical aging factors continue to be introduced and desired in the marketplace. The “Buddy” from LiveFreely, is smartwatch software that monitors and manages fall prediction and detection, medication schedules and reminders, and emergency notifications. With alerts to family members, caregivers and emergency services providers, it provides wearers with an enhanced sense of security and independence. The software operates on both the Apple and Fitbit device.
  • For any aging adult with mobility issues, or their caregivers, you know that just getting around can be a challenge and now there are advances to the most needed tool in aging: the walker. One company, Camino, has developed a sleeker, advanced walker with an ergonomic design, lights and improved navigation for bumps in the road to provide greater walking assurance and balance.
  • The “Freestyle,” from Samsung, is an entertainment component of the smart home for older adults. It is a projector device with accessibility features that can be used inside the home or out, to project content such as a movie, photos or messages from any smartphone onto any surface.

AARP’s 2022 study on technology trends also recognizes that the increasing older demographic has significant purchasing power in the consumer market, including for technology spending. The study found, “Tech spending in 2020 among adults 50+ is up 194% (from $394 to $1144) to modernize, update, or create a better experience online.”

It also projected that by the year 2030, “the 50-plus market is projected to swell to 132 million people who are expected to spend on average $108 billion annually on tech products.”

In the coming years, older adults will have a wide range of new and innovative products to exercise their market power and find the right technology to enhance and assist their lives as they age. Over the past decade, technology has empowered older adults to be increasingly more independent, battle isolation, and stay informed and connected.  While we can’t predict the future, the next decade should be an exciting opportunity for new innovations for the aging community.

Debra Berlyn serves as the executive director of The Project to Get Older Adults onLine (GOAL), and she is also the president of Consumer Policy Solutions. She represented AARP on telecom issues and the digital television transition and has worked closely with national aging organizations on several internet issues, including online safety and privacy concerns.  She serves as vice chair of the Federal Communications Commission’s Consumer Advisory Committee and is on the board of the National Consumers League and is a board member and senior fellow with the Future of Privacy Forum. This Expert Opinion is exclusive to Broadband Breakfast.

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

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Christopher Mitchell: Brendan Carr is Wrong on the Treasury Department’s Broadband Rules

The Federal Communications Commission has no excuse for why the agency finished with the same bad data it started with.

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The author of this Expert Opinion is Chris Mitchell, director of the Community Broadband Networks Initiative at Institute for Local Self-Reliance

With all due respect to Federal Communications Commissioner Brendan Carrhis reaction to the Rescue Plan Act’s State and Local Fiscal Relief Fund (SLFRF) spending rules is way off base. As I wrote last week, the rules for broadband infrastructure spending are a good model for pushing down decision-making to the local level where people actually have the information to make informed decisions. (Doug Dawson recently also responded to Commissioner Carr’s statement, offering a response with some overlap of the points below.)

See Christopher Mitchell, Treasury Department Rescue Plan Act Rules Improve Broadband Funding, Broadband Breakfast, January 13, 2022

The Final Rule from the Treasury Department gives broad discretion to local and state governments that choose to spend some of the SLFRF (SLurF-uRF) funds on broadband infrastructure. The earlier draft of rules made it more complicated for networks built to address urban affordability challenges.

However, in coming out against the rules, FCC Commissioner Carr is giving voice to the anger of the big cable and telephone monopolies that cities can, after collecting evidence of need, make broadband investments even in areas where those companies may be selling services already. Commissioner Carr may also be frustrated that he has been reduced to chirping from the sidelines on this issue because the previous FCC, under his party’s leadership, so badly bungled broadband subsidies in the Rural Digital Opportunity Fund (RDOF) that Congress decide NTIA should administer these funds and have the state distribute them.

Nonetheless, the issues that Commissioner Carr raised are common talking points inside the Beltway and we feel that they need to be addressed.

Background Note

The failure of the FCC to assemble an accurate data collection is many years in the making. No single presidential administration can take the full blame for it, but each of them could have corrected it.

President Joe Biden’s FCC is not yet fully assembled because of delays in appointment and in Senate confirmation, but it would not be reasonable to lay blame on the current FCC for the failures discussed below. That said, it is not clear that we are on a course for having better maps and data that will resolve these problems anytime soon.

Commissioner Carr’s Criticism 

Commissioner Carr jumps immediately into the rural vs urban frame, suggesting that the Biden Administration could leave rural families behind by allowing local governments to invest in broadband in areas where an existing provider may already claim to offer service. Outlawing this practice – which he and others close to the largest cable and telephone companies call “overbuilding” – has been a major point for Republican FCC Commissioners.

  • Rather than directing those dollars to the rural and other communities without any Internet infrastructure today, the Administration gives the green light for recipients to spend those funds on overbuilding existing, high-speed networks in communities that already have multiple broadband providers. This would only deepen the digital divide in this country.

Pardon me? Logically, it is not clear what exactly Commissioner Carr is griping about here. Using Maryland as an example, if Baltimore is allowed to spend some of its funds to ensure unconnected families in public housing have high-quality Internet access, it is not clear that rural Garrett County in the western part of the state is harmed. Local governments do not receive different amounts of funds based on whether they spend it on broadband or other allowable expenses.

See Christopher Mitchell and other from the Institute for Local Self Reliance in the Broadband Breakfast Live Online for Wednesday, January 19, 2022 — The Community Broadband Network Approach to Infrastructure Funding

Broadband Breakfast on January 19, 2022 — The Community Broadband Network Approach to Infrastructure Funding

States could be the issue. Perhaps Commissioner Carr is concerned that Maryland will use some of its SLFRF money for broadband and it will spend too much in urban areas rather than rural regions. That would be an historical anomaly, even though there are far more people living in urban areas than in rural areas who are not on the Internet. And yet, nearly all state and federal dollars have gone to rural areas for infrastructure improvements, with very little being spent to help the low-income families left behind in urban areas. There is no history of states prioritizing urban investments over rural.

Bad Data, Srsly?

What I found really galling though was this bit:

  • It gets worse. The Treasury rules allow these billions of dollars to be spent based on bad data. It does this by authorizing recipients to determine whether an area lacks access to high-speed Internet service by relying on informal interviews and reports—however inaccurate those may be—rather than the broadband maps that the federal government has been funding and standing up

It is 2022. The FCC announced three weeks ago that it did not have a timeline for better maps.  Many of us have complained for more than 10 years about the misleading and inaccurate collection of claims that the FCC advances as its understanding of where broadband exists in the United States.

Commissioner Carr has been an FCC Commissioner for more than four years, nearly all of that time when his agency was run by a Republican. For part of that time, the Republicans controlled the Presidency, the House, and the Senate. They have no excuse for why his party’s FCC finished with the same bad data processes it started with. No one was defending the FCC data or maps during those years, but the FCC did not bother to begin collecting new data.

Now Commissioner Carr claims that “parts of this country” have broadband services at speeds near 100 Mbps down and 20 Mbps up. OK, Commissioner. Where? Do you have a secret list? No, these are talking points to obscure the fact that Commissioner Carr and his agency has utterly failed to track precisely what “parts of this country” actually has access to broadband.

Will I agree that most, perhaps 80 percent, of the country has access to 100 by 20 Mbps? Yes. But that doesn’t matter if no one can agree which homes are well-served. And it opens up a whole other set of questions that Carr neatly sidesteps, which is that contemporary broadband service goes beyond the academic question of whether an ISP provides that service most of the time at some price. If the price isn’t affordable, then there is a problem that needs to be addressed. Or as we like to say, if it’s not affordable, it’s not accessible. And, if the service is not very reliable, then there is a problem that must be addressed.

This is why the final rule is both necessary and good: because it allows communities the flexibility they need to address not just the gaps in infrastructure, but reliability and affordability as well. But of course Commissioner Carr should know that we do not have this information at the federal level, because I’m quite sure he opposes collecting pricing and other information. Despite the many instances in which providers have lied to the Commission in presenting the areas they offer service, Carr objects per se to local evidence gathered via interviews to understand where broadband actually is.

A Prediction: This Is Not A Problem

It is remarkable to see the amount of performative horror Commissioner Carr expresses at the prospect of a city like Baltimore using some of the Rescue Plan dollars to ensure its families in public housing are on the Internet, even if a cable provider could theoretically sell them Internet access for $75/month, or provide a subsidized service if they jump through all the right hoops. Compare that to the silence from the Commissioner when it became clear that the largest telephone companies took billions of dollars in broadband subsidies and might have forgotten to upgrade their services.

The SLFRF Treasury Rules give the appropriate amount of deference to local and state leaders to act in an utter void of information about what is available to each home. Commissioner Carr is deeply worried – because the largest cable and telephone companies are deeply worried – that some places will use these dollars to build networks that are unneeded or would create too much competition for the existing companies.

My prediction is that communities will not do this. Of course it’s not zero: a cardinal rule of dealing with large numbers of humans is that there are always outliers. But of the cities that allocate some of their SLFRF dollars to broadband infrastructure, they will overwhelmingly focus on areas where there are real affordability and reliability challenges from existing services. The reality is that very few of these investments will result in any material losses to existing ISPs, but the monopoly providers know that even modestly opening the door to locally built and operated infrastructure driven by community-driven solutions could open the floodgates to the competition they fear so much.

Commissioner Carr has spent years as one of a very small number of people that could correct the abject failure of the FCC to collect useful information about broadband deployments. The rest of us have had to move on and figure out how to work in the absence of data. The best option is to allow for local decision-making where they can collect evidence and act. And most importantly, they will have to take responsibility for their actions and lack of action in ways that FCC Commissioners often do not.

Editor’s Note: This piece was authored by Christopher Mitchell, director of the Institute for Local Self Reliance’s Community Broadband Network Initiative. His work focuses on helping communities ensure that the telecommunications networks upon which they depend are accountable to the community. He was honored as one of the 2012 Top 25 in Public Sector Technology by Government Technology, which honors the top “Doers, Drivers, and Dreamers” in the nation each year. This piece was originally published on MuniNetworks.org on January 20, 2022, and is reprinted with permission.

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

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Ron Yokubaitis: GOP Putting Partisanship over Reform with Gigi Sohn’s FCC Nomination

Nominated by President Biden as Federal Communications Commissioner, Sohn understands the real reason net neutrality is necessary.

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The author of the Expert Opinion is Ron Yokubaitis, CEO of Golden Frog

The Federal Communications Commission has persistently gotten communications wrong for the past 20 years, even before broadband was a thing.

The commission was supposed to oversee telecommunications networks while leaving the then-nascent internet alone for the most part, but they dropped the ball. Gigi Sohn is the right person to help the FCC get back to its open access roots.

The 1996 Congress envisioned an open, interconnected, interoperable and user-centric internet that offers users “control over the information they receive” and facilitates “diversity of political discourse.” Congress knew that these goals necessarily required an underlying telecommunications infrastructure that was also robustly competitive and itself open, interconnected and interoperable. That is why they enacted new laws basically adopting and extending the FCC’s even then longstanding Computer Inquiries regime that made the internet possible to begin with.

“Broadband” is now provided over fiber. Even broadband wireless requires fiber for backhaul. These are telecommunications facilities, that are – or should be – subject to the FCC’s regulatory jurisdiction. Firms providing fiber-based transmission for a fee are – or should be – common carriers. That, in turn, means they must interconnect, interoperate with and sell network access to other telecommunications carriers and those who provide information services on reasonable terms.

Computer Inquiry, the 1980s AT&T and GTE divestitures and the 1996 legislation all so required. But the FCC went rogue in the late 1990s. It allowed the dominant telephone and cable companies to close their local infrastructure, which allowed them to dominate mass-market internet access. The FCC purposefully killed most local market competition. Most independent internet service providers and competitive local exchange carriers were then forced out of business. Only a few major players still compete at the local level, and it is they who control mass-market “access to the internet” over “Broadband.”

Texas.net dueled early in the Lone Star state with Southwestern Bell

I started Texas.Net in 1994. We were one of the first independent ISPs in Texas. Southwestern Bell controlled the local network, and it soon started limiting our ability to get the lines we had to have so our customers could get to the internet. We turned to competitive local exchange carriers, and even became one ourselves.

SWBT and the other incumbent carriers convinced the FCC to limit competitors’ access to the last-mile connections serving homes and small businesses. The FCC refused to enforce its Time Warner Cable open access mandate. More than 7,000 independent ISPs were put out of business. That is why the telephone and cable companies now have a largely unregulated mass-market telecommunications and internet access duopoly.

“Net neutrality” was and is necessary only because of the FCC’s decision to close access to local infrastructure. America will continue to suffer high cost, rationed broadband telecommunications and internet for residential, small business, rural and high-cost customers for so long as the FCC allows and encourages the telephone and cable companies’ domination over local network access. The FCC must return to its “open access” roots.

Sohn is practical and willing to compromise in seeking bipartisan solutions

I have known Gigi Sohn since she led Public Knowledge. She understands that net neutrality is just a patch and the real solution is true open access to the underlying local telecommunications infrastructure. I certainly don’t agree with 100% of Sohn’s viewpoints, and we’ve told her so. But even when we disagree our voices are heard, understood and considered. She is practical and willing to compromise. She will seek bipartisan solutions to the real problem.

The Republicans’ effort to derail Gigi Sohn’s nomination to the FCC is misguided. All it does is cripple the FCC’s ability to return to its roots and do what is truly necessary to get America up to speed with the rest of the developed world when it comes to advanced infrastructure in general and internet ubiquity in particular. This is too important a moment for partisan gamesmanship. Billions of dollars and the connectivity of millions of Americans are at stake.

Sohn is the right person at the right moment in history. Her 30 years of experience in telecom, broadband and technology policy, her strong commitment to the First Amendment and diversity of viewpoints, and her work to promote a competitive environment where consumers are best served more than qualify her to be an FCC Commissioner.

Ron Yokubaitis is CEO of Golden Frog, a company dedicated to protecting internet privacy online, and a director of sister company Giganews, a global provider of Usenet. Both are headquartered in Austin, Texas. This Expert Opinion is exclusive to Broadband Breakfast.

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

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