 Yes, thank you. All right. Good morning, everyone. This is Senate health and welfare April 17th. We continue to take testimony and learn about what's going on during the covert emergency. One of the things our committee has taken as our committee has taken testimony we've heard from folks in the both the designated agency world and the healthcare environment that internet connections, access to broadband and as well as cell phone connections. Those, those remote connections are extremely important in our state, both for workers at home but more importantly for access to care and making sure that people who are isolated have an opportunity to reach out to their healthcare workers so today we, I thought it would be good for us to get some up to date information first from ledge council and then from the Department of Public Service about what we have in the state and what's going on what the thinking is. So, Maria, thank you for being here. We appreciate your time. And I think this is the first time you've been. This is the first time you've been back to health and welfare. I think it is. I think it's the first time I've testified before Senate health and welfare in about, I don't know, nine, nine years. Well, it's about time. I'm happy to be back. I wish it were actually in the committee room. I know, well, enjoy that room so one day, we'll make that happen. That would be great. Okay. I wish you could make our committee room a bigger room. It's so small. Well, no, it's because we have a lot of work to do, Senator who are overwhelmed. So Maria, why don't you give us some testimony and we had that conversation I'm going to leave it open to you. I'm going to read with your testimony, and we do have something happened. So I think that I, that's you. So I hope that's okay. I hope I didn't jump the gun there, but I was also, this is great. Go right ahead, making sure that it that it works. So, for the record, Maria Royal with Legislative Council. And I think the chair just actually did a very good overview of what I'm going to be covering today, which is, you know, connectivity in general. What's the status of broadband in Vermont in general, particularly as it relates to some of the needs that have arisen with respect to COVID-19, and then also focusing on. Senator McCormick. Yes. And then focusing on some of the telehealth initiatives that are in the cares act. So it's a there's a lot to cover. And I think there's probably more in here and a lot of detail that maybe you're not so much interested at this point in getting into the weeds. But it may be helpful in terms of just providing a broad context for some of the, you know, the broadband issues and challenges that the state is dealing with. Excuse me, I apologize for interrupting. I had heard the chair call my name. I'm wondering what's what's up. Senator Lyons, I think you're muted. Yeah, Senator Lyons, you're muted. She wanted you to mute Senator McCormick. I thought I was. When it's red and has a line going through it and the mic means you're muted, right? Yes. Yeah, but we heard you speaking to someone in your in your home. Just try it again. It's not a big deal. I'm going to mute myself now. I'm going to test it. Okay, but it was read with a line going through it. Let me just see. You're all good. All right, Maria, sorry for the interruption. There's no problem at all. So with that being said, this is just an overview of what's going to be in the presentation. Again, making the connection between the delivery of telehealth services and the need for the underlying technology the broadband infrastructure to support the delivery of those services. I'm going to talk very broadly about what Congress has done to date in response to COVID-19 as it relates to both telehealth specifically and broadband deployment generally. I'm going to review some regulatory actions taken by the FCC, the Federal Communications Commission, as well as some regulatory action taken in the state of Vermont that pertain to communications in light of the pandemic. And the next section has to do with the programs and initiatives that exist currently in Vermont. These are pre COVID-19 programs that are all related to broadband build out or the facilitation of broadband deployment. And again, I think that's really broad. I don't expect you're going to want to get into the details of all of those programs, but they are here as you think about, you know, going forward what areas you're most interested in and how you can get funds out to support services like telehealth. And then I just conclude with some data that's relevant to the status of broadband deployment currently in Vermont. And then I know the department is going to follow up and really look at the mapping and the availability of, you know, where there's service and where there isn't generally and also at a granular level so that's there's a lot of information there please stop me at any time if you have questions. And we'll just start going through. So I did include some definitions on this slide and the following slide. I'm not going to read through them word for word. You know, the sometimes the terms I've noticed telehealth and telemedicine for example are used interchangeably, but really telehealth in Vermont at least as defined by the Department of Health Access is kind of the broader category of services related to healthcare, including information storage, healthcare education, health administration, as well as telemedicine, which is the next definition and I just realized that I, I've cited title 18 but that should actually be title eight this is the definition in title eight currently for telemedicine that relates to coverage health insurance coverage for telemedicine. And so telemedicine in Vermont is, you know, patient centered looking at the delivery of healthcare services to patients and that could be diagnosis consultation treatment. And I just wanted to compare that to because I'm going to be talking a lot about some FCC telehealth programs. There's some consistency and some differences in the terminology telehealth pretty much use the same way by the FCC as it is in Vermont. I would say one difference, you know, instead of referring to telemedicine. I think the equivalent term that the FCC would be connected care services, but again, patient oriented the delivery of that care to the patient remotely, whether it's at a mobile location, or at a residence. So just to be clear kind of about some some of the terminology underlying all of this telehealth in general is the assumption that you have the infrastructure, the broadband network to deliver the services. Again, which is why I think you're looking at broadband and status of deployment in Vermont generally. The things that are not covered here are, you know, the telehealth issues that are related to things like privacy insurance licensing, all the things that you would normally go to Gen Carvey for who can give you, you know, much, much more information on that but this is really just looking at some of the newer programs and kind of focusing on the infrastructure as well. So I didn't look at there are a number of federal telehealth programs that are not part of the cares act that predated the cares act. I didn't mention them here. I'm not sure that I'm aware of all of them, but just to let you know there are numerous federal programs out there offered by different agencies. So I'm just going to focus on the ones that were funded or created under the cares act, or in response to the recent pandemic. So in terms of congressional action, broad review, you know that Congress has been rolling out legislation in response to the pandemic pandemic and phases, there have been three phases of legislation. You'll see the last one adopted or enacted and signed on March 27. That's the cares act. So that's the $2.2 trillion economic stimulus package related to social distancing measures. And in terms of the connectivity issues in the cares act. Again, these are issues that have been brought to the forefront because of the pandemic and because of the, the social distancing, the need for remote telehealth access, distance telecommuting, digital inclusion, meaning not only do people have access but is it affordable? Can they access it? Do they have the literacy skills? All of these issues now have become extremely important to the extent we are all in our homes trying to go about our daily activities and having our needs met. So I'm going to focus on telehealth, as I've mentioned before. And just to give you some idea, in the cares act, there are some emergency appropriations that are specific to federal agencies, some existing programs, some are expansions to programs. For example, 180, that should be million to the health resources and services administration within the Department of Health and Human Services. This is to expand services and capacity for rural hospitals, including telehealth services. There's approximately $2 billion to the Department of Veterans Affairs to support IT for telework and telehealth, including broadband for veterans for telemental health care services. Maria? Yeah, sure. I'm not going to, I'm going to try not to interrupt you. No problem. One of the questions that I think we have around the $180 million for going for tele rural hospitals. Does that include, do you know, I mean, probably down in the weeds somewhere, whether or not the hospital can provide technology to someone living a distance from the clinic or the hospital. Is it, does it allow for patient access to telehealth away from the hospital? Right. So are you talking about like connected devices, like actually having maybe a tablet or this or subsidy for the service? Yes. You know, I'm not certain. I would want to, I can absolutely find that out for you. I'm going to call off the top of my head. Okay. And maybe Commissioner Tierney might have investigated that. I don't know. Maybe when the department is testifying, it might give me a chance to go to go look and see if I can answer that for you today. All right. For example, the, the money that goes to the veterans affairs. There is a subsidy for broadband access for for veterans in their home so that they have their own subscription. And they can call it they can get money for some of the costs of that service. And there is another existing program that's offered by the rural utility service, which is in the US Department of Agriculture. This is a program so they got $25 million under the CARES Act. And this is a program that provides grants to support rural communities and their access to telecommunications enabled information audio video equipment, as well as related technologies, not just for medical professionals, but also for students and teachers. The one so there are two fairly substantial programs new pro one of them is a new program. The other one, and then there's some appropriations to some existing programs, but in terms of what's in the CARES Act. They've appropriated $200 million to the SEC, or a new program called the COVID-19 telehealth program. The program's already been adopted was adopted on April 2. And these funds can be used to support the provision of telehealth services and can be used to reimburse health care services and broadband connections at the from the provider is located, and also for where the patient is located. So the money can be used to reimburse patients, broadband access. The funding window opened on April 13. And I just actually read today that grants have already started to go out. And about $3 million of the $200 million has already been appropriated. And the range in grants has been between $200,000 to a million a million is about is about the cap that they're estimating to give out. So I do mention that because it is. So obviously the money's going out on a rolling basis, and it's only going to be available for as long as there is funding in the program so once that $200 million is expended. The program will end or the pandemic ends. But so this is directly related to costs that are being incurred to either provide COVID-19 health services to patients in their homes or to provide other healthcare services to keep people from having to come to the hospitals and healthcare facilities where they might be more likely to be exposed to the virus. So this is an immediate program that's available now. As you can see, I won't go through all of them. I, you know, but this is just sort of for, you know, kind of public awareness of who eligible healthcare providers are nonprofit and public entities. There's a list of the types of services that are covered under this particular grant program telecommunication services and broadband connectivity services. There's patient monitoring platforms, as well as the devices and equipment that patients can use in their home. The other program that I wanted to mention, so I'm now moving into what the FCC has done under its existing regulatory authorities so this was not part of the CARES Act, but there have been actions taken related to what you're interested in. And in particular is the connected care pilot program. So the telehealth, the COVID-19 telehealth program that's an immediate program to deal with the pandemic right now, but the FCC is also looking at more long term ways that telehealth can be used to improve health outcomes, reduce healthcare costs, etc. And, you know, whether or not going forward, universal service funds should be used to on an ongoing basis to support telehealth services. So this is, again, it's a pilot program. It's not clear yet how many projects will be funded, but they will be funded for a period of three years. There's going to be a particular focus on providing healthcare to low income persons and veterans. But again, this is, you know, a program really designed to help the FCC better understand what it can do in terms of bringing broadband to populations that might most benefit. So is there a, do you know what the eligibility level is when they talk about low income? Or is that that's probably back there on the weeds as well. I, you know what, I don't know if it is defined. Okay. Would it be then maybe left to the state to make a determination of that or we don't know. It's okay, don't, don't look it up now, don't worry about it, but I think it'll be a question that we might have. Yeah, so it's a great question. I don't remember seeing any kind of income threshold in the report and order. I do know that the Wireline Service Bureau, you know, has issued a guidance on the COVID-19 telehealth program. And I'm not sure if there's been a guidance issued related to this pilot program, but that might be where that information is so I can look. And so then I just wanted to also touch upon, you know, this is just sort of that you're aware generally of some of the other FCC programs that are preexisting programs but have been fully funded in at least for a period of time related to the pandemic. There's the Rural Health Care Program, which has two components, a telecom program and a health care connect fund program. And these basically provide discounts to health care facilities for broadband, as well as, well actually I don't know that the health care connect program funds a discount to patients. I think it's primarily to the providers. So then there is also under their e-rate program, which applies not just to rural health care clinics, but to schools and libraries. You might have heard about telecom providers opening up or providing new and expanded Wi-Fi hotspots, access to Wi-Fi at schools and at libraries, even at health care facilities. But there are some federal rules that normally prohibit telecommunications providers from providing discounted or free service has to do with competitive bidding procedures, but those rules have been waived, which is why you are seeing kind of the proliferation of free hotspots for at least the duration of the pandemic. There have been some tweaks to the Lifeline program. You're probably familiar with that program. This is a subsidy program for voice, telephone and broadband access for low income individuals. And the FCC regulations that have been taken in response to COVID-19 have to basically do with keeping current subscribers enrolled in the program and not being kicked off because they failed to recertify or re-verify. And then finally, I'm just going to touch upon, you know, one of the other things that the FCC has done is allowed for greater use of spectrum. So the availability spectrum is usually, you know, to licensed entities. The FCC is granted wireless providers greater access to deal with the increase in broadband usage. So there are a lot of things that have happened at the regulatory level under the FCC's existing authority. And then that brings us to some of the initiatives that the FCC is encouraging. As you know, with some of the changes that have happened at the federal level in terms of how broadband is classified, the ability of the FCC in the states to regulate broadband has been curtailed. However, the FCC has been encouraging providers to take actions that will help to mitigate some of the potential disconnections and lack of service that might be caused by the pandemic. For example, you may have heard of the Keep Americans connected initiative. This is basically where companies pledge for 60 days, not to terminate service because the customer can't pay as a result of the pandemic. The company pledges not to waive any late fees related to the pandemic, and then to open up their Wi-Fi hotspots based to the general public. Today over 700 companies have taken this pledge, and you will see, you'll hear from the department, they're actually keeping track of what programs and services Vermont companies are offering during the pandemic. Also, the FCC has been encouraging providers to either establish or to expand and improve their low income broadband programs. These are discounted services that some providers already offer, and some providers have just established. And again, Vermont companies are participating in this, and the department is keeping track of that on their website. And then finally, this pertains primarily to wireless companies. The FCC has asked that they relax their data usage limits. So with the increased usage of broadband, people don't exceed and then have to incur the costs of going over their usage limits. So this just gives you a kind of a general sense of what's happening at the federal level through Congress, through the FCC's regulatory authority, and then the FCC encouraging certain actions. So bringing it a little bit more local in Vermont, with respect to telecommunications as well as other services, natural gas and electric. The Public Utility Commission has issued a moratorium that basically prohibits involuntary service disconnections until, and I believe that's ineffectual April 30 at this point. So your service is not going to be disconnected in Vermont, at least for the period of this moratorium. And then again, in terms of what DPS has been doing, I mentioned already, I'm not sure if I mentioned the first one actually. They're mapping those, those Wi-Fi hotspots that are available statewide, they provided a map so that the public knows where they can go to access broadband if they don't have it at home. And then what I did mention earlier is what Vermont companies are doing, what kinds of programs they're offering at this time. So now we're going to get into, I don't think I'm going to go into this in detail, unless you would like me to. But this is going to just touch upon some pretty significant federal programs that are related more generally to broadband build out in unserved and underserved areas. There's a reconnect program that's offered through the Rural Utility Service, and there's the Rural Digital Opportunity Fund, which is offered through the FCC. And again, this is just addressing, you know, providing grants, subsidies to providers, to internet service providers, to build out broadband in areas that don't have access and the speeds that they would need to ensure is available has to be at least 25-3. Those are the download and upload speeds that relate to broadband access. And then, you know, the last thing I'm just going to touch on is, you know, wireless connectivity is an issue that's getting a lot of attention by the FCC. There's been a lot of investment. There are new funds that have been created, the regulatory actions that have been taken to basically support and expand wireless connectivity, whether it's through 5G service or increased use, unlicensed use of the radio spectrum, and potentially service that would be offered by low earth orbit satellites. You know, I don't think you want to get into all of the details, but this is just kind of more of your general awareness of all these activities that are taking place now that will have an impact on the types of service that are available to providers, potentially in the very hard-to-reach, high-cost areas. I'm not a network engineer, so I can't talk specifically about, you know, particularly for the newer, more advanced technologies when those services will be available in Vermont and at what speeds and etc. But this is kind of broad context for you to keep in mind. Again, if just, you know, to kind of be aware of some of this will just be a reminder, but what Vermont is doing related to broadband deployment generally. There have been a number of grant and subsidy programs created, which I'll talk about on this page here. These are just the broad categories. You have taken a number of steps to facilitate broadband deployment. We'll go over these probably not in detail, but you know, you can consult this as you, as you figure out how you want to move forward and the things that most interest you related to healthcare or public health and public safety issues, areas around digital inclusion, public health and safety, data collection and planning, and then some consumer protection. So just generally this is a list of some of the investments, investment programs, the grant programs that are currently exist in Vermont. There's what's known as the connectivity initiative. This awards grants to internet service providers to build out an unserved and underserved areas of the state service that is at least 25-3. There's a high cost program that also provides money for the build out in high cost areas. This goes particularly to the incumbent local exchange carriers. These are the basically the traditional phone companies here in Vermont. And then there's what's called the Broadband Innovation Grant Program. The department is offering grants up to 60,000 for any entity really that wants to do a feasibility study related to broadband deployment. So this could be a communications union district. It could also be an electric distribution utility. In fact, and up to two electric distribution utilities are eligible to receive this grant. And I believe it was just the last week the department announced that Washington Electric Co-op and Vermont Electric Co-op have both applied for and received grants to do these feasibility studies. So these are electric companies that are considering offering themselves or partnering with an internet service provider to provide broadband in their service territories. So that's something that's happening in the state right now at a kind of a study level. And then in terms of broadband, you know, other attempts to facilitate deployment, there is a loan program through VEDA, which helps for the startup and build out of broadband initiatives. Loans can be up to $4 million. There is also authorizing legislation for, you're probably familiar with communications union districts. The largest CUD in Vermont currently is EC-Fiver. There have been a number of other areas of the state that have formed CUDs. Some of them just recently, this spring, others last year, but they're kind of in the earlier stages of development, but those are in the works now. There are opportunities for municipalities to work together through formation of rural economic development infrastructure districts, ready districts, not specific to telecom, but can be used to facilitate telecommunications communications build out in rural areas. Also last year, you authorized municipalities to engage in public-private partnerships with ISPs if they would like to pursue that as an option for bringing broadband to their residents. And then you have other measures I'm just mentioning. This is all related with respect to siting of telecom facilities. You're familiar with the 248 sighting of cell phone towers on a statewide basis as opposed to through Act 250. And you have rules related to making it easier for broadband entities that want to attach their facilities to poles like antennas. There are rules in place that will facilitate that process. So then in terms of digital inclusion, I mentioned that has a lot to do with affordability. So people who might have access to a broadband connection but can't afford to pay the monthly fees. As I mentioned earlier, there is a federal lifeline program. Vermont also has a supplement to that program. It's specific to voice services. Vermont also has a telecom relay service, which provides funding for the hearing impaired so that they have equipment that they can use to enable telecommunications. Vermont does a telecom plan, which looks out 10 years to see what the needs of the state are with respect to broadband and offers recommendations for how the state can proceed and target resources. And also does mapping of broadband services and you're going to hear from the department about what the current state of broadband is more specifically. And then I just included in here, just trying to be comprehensive there. In terms of consumer protection issues that have gone on, this is related to net neutrality. So as you know the federal net neutrality rules have been repealed. There's an issue around preemption whether states can have their own net neutrality rules. Vermont took the step of requiring that internet service providers comply with net neutrality if they want a government contract for internet service. That law has been stayed pending a litigation that's going on related to the FCC repeal of the net neutrality rules. So just wanted to mention that. And also the Attorney General's office monitors ISP compliance with net neutrality not because they're required to, but just to help Vermonters understand which providers do comply with net neutrality rules. To the extent they want to Vermonters want to access that information. So then a couple of programs here related to public health and safety. E 911. There are concerns or have been concerns related to outages and the ability of Vermonters to make to access the 911 system. So a couple of things that are going on right now. The 911 board is actually working on a rule that you authorized last year related to reporting of outages by communications providers. In particular, the reporting already already applies to the landline phone companies so this is to expand it to the wireless carriers cellular carriers, as well as the VoIP providers so if you get your voice service over a broadband network. You, those providers would also have to report tonight when one of their any system outages. This is related to backup power obligations, you know ensuring that particularly for those VoIP providers that are not line powered that people are aware of, you know that you, if there's a power outage, you might want to have backup battery to ensure that you're able to continue to call. And some of this is just consumer awareness so that they understand this isn't the traditional copper phone line that you would still be able to use even if your power goes out. That's not the case for these internet enabled voice services so this is, you know, these are kind of things that are being looked at to keep, make sure that consumers understand. What their access is. And then I think you're familiar with the CARE program, the citizens assistance registry for emergencies program and this is basically a registry where people who might have special needs. In the time of either a power outage or disaster and evacuation. This, these could be elderly individuals people with limited mobility or have specialized medical equipment, basically it's a it's a notice to first responders. So that they understand in the event of a some kind of a situation in a particular area that there may be particular vermonters that will need some assistance. So that's a relatively new program, and then the chair also asked that I give kind of an update on first net. Kind of a brief reminder, if you haven't thought about first net in a while. So first that first responder network authority is actually it's an agency within the US Department of Commerce, and they were charged with building out a nationwide broadband network that's dedicated to public safety. They awarded a contract to AT&T to build that network. And then each of the states were given the opportunity to decide whether they wanted to kind of opt in to the AT&T solution first net solution for their state, or to potentially contract with another provider. Vermont ultimately decided to build the AT&T first net solution so AT&T right now is in the process of building what's called a radio access network for Vermont, the wireless communication services that will give first responders prioritized and preemptive coverage. They are AT&T is permitted under the program to use any excess wireless capacity. So in terms of how that and they have five years to basically build to the build out what they've committed to doing which is 36 new sites in Vermont. And I believe, as of now one new cell tower became operational in 2019 and there are forecasted to be an additional 16 sites, which could be either a tower or an antenna co located on an existing tower or building. Those are forecasted to be deployed and operational this year. So that is a lot of information about all of the programs and initiatives related to broadband going on now. And the last thing that I'm going to leave you with is just to give you an idea of some connectivity data points that might be of interest to you. So Vermont has a population of about 620,000 people. In terms of how we measure broadband deployment we look at the state looks at 911 addresses, these are residential and business addresses of where you would bring internet connections. So that's, that's the measure of how many addresses require broadband or require some kind of internet connectivity. And right now the FCC defines broadband as 25 three. So that's what the FCC has determined is kind of the minimum speeds that you need to make use of all of the uses that the internet is commonly used for whether it's telehealth or whether it's remote working or remote learning. These are kind of, this is kind of the minimum speed that the FCC recommends that people have to participate fully using their broadband connections. So as of now, and this information is based on some of it's based on a report that the department, along with the firm conducted in last year just in December, and some of it's based on their information that they have on their broadband availability and internet, but just in general again this is just to give you a sense of where Vermont is now about 23% of Vermont addresses lack internet service at 25 three. So what the FCC defines as the minimum broadband. And in that the report that I just mentioned earlier, the cost. This is just an average and imagine there's a lot of potential variability here, but the cost to provide broadband particularly fiber actually to an individual premise is about $5,000 on average. So if you were to build out a fiber connection to those 23% of Vermont addresses, it might cost you roughly $350 million. Vermont connectivity goal, what the state hopes to achieve in terms of connectivity is 100 100 symmetrical. Those are your download and upload speeds right now fiber is the only service that's capable of delivering that 100 symmetrical speeds. So, 82% of Vermont addresses do not have access currently to those speeds and using the figures that I referenced earlier, if you were to build out to those addresses, it would cost you roughly in the neighborhood of $1 billion. So this is just to give you a really big picture of kind of the numbers and what you're looking at. You know, in terms of who has access to broadband and how achieving statewide universal access might be achieved. And so that was a lot of information and you let me know if there's anything I can go back and answer questions or if there are things that you would like me to look into further going forward or whoever I can be helpful. Maria, you've done an amazing amount of work to bring this to us. I really appreciate the time that you've taken both to prepare this and then to present it. And it, it sounds like you've, you've had some connectivity yourself between the federal government and the department and current statute so Yeah, you know what, do you mind taking your presentation down and then I'll be able to see the entire committee so we can ask questions. Perfect. Thank you. So I think there probably are a lot of questions, particularly with regard to what might be coming to us from the federal cares act and other things. So what I'm going to suggest committee unless there's a burning question of understanding that we move on to our next witnesses, because they're also going to provide us some some information that we're not ordinarily receiving in our committee. Does anybody have a burning burning burning question. Okay, this is good and I would like to know for note that no one has yet brought up the conversion to fiber from something else. So we'll leave that one alone. That was probably an inside joke. Thank you. Thank you for being here. I know you have clay purpose along and I'll leave it up to you how you want to proceed with your testimony we do have. I think three documents from you folks on our webpage so welcome. I think this might be a first. I think you've been in our committee before officially I think that's correct. I've not been before your committee before I think I have prior acquaintance with just about everybody on the committee, but it's a pleasure to be here in a formal capacity. Go right ahead, introduce yourself and your topic and we'll, we'll mute ourselves and listen. Thank you. All right, very good. The way we will proceed this morning is to develop some of the details that Maria presented. I agree it was a wonderful presentation. Marie I've seen it several times now and it gets better every time, but that's hard to do considering that it was so good to begin with clay will be providing that detail. He is our expert on the substantive ins and outs of both the programs and the infrastructure, to the extent that you have any more detailed questions about the infrastructure that clay may not be able to answer. And off the top of his head this morning we also have a staff at the department that has some pretty deep knowledge about telecommunications infrastructure and could come in and give testimony, but judging from the overview that Maria gave I don't think this community is going to need to get into that. I will start out by giving the following broad assurances. The department and Governor Scott are well aware of the importance of telemedicine and telehealth in the state. It's not lost on me that in recent years Medicare budgets have been cut to the point where rural hospitals have been struggling. This pandemic is really exposing what the deeper implications have been of those funding cuts because I think on the latent level, we've assumed that oh yeah telecommunications would be there. And services and the like at hospitals can be filled with telemedicine and telehealth and then something like this hits. I find that that may be true for some people but not all people and regrettably for a lot of those people who don't have good connectivity there's also a significant overlap with the need for telehealth and telemedicine. That said I would want to assure the committee that in terms of the adequacy of available bandwidth. And the topic that became a hot button early on in the pandemic. The department is able to assure you that there is adequate bandwidth of the pandemic and the associated increase use of the internet is not threatening to break the internet per se. What is happening is folks are learning in real time, some of the limitations of their data plans and the like that they've been living with without having to really learn the finer ins and outs because they weren't using their access the way or should the degree that they are now. However, many companies through the the call to action from the FCC have lifted those data caps or put a temporary halt on things like that. So that seems to have eased whatever concerns there might have been in terms of whether people have the adequate ability to use their service if they have it at home. But it still leaves the question of what to do for the folks who don't have any access right now. What the department is doing on that front is two things. Frankly, I took matters into my own hands last Friday and issued a call to action to the utilities in the state and challenged our electric utilities and our gas utility to see what they could do in order to step up and perhaps help deploy temporary connectivity solutions if nothing else. And we did that in conjunction with looking to also gather data from Vermonters directly as to who it is who's at home who has a student who can't access remote learning because they don't have broadband or who can't access telehealth people at home who can't access telehealth or telemedicine for one broadband. And I would I don't mean to interrupt but as you keep mentioning telehealth and telemed. There are a number of folks who need access to, and I think we're probably including this and you're thinking what substance use disorder workshops and access to some of the remote needs that are out there for our workers as our counselors and so on so. Indeed. I appreciate that clarification Senator Lyons because Senator Cummings has been engaged on this issue as well as Senate Finance, and you're quite right I was improperly lumping that in if you will. I find you're not you're not improperly lumping at all but it's kind of the way we might lump it to but I just wanted to clarify for anyone who's out there. Looking in that there it's, we're trying to be as inclusive as we can. We're talking about these access issues so. No, absolutely. And I find that having worked in this area of regulation for for as long as I have. I'm forever challenged by the the granularity with which things are described and how easily you can miss communicate and describe what you're talking about. But you're getting at a different point which is the need to be inclusive in our thinking, especially when it comes to helping people. And you're quite right. Later, just moments ago the department set out a press release that describes the second half of what we're doing to try to close this access gap. And you'll see in that that the point I'm trying to get at is that folks daily connection to daily essential needs and services has been torn away, if you will, by the, the need to stay home. And so when I think of those essential services, one of the things foremost in my mind is the access to mental health support, for instance, that you're talking about Senator Lyons, but I will do better. That's all you can ever say. And you were not criticizing I know. No, no, you're doing, you're doing great. That wasn't a criticism of you that was a communication to folks out there, we get it. You got it. So what the department is trying to do on the other side, in addition to challenging the utilities to step up is we've made a direct appeal to the public to, excuse me, to identify yourselves to the department if you have a student at home who needs to be engaged in remote learning but can't because they don't have access to broadband. If you are somebody who is in need of telehealth telemedicine and as you say, other services of a support nature. If we can, if we can identify clusters of individuals that puts us in a position to go back to the utilities and to say hey, there's a group of 20 people here who all need something and don't have broadband. Can somebody put a line out there can somebody get a radio signal out there. Can we do something at least on a stop gap basis to help these people during this pandemic. This call to action is frankly an extension of an experience that I had during tropical storm Irene, where my own home was destroyed. And in my capacity the time is General Counsel the public service board I saw in real time, how many communities in Vermont were affected by the sudden absence of bridges and roads and the like. And to my mind, it's not a stretch at all to recognize that what has happened here is through the stay home stay safe order, folks have properly confined themselves to their homes. And with that they have had torn away this essential infrastructure, meaning their ability to make their daily courses or or contact with community resources government resources their jobs their schools and so forth. The internet's effectively a highway. It's a it's a road system and it's a system by which information travels and goods and services are exchanged. If you have it, you're not in the loop. If you're not in the loop you effectively are cut off, much as a bridge or a road cuts you off if it's wiped out in the storm. So the department is hopeful that monitors will respond. Senator Cummings gave us a very helpful insight that it shouldn't need to be said but modern life moves so quickly that one is apt at times to forget. If you can't get on the internet you can't see the resources available. People need to have another ability to contact us besides just the internet there's also the good old hotline phones. And so part of our appeal that we've launched this morning is to encourage people to call the consumer affairs public information division of the department to let us know who you are and what your needs are. We had to take a little time to roll this out because we were watching what's happening in our sister agency the Department of Labor. And we wanted to make sure that we were ready should the deluge of contacts come and that we're able to handle them I have a little staff and the consumer affairs public information division but they pack well about their weight class. If, if they have enough notice and I think at this point we're well prepared for that. I've gone on at great length, and I think I have covered. Most of what I wanted to do at the 10,000 foot level I just wanted to let the committee know something that has evolved and in my thinking as I deal with these connectivity issues I'm increasingly aware that there are three. There's an intersection of three points that you have to keep in mind. Sometimes we're talking about the affordability of connectivity. Sometimes we're talking about whether folks have the requisite year to be able to be connected. Do they have a cell phone, do they have a computer. There's some household that is paying for a landline and also a cell phone but they can't use their cell phone at home because they don't have connectivity. And so they're incurring an untenable double burden in trying to have both phone service and cell service in the world at large. And then there's a third point infrastructure and infrastructure I think is where we hurt the most. This is not a new issue as so many of you on the committee know, but the pandemic is certainly made real to us that the way we've been getting by with infrastructure is. It's not that we haven't known it was untenable it's that we're now really feeling in real time how untenable it is. And I am hopeful that we can make this clear to the federal government that is where the department has been focusing its attention. I've been both meeting with the FCC commissioners personally. I have a meeting with chair pie on Monday to talk with him personally about what is happening to Vermont. And we have also been engaged in litigation and trying to persuade the FCC that it needs to rethink how it disperses federal dollars in the broadband front that it's, it's not enough to just rely on a symbiotic relationship between the FCC and the industry by auctioning off monies as they do to get the market to do the right thing. I don't mean to use that phrase the right thing because it implies that one is all is perhaps not doing the right thing but the wrong thing. And I think to think of this in terms of when we first embarked on breaking up the monopoly of mobile, which, you know, definitively happened in 1984. We were addressing a different set of problems we were addressing the the ills that had accrued from a monopoly that was completely unchecked that was largely in the private sector. Probably the signature ill at the time was that he had all this great technology and yet long distance calls were so incredibly expensive. Why, because there was no competition for that expense to come down. So the good news is that the vision of technology being unleashed and economic forces being unleashed and bring down prices and increase consumer options happen. Telemedicine telehealth for example are a direct outgrowth of that. That's that's all good. But what we're seeing now, close to me see if I do the math rights, close to 40 years later. I think that's right or 45 years later. What we're, we're seeing is, I mean to say the time from 1984 to now whatever that is. What we're now seeing are the ill effects if you will of having turned almost entirely to the private sector, and not just having relied on on the private sector market forces to modernize or telecommunications, but also to have restrained the states the way Congress saw fit at the time to do such that the states didn't have jurisdiction over broadband and cell service. The theory was that the market would be a more efficient way to encourage the deployment and modernization. We're now seeing it's left terrible gaps that market forces simply don't motivate companies to to address. And that's bad enough but worse still is that the state governments are so hampered, and their ability to do something about it. One of the things that really hampers the states is that, even if they come up with programs like Vermont has with a connectivity fund and put some dollars in it or the Vermont Universal Service Fund and we put some dollars in it. These federal programs tend to be designed, particularly the ones at the FCC, in a manner that in the end penalizes the state, or risks penalizing the state to those dollars into state programs the idea is well, if the states put a dollar into something, we don't need to put a federal dollar into it, we don't want to overlap those dollars. There are also some other quirks as I'm sure some committee members are aware, such as when some carriers get funding to do something in Vermont and they do something in Vermont, and they do it well but they don't do it perhaps the way we need it to be done. Under federal rules, other carriers are foreclosed from stepping in to the gaps left by anyone carrier to fix that. Again, the idea being that if the federal government has lent or borrowed lent or or granted money to a carrier to do a project. They reserve a period of time for repayment of that loan for that carrier, and the federal government doesn't want to undermine that carriers ability to repay the loan by allowing other competitors into the area. It's all very good on the drawing board, but the reality is different. I have taken you far afield and I apologize from from the particulars of the subject matter your committee deals with. But I think it's important to carry that background forward, because it helps explain why it's so hard to to address these issues that you are immediate. Thank you. I actually appreciate what you have said, because it very much resonates I think with us when when you start talking about the ineffectiveness of the current market for situation. And I'm glad that you're bringing that conversation to the FCC and. Yeah, absolutely. And then I have to say I've been surprised, but pleased that the FCC has been as accessible as it has been. I'm sure it's not going to any charm that I have my closing note here would be before I have this off to clay, that I see what we have to deal with right now is phased there's the immediate response to the emergency. There's the 30 to 90 day window of the pandemic. I think the legislature is well advised to also be thinking about what happens if scenarios. The prime what happened if scenario especially in your field is what happens if there is a resurgence of the virus. Come the fall or the winter. I have no data on this. This is not my area of expertise and I am happy to refer the matter to Dr Levine and the administration they've been doing a wonderful job of making very data driven judgments. My reading in the area just as a citizen is that we need to be thinking ahead. My own parents live in Germany, I've been watching the German response it's been very different it's been an emphasis on testing, and even the Germans are thinking about what happens if this virus survives, or has a second outburst if we, if we lift the social distancing and stay at home measures too soon. So anyway, and then of course there's the long term window of what to do, if and when funding comes from the federal government that would allow us to more permanently address some of our connectivity issues and I can assure you that all of those time windows are at the center for the department in thinking about about how to advance our teleconnectivity agenda in Vermont. The one area that I'm mainly focused on right now is whether there is an ability for Vermont to leverage FEMA resources in the teleconnectivity space, owing to the pandemic, if you accept my analogy that roads and bridges have been torn away there ought to be at least a space to try to make that argument and the department certainly plans to do so. So with that, if the committee members have no questions of me, I would hand the mic over to Clay. Thank you. Thank you. Good morning, Senator. Hello. Senator Inwin, a quick question for Commissioner Tierney. Yes. Okay. Thanks. Yes. Yes. And thank you so much for your comments, especially at the end there because that was exactly where my, my mind was, was going. I presented the numbers of what it would cost to bring the rest of Vermont up to just up to the bare minimum the 25 three was $350 million and I, and I wondered if you had any, you know, if you were a betting person if you had, you know, any percentage of hope that maybe FEMA would be able to pay $50 or something related to the COVID crisis sometimes a crisis can be and present new opportunities right so do you think that this is being additional pressure on the federal government to help you know to help us bring the rest of our population, you know, up to speed. And I don't know if it's putting additional pressure on the federal government, but I do think that the federal government has programs that are well established. And I think there is an opportunity to make arguments that are going to fit within the parameters of well established programs. And then as you can see with the paycheck. I always say, if the federal government doesn't put the adequate dollars in there. All the programs in the world and all the pressure in the world aren't going to get us there. But I am. I demanded myself to be helpful on that score. Certainly my experience in tropical store my ring. I was against any recovery for my property under the hazard mitigation program but people of good faith and good minds, ultimately, were open enough to arguments to be made so that we could leverage those dollars at the time. So I fully intend to do that here and I have to be optimistic in that pursuit. I think for the cares dollars. One of the hitches in that program I think Maria pointed this out is that the cost. It has to be incurred directly in response to the pandemic. And it has to be drawn. Well, here's the question. There is a timeframe under cares now until the end of this year. But what we don't understand yet clearly is does that mean that the cost has to be incurred and paid for before December 31. Does it have to be those funds have to be obligated before December 31. We don't know that yet. All I know is that that's eight months. And so if the issue is what what costs can be sought to be reimbursed from the cares money in eight months. I'm going to be at the table making the argument that whatever the utilities do. If they're able to do something to help us with connectivity solutions and the like ought to qualify for those funds. And then of course FEMA as well. I hope that answers your question. Godspeed in your in your question. Thank you. Thank you. Okay, Clay, off to you. Thank you for being here. Thank you for having me for the record on clay purpose with the department of public service. And going last and seeing Maria's presentation. Some of what I present will be a repeat so I'll probably go quickly through some of the cares act program information and try to fill in any anywhere I can questions that you might have on on those programs. And then talk a little bit about broadband availability in Vermont and try to present some information that might be pertinent to this committee in particular. So, I'll start going to try to share my screen. You share. I may not share my screen so we have all we have your, I think that we have great we have three presentations for you the first one is a PowerPoint. And then a data list of institutions or in facilities medical facilities that have broadband, and then the map. So you can point us in the right direction will be there. Right. Yeah, there, there are three other maps that I also wanted to share. But they're too. They're, they were too large to send to the committee through email so I was hoping to bring those up and share them with you on my screen but I can send you a link. These are the broadband availability maps for Vermont so it's important for you to see those just so you get an idea where we have connectivity and where our efforts are going to be focused on bringing new connections. So I'll start with the, the PowerPoint presentation, which I have sent as a PDF. This is the, the telehealth programs that are available at the federal level. The first one is the the COVID-19 telehealth program. I think Maria did a great job of covering this program. So I'll go quickly through it. It's 200 million, the application period open two days ago and as Maria pointed out. We're starting to be dispersed. There's no deadline set it's very much first come first serve so to the extent that healthcare providers in Vermont can take advantage of that program. It's important to act now. As far as eligibility. Just about every healthcare facility is eligible, but that's defined in the telecom act. Maria's presentation already went through that. The costs have to be incurred during the pandemic so these are costs related to the pandemic beginning March 13. The cap is one million and an important thing to think about is that it's pretty much open nationwide to any healthcare facility rural and non rural. This is a program where we would be competing with urban facilities as well which greatly opens up the number of healthcare facilities that will be applying for that money. The supported services under this program. This is an important component. Telecommunications and information services such as broadband connectivity for patients can be drawn down connected devices, tablets, smartphones and data enabled devices such as blood pressure monitors. This is a very helpful host of, as you probably know, medical devices that are used for monitoring and telemedicine. Now, an important distinction though this one has to be used for connected devices so equipment that would be used in the home that is not broadband enabled is not eligible for this program. The second program is the connected care pilot program. This actually began before the pandemic. It's being fast tracked in response to the pandemic. So the same FCC order that describes and authorizes the use of the 200 million COVID response money also activated this program. This is a pilot program. The purpose of this program is for the FCC to collect information on how they can better spend federal universal service dollars on telehealth. So the focus is really on collecting data and piloting different forms of connected care. I believe the committee asked a question about income threshold under this program, because there is a focus on veterans and low income patients. They didn't cite an income threshold. It's very much up to the applicant to describe what it is they're trying to do and the community of patients they're trying to serve. The FCC when it makes its decision decisions about who is going to get funding under this program. They will announce the rationale for each selection so there are no hard and fast rules about what qualifies as low income. They're looking to test different ideas. There is a focus on public health epidemics. So to the extent that applicants can show that they're focused on widespread public health concerns is important. The due date for applications will be soon, but there's no set date yet. It's 45 days after the publication of the connected care pilot order in the federal register and I don't think it's been printed yet in the federal register so that would be coming up very soon. Again, eligibility it's open to the same health care providers that the other program is open to rural and non rural. And like I said there's focus on data collection so there's no applicant limit. It'll all depend on what the number of applications they get and for how much money. As far as supported services go. They want to cover 85% of the cost of broadband connectivity for patients network equipment and information services. So I think like platforms that would be used to deliver telehealth are included. The third program under the FCC is the rural health care program. It's been a long standing program. This helps health care facilities access broadband and telecommunication services that's broken into two sub programs the health care connect and the telecom program. It's about $571 million a year paid for through the universal service fund. Health care providers are eligible so this is not program where we're competing with urban counterparts. Though non rural facilities are eligible if they are a member of a consortium that is mostly rural. So they're serving over 50% rural market. Many Vermont facilities already participate in this including the major hospitals in Vermont. This is a program that Vermont is doing a good job of drawing down already. As far as supported services. It subsidizes the cost of telephone service so it brings the cost of rural telephone into parity with urban rates. So it makes telephone service cheaper. The health care connect program provides a 65% discount on dark fiber business data needs and DSL and private carriage line as well as I omitted from this other broadband so the bias service that hospitals would buy. This is an important program that we already use. Please stop me if you have any questions. The last major, we're not going to stop you because we're, you know, we've got, we've got like six minutes before we have to be at another meeting so. Okay, thank you for letting me know that I will. Yeah, I wish I wish we had more time. I really do. So, okay, well then it would probably be helpful for me to move on. This is the USDA telehealth and distance learning program. This is really for hardware. So, grant grantees that get money through this program are mostly spending it on equipment. It does support some broadband transmission facilities up to 20% of the grant can be used for broadband transmission to the facility, but that's really for the drop or for a fiber connection between two buildings or something like that it's not. Not going to be used for widespread broadband deployment. It's really inside wiring and that kind of thing. This is our broadband statistics broken down. I wish I had more time to explain them. I think it's important for you to understand what the buckets are. We're putting broadband into buckets. You see on the left hand side for one megabits per second. That is DSL. So we met broadband at 41 megabits per second up to 25 three so anything that's less than 25 three but more than 41. We're covering 93% of the state with that broadband that level broadband service. 25 three or better is more or less cable. So companies like Comcast Charter. Duncan cable. We have, I think 10 cable companies so cable that this is the service they provide. I just want to be clear that almost no one sells 25 three service, the cable companies are selling something much higher 50 megs 100 megs 150 megs. They can even do a gig down to a lot of their service territory now. What they can't do is the upload speed of 100 100. So 100 100 bucket is really fiber. And that's companies like you see fiber Burlington telecom Vermont telephone has fiber to every location in its traditional telephone network. So I'm going to move along to map that I provided to you this morning called broadband deployment at health at Vermont health centers. So you see in the legend the same buckets fiber cable and DSL. We've got one one location that appears to not have good broadband. But by and large, we have most health care facilities are well served with service that's either fiber or good cable service. So, to us the, the issue would not be broadband to health care facilities but rather broadband to patients. Can I ask a question about that. Because I think the whole issue of communications does get to the patient. And so what we've heard from some of our hospitals and our hospital clinics is that, at least during this pandemic there are a number of vulnerable folks, older, or some other auto immune or whatever their condition is, who are somewhat isolated, and particularly isolated from internet access. I know that public safety I know the direct director of 911. Oh gosh. Anyway, senior moment has been does reach out and look for people who are in that situation. And I know you've been you've been great at going around and looking for cell phone access through the state. Is there any initiative going on right now to with the health care community or communicating to the health care community about reporting identifying those people who don't have access and to link them with some kind of an application particular in the, particularly with the first grant that you were talking about the $200 million that's now going out. Is it is that happening, because it seems to me that there's got to be a collection of people out there right now who are really hurting. I think that that's important data to get and we begin engaging with the telehealth consortium in the state. And I think that's in line with what June discussed about our effort to find residents who are having connectivity issues. So that's something that we'd like to work on. I don't think we have a developed system yet but it's something that we've started thinking about and and hope to be able to facilitate soon. So it's an important question that address quickly. I think Commissioner Tierney wants to make a comment too but the certainly director Niels program care program with 911 deploying radio access but it might be interesting to connect those people commissioner Tierney go ahead. Yeah, I just wanted to underscore what clay saying, we, the appeal that we made this morning specifically asks for people with, you know, connectivity issues who have medical needs to identify themselves. I think it probably goes without saying that people who are related to such a person, or have an acquaintance neighbors and the like, they may see as well and make the connection but that's not the the only step I think that we would be talking this is a first cut, talking to Barbara Niel is also a good idea. I regret to say that that we also find there are privacy issues. Oh yeah, that we have to deal with which is is why we went in the first instance with the direct appeal it's like if you're willing to disclose yourself. Then we at least know who you are and that's a start. I'm mindful of your time. You know, I wish we had another hour. This is a great start clay. I know you probably have 12 other maps to show us and we'd like to see them. I can, I can send the link so you can take a look we have a lot of information on our website about broadband availability broken down by town so I'll send that information to you and if you're interested in seeing, you know, which, which towns are most broadband availability will have that for you. Thank you. This has been very enlightening and the work that you're doing is terrific. I want to thank Maria again for your in depth presentation of the programs that are out there, and you're probably getting really good at this. I appreciate it we will come back with more questions commissioner tyranny thank you very much for your perspective and your input. I hope that we can continue to work together I know that we'll be looking at possible communications with our federal delegation and perhaps with our Commissioner of Department of Public Service, so that would be good to stay linked up with you and play just to just to make the point, Chair Alliance, we're also in contact with the fed delegation just figured that I figured we don't want to we don't want to take a step that steps on a toe we want to make sure that we're working together on this so. All right committee we're late for our next meeting and I want to thank you all for your endurance and your interest, but we'll come back to this for discussion purposes. We'll see you early next week sometime the week after so thank you. Take care. See you in a minute. We're finished. Nellie were truly we're finished. All right, ending live stream.