Broadband Committee July 20, 2021 - California Telehealth Policy Coalition - Center for Connected Health Policy
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Broadband Committee
July 20, 2021
© California Telehealth Policy Coalition
1
Contents
Welcome and Introductions 5 min.
Budget Updates 10 min.
Legislation Updates 5 min.
News and Announcements 10 min.
Next Steps and Wrap-Up 5 min.
© California Telehealth Policy Coalition
2Budget Update: AB 133 – Health Trailer Bill (1/3)
Status: Presented to Governor 7/15
Medi-Cal Telehealth Provisions (Section 380)
• Extends temporary Medi-Cal telehealth policies until December 31, 2022
• Payment parity for all modalities, including audio-only, and for providers including FQHCs/RHCs
• DHCS to convene an advisory group to inform the department in establishing and
adopting billing and utilization management protocols
• Supposed to be completed in time to incorporate into 2022-23 budget
• Protects pre-COVID-19 policies, including store-and-forward
• Allows Department to authorize RPM with separate fee schedule
AB 133 Language – Section 380 contains telehealth provisions:
https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB133
© California Telehealth Policy Coalition
3Budget Update: AB 133 – Health Trailer Bill (2/3)
Other Telehealth Provisions:
• Authorizes State Hospital Use of Video Telehealth – Ensuring more timely treatment transfers (Section 344)
• Requires that the local jail provide the DSH clinician access and capability to conduct the evaluation through video telehealth to
reduce IST waitlists and ensure more timely access to care when necessary
• Creates the Children and Youth Behavioral Health Initiative – Incentivizes school-based Telehealth (Section 355)
• Allowable activities for the grant funding include implementing telehealth equipment and virtual systems in and around schools
• Health Information Exchange and Health Information Technology Advisory Group – Includes addressing telehealth privacy and security
telehealth issues (Section 340)
• Advise CHHSA on relevant issues, including how to “address the privacy, security, and equity risks of expanding care coordination,
health information exchange, access, and telehealth in a dynamic technological, and entrepreneurial environment, where data and
network security are under constant threat of attack.”
• Provider Telehealth Data – Informing health care workforce policy (Section 4)
• Data requested must include hours spent in direct patient care, including telehealth hours
AB 133 Language https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB133
© California Telehealth Policy Coalition
4Budget Update: SB 156 – Broadband Trailer Bill (3/3)
Status: Presented to Governor 7/15
This bill implements the first year of a three-year $6 billion investment in the broadband. Funding appropriated in SB 129 (Skinner) as amended by AB/SB 164 provides $4.372
billion ($3.25 billion General Fund) in 2021-22 to begin this project. This includes:
Middle Mile Broadband Infrastructure: $3.25 billion federal American Rescue Plan Act (ARPA) funds for the construction of a state-owned open-access broadband middle mile,
appropriated in 2021-22.
• Prioritizes build out in areas underserved by ISPs
• Requires the middle-mile network to be leased for less than fair market value
• Establishes the position of Deputy Director for Broadband and the Office of Broadband and Digital Literacy to oversee project
Broadband Last Mile Support: $2 billion ($928 million General Fund and $1.072 billion federal ARPA) for last mile funding, of which $1.072 billion is available in 2021-22, $125
million is available in 2022-23, and $803 million is available in 2022-24.
• Funds CASF through the Broadband Infrastructure Grant Account Program and requires $1 billion to be spent in rural counties and $1 billion to be spent in urban counties
• Redefines “unserved area” as not receiving 25/2 mbps
• Updates speed requirements for infrastructure projects to be at least 100/20 mbps or must current speed set by FCC
Loan Loss Reserve: $750 million General Fund for the loan-loss reserve, of which $50 million in appropriated in 2021-22, $125 million is appropriated in 2022-23 and the balance
of $575 million is included in 2023-24.
• Allows counties to acquire funding for the acquisition, construction and improvement of broadband infrastructure and operate a broadband service
AB 156 Language –: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB156
© California Telehealth Policy Coalition
5California Legislative Developments (3/3)
Broadband Bills
Bill No. Coalition Recent Developments Brief Description
Support?
AB 14 Passed Sen. Com. On Revises law regarding California Advanced Services Fund (CASF)
(Aguiar-Curry et EU&C (7/8); amended
al.) (7/12), re-referred to
✅ Comm. On Gov & F.
Withdrawn from committee,
re-referred to APPR (7/13)
SB 4 Passed Asm. Com. on C. & Revises law regarding California Advanced Services Fund (CASF)
(Gonzalez) ✅ C. (7/8); In Asm Approps
SB 28 Letter of Support is Passed Asm. Comm. On Rural Broadband and Digital Infrastructure Video Competition Reform Act of 2021
(Caballero) being drafted by C&C (6/23), passed Asem.
Coalition Staff Comm. On P&CP (7/1), in
Asm Approps
AB 34 Held in Asm. Approps. Authorizes the issuance of bonds in the amount of $10,000,000,000 pursuant to the State
(Muratsuchi) Committee (5/20) General Obligation Bond Law to support the 2022 Broadband for All Program
AB 537 Passed Sen. Comm. On Requires that the time period for city/county approval of collocation or siting applications for
(Quirk) Gov. & Finance with wireless telecommunications facilities be deemed approved if the city/county fails to approve
amendments (7/12), In Sen within the standard set by the FCC
Approps.
SB 378 Passed Asm. Comm. on C. Broadband: methods of fiber installation
(Gonzalez) & C. (7/8), in Asm Approps.
SB 556 Passed Asm. Comm. on C. Seeks to ensure local governments provide access and quickly permit approval of small wireless
(Dodd) & C. (7/8), in Asm Approps. facility siting applications
© California Telehealth Policy Coalition
6Report Estimates Funding Need to Update Broadband Infrastructure
ACA Connects is an association that represents small and rural broadband providers Study Limitations:
Their new report estimates the needed funding to ensure broadband availability and adoption. The
• Uses previous RDOF incentive
publication addresses three key questions:
numbers
• What is the state of broadband service availability and adoption today?
• Does not consider building publicly
• What would it cost to address both the availability and adoption gaps? owned open access broadband
• How can available funds be prioritized in order to make meaningful progress towards both
networks
objectives?
• Assumes prices would remain high
The report estimates $179 billion would be needed to ensure high speed broadband availability and would require subsidies
across the country, much higher than the $65 billion appropriated in the latest infrastructure bill:
© California Telehealth Policy Coalition
7Biden Executive Order Targets Broadband Competition
To “promote competition, lower prices, and a vibrant and innovative telecommunications ecosystem”, the Executive Order on Promoting
Competition in the American Economy, signed on July 9, encourages the Chair of the FCC to work with the rest of the Commission, as
appropriate and consistent with applicable law, to consider:
• Adopting “Net Neutrality” rules
• Conducting future spectrum auctions under rules that are designed to help avoid excessive concentration of spectrum license
holdings in the United States,
• Providing support for the continued development and adoption of 5G Open Radio Access Network (O-RAN) protocols and
software,
• Prohibiting unjust or unreasonable early termination fees for end-user communications contracts, enabling consumers to more
easily switch providers;
• Requiring broadband service providers to display a broadband consumer label, to give consumers clear, concise, and accurate
information regarding provider prices and fees, performance, and network practices;
• Initiating a rulemaking to require broadband service providers to regularly report broadband price and subscription rates to the
Federal Communications Commission for the purpose of disseminating that information to the public; and
• Initiating a rulemaking to prevent landlords and cable and Internet service providers from inhibiting tenants’ choices among
providers.
Read the Executive Order here: https://www.whitehouse.gov/briefing-room/presidential-actions/2021/07/09/executive-order-on-promoting-
competition-in-the-american-economy/
© California Telehealth Policy Coalition
8Update on outreach to broadband advocates
• Staff call with California Emerging Technology Fund and California Forward
• Interest in plugging broadband policy leaders into our committee and meetings
• Key issues discussed
• How best to provide last-mile access to the internet
• Treating broadband like a public utility, even though it legally is not one
• Broadband trailer bill as a major policy milestone, with the state making a significant public investment to build out
middle mile infrastructure, help to fund last-mile support
• CETF report on broadband for health care in CA available here: https://bit.ly/36Oi9JT
© California Telehealth Policy Coalition
9Closing Announcements
Save the Dates
Upcoming Meetings Please reach to staff if you have any questions
California Broadband Mei Kwong: meik@cchpca.org
Council
August 5 from 9am – 11am Amy Durbin: amyd@ccpca.org
https://us02web.zoom.us/j/8
8136017974#success Robby Franceschini:
robby.franceschini@bluepathhealth.com
Education Committee
August 11, 2-3pm
Legislation Committee
August 12, 1-2pm
Monthly Meeting
August 20, 1-2pm
© California Telehealth Policy Coalition
10Broadband Advocates 1/2
Organization Description
Media Justice MediaJustice is building a powerful grassroots movement for a just and
participatory media, fighting for racial economic and gender justice in the
digital age. Open and affordable internet is one of their main focus areas.
New America’s Open OTI brings together advocates, researchers, organizers and innovators to
Technology Institute work at the intersection of technology and policy to ensure that every
community has equitable access to digital technology and its benefits.
California Forward California Forward (CA FWD) leads a statewide movement, bringing people
together across communities, regions and interests to improve government
and create inclusive, sustainable growth for everyone. Connecting California
to broadband is one of its eight action-areas.
One Million New Internet Users Non-profit training English-learners in central and southern California to
adopt technology and use broadband. Spoke at California Broadband
Council May meeting.
© California Telehealth Policy Coalition
11Broadband Advocates 2/2
Organization Description
Electronic Frontier Foundation Non-profit organization based in San Francisco, defending civil liberties in
the digital world through policy analysis, litigation, grassroots activism.
Benton Institute for Broadband Non-profit that supports legal and policy experts with the goal of bringing
and Society open, affordable high-capacity broadband to all people in the US.
Greenlining Institute Non-profit working toward a future where communities of color can build
wealth, live in healthy places filled with economic opportunity. Uses
multifaceted advocacy efforts to address the root causes of racial, economic
and environmental inequities. Focus areas include health, economic, energy
environmental and technology equity.
Center for Democracy and Non-profit advocacy organization that brings together thought leaders
Technology working to promote democratic values by shaping technology policy and
architecture with a focus on the individual. Focus areas include open
internet.
California Emerging CETF has been established as a non-profit corporation pursuant to orders
Technology Fund from the California Public Utilities Commission (CPUC) in approving the
mergers of SBC-AT&T and Verizon-MCI in 2005. Its mission is to Provide
leadership statewide to close the “Digital Divide” by accelerating the
deployment and adoption of broadband to unserved and underserved
© California Telehealth Policy Coalition
communities and populations.
12California Legislative Developments (1/3)
Telehealth-Related Bills
Bill No. Coalition Recent Developments Brief Description
Support?
AB 32 In Sen. Health (Hearing Makes permanent Covid-19 telehealth flexibilities
(Aguiar Curry et al.) ✅ cancelled; bill no longer
moving)
SB 365 Passed Asm. Health (7/6), Requires Medi-Cal e-consult reimbursement
(Caballero) ✅ referred to Approps.
SB 371 In Asm. Health Creates a Deputy Secretary for Health Information Technology to coordinate health
(Caballero) ✅ information technology efforts regarding hie, broadband, and telehealth
AB 457 Passed Sen. Health 6/24; Creates Protection of Patient Choice in Telehealth Provider Act
(Santiago) amended 6/28, re-referred
to Approps
AB 523 Referred to suspense file Requires DHCS to make all COVID PACE program changes permanent, including
(Nazarian) (7/5) telehealth flexibilities
SB 801 Amended (7/7), re-referred For purposes of telehealth, defines health care provider to additionally include an
(Roth) to Asm. Comm. On B&P associate clinical social worker and an associate professional clinical counselor
© California Telehealth Policy Coalition
13California Legislative Developments (2/3)
Telehealth-Related Bills- Two-Year Bills
Bill No. Coalition Recent Developments Brief Description
Support?
AB 1264 Two-year bill Creates CHHS Agency Project ECHO grant program for children’s hospitals
(Aguiar-Curry) ✅
AB 410 Two-year bill Nurse Licensure Compact
(Fong)
AB 552 Two-year bill Integrated School-Based Behavioral Health Partnership Program
(Quirk-Silva)
AB 935 Two-year bill Requires health plans and insurers to provide access to a telephone mental health
(Maienschein) consultation program for children and pregnant/post-partum women
AB 1117 Two-year bill Establishes Healthy Start: Toxic Stress and Trauma Resiliency for Children Program
(Wicks)
AB 1131 Two-year bill Requires participation in statewide health information exchange network
(Wood)
AB 1252 Two-year bill Defines privacy protections for personal health record information
(Chau)
SB 508 Two-year bill Authorizes a local education agency (LEA) to provide mental health services and includes
(Stern) telehealth as an approved modality
© California Telehealth Policy Coalition
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