#rural telehealth

[wat3rm370n]

Congress needs to ensure telehealth access continues for Medicare patients.

Telehealth for Medicare is going to expire at the end of December 2024. Private insurers tend to follow Medicare on things like this. So this can and will affect everyone’s ability to get telehealth services.

It will force disabled, terminal, high risk, immunocompromised, into in-person visits for things that absolutely don’t require in-person exams. They will force terminally ill and high risk and immunocompromised people to get mental health services in person. This will shut out many rural patients who have trouble traveling for appointments, and need telehealth access.

This will also lead to patients with highly contagious diseases such as covid to be forced to go into the doctors offices at the same time you’re there for preventative or chronic illness care. Bonus, most of these healthcare providers do not require masks at all, and may never do so again for many years as we slide backwards, no matter how bad things get, or how many serious diseases circulate. The best hope for many people is protecting access to telehealth.

✏️ My letter to reps (congressperson and us senators):

Telehealth services via Medicare must not expire. Telehealth service should be a permanent option for all patients, and covered by all insurance, including Medicare and Medicaid.

Please feel free to repurpose for your own letters to reps.

MarketWatch - 67 million Medicare recipients face ‘chaos’ if Congress cuts telehealth benefits Elderly and disabled patients could miss out on healthcare services unless an extension is passed before the end of the year By Jessica Hall Last Updated: Sept. 25, 2024 Medicare beneficiaries’ access to telehealth services will expire at the end of the year unless Congress acts, and public-health experts say that doing away with video-enabled medical care would lead to “chaos” in the healthcare system relied on by 67.4 million Americans. About 5% of Medicare’s overall outpatient visits are currently conducted via telehealth, according to Ateev Mehrotra, a professor at Brown University’s School of Public Health. Telehealth usage was as high as 42% during the height of the COVID-19 pandemic, he added. The types of medical appointments carried out via telehealth include mental-health visits, dermatological screenings and conversations with a primary-care doctor about cold or flu symptoms or about getting physical therapy. “If the rules were to expire, many people would be devastated. People are going to be frantic,” Mehrotra told MarketWatch in an interview. “Anxiety is increasing by the day because the year-end is approaching and Congress hasn’t passed these extensions.”

American Physical Therapy Association - Congress Must Act on Telehealth Flexibility Before Provisions Expire - Without action, PTs and PTAs will no longer be eligible for the provisions that have allowed them to be paid for telehealth services. Date: Friday, November 22, 2024 For PTs, PTAs, and their Medicare patients, extension of these telehealth flexibilities is critical to maintaining continuity of care. To that end, APTA and other therapy provider associations are urging Congress to extend the pandemic-era Medicare telehealth policies. We need your help in these advocacy efforts: Ask your members of Congress to pass a year-end legislative package and support extending telehealth via APTA's Patient Action Center.

KFF - What to Know About Medicare Coverage of Telehealth - Alex Cottrill, Juliette Cubanski, and Tricia Neuman - Published: Oct 02, 2024 Prior to the declaration of the COVID-19 public health emergency, Medicare coverage of telehealth was largely restricted to beneficiaries in rural areas and to certain types of providers, facilities, and services. At the time, beneficiaries were typically required to travel from their homes to approved clinical sites where they could receive care from providers at other locations. To make it easier and safer for beneficiaries to seek medical care during the pandemic, the Secretary of the Department of Health and Human Services (HHS) waived many of these restrictions in March 2020, enabling broader use of telehealth services for all Medicare beneficiaries.

[ivygorgon]

AN OPEN LETTER to THE U.S. CONGRESS

Fund the Affordable Connectivity Program NOW!

130 so far! Help us get to 250 signers!

I’m a concerned constituent writing to urge you to fund the Affordable Connectivity Program or ACP. Digital connectivity is a basic necessity in our modern world and the internet must be treated as a public utility. We use the internet to apply for jobs, perform our jobs, receive telehealth medical treatment, and pay bills, and students use it to complete homework assignments. But for millions of people in rural and urban areas, and Tribal communities, the internet is a luxury they cannot afford. Failure by Congress to fund this program will force millions of households already on tight budgets to choose between being able to stay online or potentially losing access to this essential service. If Congress doesn’t act fast, funding for the Affordable Connectivity Program will run out and more than 22 million Americans -- 1 in 6 households -- will lose this vital service. The implications of this will be devastating. In 2019, 18% of Native people living on Tribal land had no internet access; 33% relied on cell phone service for the internet; and 39% had spotty or no connection to the internet at home on their smart phone. The ACP has enrolled 320,000 households on Tribal lands -- important progress. The largest percentage gains in broadband access are in rural areas. Nearly half of military families are enrolled in ACP, as are one in four African American and Latino households. Losing access and training on using computers and the internet will have devastating impacts on all these communities as technology becomes increasingly integral to work, education, health, and our everyday lives. Without moves to address tech inequality, low-income communities and communities of color are heading towards an “unemployment abyss.” The Affordable Connectivity Program has broad bipartisan support because it is working. As your constituent, I am urging you to push for renewed funding for the ACP before it runs out in the coming weeks.

▶ Created on April 11 by Jess Craven

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[eloisemia]

Virtual Doctor Care: Bridging Gaps in Rural Healthcare

Virtual doctor care bridges gaps in rural healthcare by providing remote access to medical services. Residents in remote areas can connect with healthcare providers via telemedicine, receiving diagnoses, treatment plans, and prescriptions without needing to travel long distances. This improves healthcare access, reduces wait times, and addresses shortages of healthcare professionals in rural areas, ultimately enhancing health outcomes and patient satisfaction in underserved communities.

[isprevolution]

The Crucial Importance of 100 Mbps Download and 20 Mbps Upload Speeds in Rural Areas

In the digital age, the need for high-speed internet has become increasingly important, and rural areas are no exception to this rule. Access to the internet is not just a convenience; it’s a necessity for various aspects of life, including education, healthcare, business, and overall quality of life. In this blog post, we’ll delve into why having internet speeds of at least 100 Mbps download and 20 Mbps upload is crucial for rural communities.

Educational Advancements

Online Learning: The advent of online learning has transformed education, enabling students of all ages to access a wealth of educational resources from the comfort of their homes. A high-speed internet connection is a prerequisite for seamless participation in online classes and accessing educational materials. In rural areas, where traditional educational resources are often limited, these high-speed connections are a lifeline for students.

Interactive Learning: High-speed internet fosters interactive and engaging learning experiences. Students can join video conferences, participate in virtual labs, and collaborate with peers, all of which require robust upload and download speeds. A 100 Mbps download speed ensures that students can stream educational content without buffering, while a 20 Mbps upload speed supports their ability to actively participate in virtual classrooms.

Healthcare Access

Telehealth Services: In rural areas, access to healthcare services can be challenging due to geographical distances and limited healthcare facilities. Telehealth services bridge this gap by allowing individuals to consult with healthcare professionals remotely. A 100 Mbps download speed ensures clear, uninterrupted video consultations, while a 20 Mbps upload speed facilitates seamless communication with medical professionals.

Medical Data Transfer: Fast and reliable internet connections are essential for the transfer of medical records and data. Whether it’s sharing diagnostic images, patient history, or test results, a 20 Mbps upload speed ensures that healthcare providers can access and transmit critical information efficiently, leading to better patient care.

Economic Opportunities

Remote Work: The ability to work remotely has become a standard practice in many industries. High-speed internet empowers individuals in rural areas to take advantage of remote work opportunities, reducing the need to relocate to urban centers for employment. A 100 Mbps download speed guarantees that they can participate in virtual meetings and handle data-intensive tasks, while a 20 Mbps upload speed enables them to contribute effectively to their teams.

Business Growth: Rural businesses also benefit from fast internet speeds. A 100 Mbps download speed allows them to reach a wider customer base, access cloud services, and run e-commerce platforms efficiently. Moreover, a 20 Mbps upload speed supports seamless online communication and data sharing, helping rural businesses expand and thrive.

Quality of Life

Entertainment and Communication: Fast internet enhances the overall quality of life in rural areas. It allows residents to stream high-definition content, connect with loved ones through video calls, and enjoy the conveniences of smart home technologies, just like their urban counterparts.

In conclusion, high-speed internet with 100 Mbps download and 20 Mbps upload speeds is not merely a luxury but a necessity in rural areas. It’s the linchpin for educational advancement, improved healthcare access, economic opportunities, and an enhanced quality of life. As rural communities continue to thrive and evolve, these speeds are vital to ensure they are not left behind in our increasingly interconnected world.

Checkout more topics — https://isprevolution.io/blog/

[onesecretperson]

Aw I hate having time and energy and wasting it neither getting work done or doing something fun, but instead doing a secret third thing: Sitting and vibrate in front of the computer for hours until It's too late to do either.

[nrsnursing]

Top 4 Nursing Technologies Used Today

Nursing technologies being used now days are on a different level then the last 10 years or so. The healthcare industry has been transformed by technology in recent years. With advances in areas such as telemedicine, wearable, and electronic health records (EHRs) is leading to significant improvements. These improvements can be seen in patient care, clinical workflows, and data management. Other than this technology also changed the common practices used for teaching nurses. In this blog post, we'll explore some of the top 4 nursing technology used today.

Electronic Health Records (EHRs)

An electronic health record is a standardized collection of patient and population health data that has been digitally saved. EHRs have become a standard in healthcare and nursing practice. This enables nurses to access and update patient data in real-time, improving care coordination, patient safety, and clinical decision-making. EHRs also facilitate the use of data analytics to identify trends and patterns in patient data, leading to more personalized and effective treatment plans.

Wearable Devices

Patients are increasingly using wearable technology, such smart watches and fitness trackers, and nurses are now using it to keep tabs on patients' vital signs and health. Wearable can assist nurses in seeing early warning indications of health issues, monitoring patients' progress, and giving patients real-time feedback on their dietary and exercise habits. In addition to enhancing patient outcomes and satisfaction, wearable technology can support patient engagement and self-management.

Telehealth

In nursing practice, telehealth centers has become a crucial tool, especially during the COVID-19 epidemic. Nurses may consult with patients remotely, keep track of their health, and give information and support to patients and their families thanks to telehealth. Patients who may be unable to travel or who reside in under-served areas now have more access to healthcare services because to telehealth. Telehealth has also contributed to lower medical expenses and better patient outcomes.

Simulation Technology

Nursing students may receive practical experience in a secure and regulated setting thanks to the growing use of simulation technology in nursing education. They can strengthen their clinical skills, decision-making abilities, and collaboration via the use of simulation technology, which can model a variety of clinical settings. Nursing teachers may evaluate students' clinical competence and offer comments for development thanks to simulation technologies.

Nursing technology is rapidly advancing, and it has the potential to transform the nursing profession in many ways. From EHRs and wearable to telehealth and simulation technology, the latest advances in nursing technology are helping nurses to provide more personalized, efficient, and effective care to patients. As technology continues to evolve, it will be important for nurses to stay up-to-date with the latest trends and adopt new technologies that can improve patient outcomes and drive nursing practice forward.

[uncanny-tranny]

Thank you for taking the time to draft this up. I hope people will take inspiration from these words; it perfectly encapsulates why telehealth is vital - to disabled people, high-risk people, poor people, and those in healthcare deserts. There is no point in telehealth if we are forced into going to a physical (in location) doctor.

If you are an American citizen and have not written a comment, consider doing so. So many people rely on telehealth, both to keep themselves safe and ensure they can continue living their lives. People deserve the same access to healthcare. Telehealth is a vital component of our healthcare system. It must be accessible to all people.

The Drug Enforcement Administration (DEA) is planning on changing their regulations for telehealth prescriptions of controlled substances. However, they have opened comments up for people to voice their opinions. You can submit a formal anonymous comment HERE. The comment period ends on March 31st, 2023.

This is an important issue for those who are prescribed controlled substances (e.g., testosterone or ADHD medication) through telehealth, which means it can and will impact trans people on testosterone and a ton of others if this goes through.

[genderqueerpositivity]

After Mississippi banned his hormone shots, an 8-hour journey

Katie had done all she could to prepare for this trip. She’d asked a relative to pick up her two younger boys from school. She’d researched how to change a tire, and she’d spent hours on Google Maps, searching for the closest Walgreens in Alabama. She’d finally found a destination in Thomasville, a rural town nearly 200 miles from their suburban Mississippi home, but much remained unclear. Would they make it by noon for Ray’s telehealth appointment? Would the pharmacy give him testosterone?

Katie looked at her boy, a thin 17-year-old with wavy hair and an easy grin, and she asked herself the question that had begun to matter least: Was she breaking the law?

Two months earlier, Mississippi had banned transgender young people, like Ray, from accessing hormones or other gender-transition treatments. By mid-spring, nearly half the country had passed similar bills, according to the Movement Advancement Project, and now, 1 in 3 trans children lives in a state with a ban. Conservative lawmakers said they’d pushed the bills to protect young people, but Katie felt like they’d done the opposite. Testosterone had allowed her son to embody himself for the first time. Ray was present, happy. The ban would take that happiness away.

Across the country, families were doing everything they could to protect their trans children. Some uprooted their lives in red states for the promise of protections in blue ones. Others filed lawsuits. Katie couldn’t afford to move, and she needed a solution faster than the courts could offer, so she’d settled on a cheaper, quicker plan: She’d take a day off from her nursing job, and she and Ray would travel out of state for his medical care.

No one should have to go to these lengths just to access what is essentially basic life-saving heath care.

Also, major shout out to QMed and Dr. Lowell and the Southern Trans Youth Emergency Project for the work that they are doing to help trans youth and adults in red states access gender affirming care.

[spooniestrong]

Telehealth 2025: The Final Rule - AAPC Knowledge Center

https://www.aapc.com/blog/91584-telehealth-2025-the-final-rule/

Pre-pandemic geographic and location restrictions for telehealth (before March 1, 2020) are being reinstated. This means that unless a Medicare patient lives or is located in a health professional shortage area, a rural census track, or a county outside of the metropolitan statistical area at the time of service they will not be covered for telehealth services.

[runwayrunway]

No. 46 - Royal Flying Doctor Service

In contravention of my normal operating procedures I've fast-tracked this request to the front of my queue because of how fantastically timed it is. It was requested the day my BermudAir post went up, and the moment I saw it I realized I was going to publish it as the next entry on this blog, because I want to highlight something really important and really positive about aviation. So thank you @alionessespride for the impetus to discuss why aviation is genuinely indispensable, regardless of what cynical things people might use it for.

My most recent post on BermudAir is definitely a major downer, and other posts I've done, like my David Neeleman special and various other assorted brief allusions, have been really distinctly pessimistic and jaded about the motivations of airlines. Which I don't regret or think is bad or wrong - these are very omnipresent specters in the airline industry, which is inherently more than a little predatory both due to its necessity for profit and its very heavy ties to the military-industrial complex, with airlines, governments, and manufacturers ending up in elaborate daisy chains of sweetheart deals and making money being sort of incompatible with anything I'd consider a virtue.

But I went on about this in my Neeleman post and sort of alluded to it with BermudAir as well - aviation isn't just that, and it's really hugely important. In addition to the sheer fact that people who live on islands or in remote places with poor infrastructure can easily access the rest of the world, aviation provides a lot of important services - weather research/surveillance, aerial firefighting, aerial inspection of things like power lines, agricultural work, greatly increasing the speed and thoroughness of search and rescue, and of course air medical services.

If you live in a major city you probably get a handful of ambient helicopters (I've been told a lot of people find them annoying because they tend to fly quite low), and if you've ever wondered what they are, they're probably medevac helicopters. There's a chance they're news, or private helicopters, or something else, but most of the time they're there to airlift people to hospitals if their condition is too dire to wait for the length of time an ambulance would take to get them to the trauma center, and a helicopter can easily land in a small, precise area and bring them there.

Which is all well and good, but that's for large cities. But most of the world actually isn't large cities. Case in point: most of Australia is borderline empty.

Most of Australia is on par with places like Alaska. While it's overall the fourth least dense country in the world, that density is wildly skewed and the best thing I can say for the dark green section is that it's still denser than Greenland, but not denser than Mongolia. Safe to say you aren't getting an ambulance if you live in there. So what if you have an acute medical problem which needs immediate attention to prevent your death?

The Royal Flying Doctor Service (RFDS) is probably the best-known aeromedical service. It was the first such organization, nearly 100 years old, established in 1928. They provide medical services, particularly in medical emergencies, to the parts of Australia where getting someone to a hospital would probably otherwise take days. They also provide telehealth services, transfer of patients between hospitals, and transport general practitioners to places which lack access to primary care, among other things.

The initial ask requesting them outlined a lot of this:

RFDS is an absolute lifeline in rural, regional, and remote Australia, staffed with flight doctors and nurses that fly out 24/7/365. Often they land on runways that are actually just roads or dirt strips, sometimes with the runway lit up for a night landing with rolls of toilet paper dipped in kerosene and lit on fire. They move patients that may be many many hours from any medical service, as first responders to an incident or as a medical evacuation service for small hospitals to big city hospitals.

It takes a special kind of skill to land a plane somewhere like this, and an even more special kind of skill to do paramedic work while someone is landing the plane you're in somewhere like this.

While initially RFDS just rented their airplanes and pilots from Qantas, these days they have their own fleet and pilots, and while it's hard to find exact numbers because of their several regional branches their planes number in the triple-digits and are mostly small-to-medium and capable of operation on very short, poorly-equipped airstrips (STOL). The most-used models are the Pilatus PC-12 turboprop, Pilatus PC-24 very light jet, and Beechcraft King Air 200 twin-turboprop.

They have a couple of different liveries, presumably varying by time and branch, so I'm going to stick with one I think is both more visibly distinct and more current.

Here's a fairly standard example of this livery. The 7NEWS sticker is, I believe, a sponsor - there are different ones on different planes. As you can see, the livery is primarily red, white, and blue, which I suppose is fair enough for a non-profit service in a country with a flag based on the Union Jack, though I still find it a bit of a pedestrian choice. That said, it's at least quite an ambulancey color scheme, though it's missing giant strobe lights and a siren. I think you could install those on a plane (I mean, strobe lights are actually mandatory, just not that type) but I feel like you also shouldn't, and this is better.

Here's a view from below, so you can see the clear and bright underside with RFDS emblazoned very visibly on it. Being easy to spot and identify is a broadly desirable trait in an emergency medical vehicle, and I love their specific choice in shade of fire-engine red. Note also the suspension on the landing gear and the weather radar on the wing facing towards the camera. The PC-12 is an incredibly designed aircraft which is popular for good reason, and is very well-suited to exactly what the RFDS is doing.

The white is used in a very interesting way, where the transition between it being a dividing line separating red from blue and the main body of the aircraft with the blue as just a swash is very very subtle, and the taper of the red is extremely well-executed. The red underside is excellent because it specifically prevents the blue and white from blending in with the sky, which wouldn't be ideal.

The Royal Flying Doctor Service and/or RFDS name is placed in three distinct places - the underside, the rudder, and above the windows. My gripe is that I wish they were a little bigger and more visible, I think. I'm not sure about the rudder, but I think a relatively easy fix would be to make the text above the windows bold and red - perhaps they just wanted to sequester the red fully to the bottom of the plane rather than having it on both sides of the blue, which I understand but don't think I fully endorse.

Another great view of how the red tapers, though, and the blue's termination just below the nose, far enough back that the end is still clearly visible behind the propeller. I've always felt like PC-12s (and similar single-prop aircraft but for some reason especially the PC-12) look like they have a moustache, and this adds a pair of whiskers. I enjoy that.

Admittedly, with the painted nacelles on the King Air something about it can begin to get a little...plastic-looking, I don't have any way to word it better. The blue in general isn't my favorite - unlike the saturated red's strikingness, it just sort of looks over-saturated in a way that I dislike. I'm not sure what would fix this. Maybe a darker blue?

Now, the RFDS's livery is by far the least worth-discussing thing about them. The service that they provide goes way beyond appearances, and because of that and because of the fact that designing liveries for smaller planes like this begins to get difficult I'm going to not be as harsh to them as I would other subjects. I'm just not really going to take into account the fact that this is a pretty generic scheme, because that's fine, there's no reason to care. My main takeaways are that the placement of the colors is quite well-executed, and that I wish the wordmark on the main fuselage body was more distinct. In photographs it's honestly downright illegible, and the text on the rudder doesn't exactly pop out either. The tailfin, in general, looks a little cluttered, like they didn't want to leave it empty but couldn't figure out what to do with it - the RFDS text doesn't even appear centered. But at the very least it's visible, which is crucial for an air ambulance service. Maybe I wish there was less white, but there's enough red and blue, and it's bright enough, so it's done its job.

That said, I'm giving them a C.

This is exactly what I expect of them. They've done a completely adequate job, and probably in a roundabout way it's good they've been spending their money on things that aren't genius graphic design. So if you have anything to take away from this post, don't have it be the grade, or even the fact that the Pilatus PC-12 is a really fantastic airplane - have it be the fact that aviation isn't just airline startups and massive conglomerates, and that it literally saves lives and provides services that we city-dwellers take for granted to people who would otherwise have to go without.

[autisticadvocacy]

This infographic from NIHCM addresses barriers to health care for Americans in rural areas: https://nihcm.org/publications/rural-health-addressing-barriers-to-care

[mariacallous]

The North Star of communications policy should be to make services faster, better, and cheaper for all. Yet, next year, about 50 million Americans could find that their access to the core communications service of our time—broadband—has become slower, worse, and more expensive, with many even likely to be disconnected. That shift would constitute the biggest step any country has ever taken to widen, rather than close, its digital divide. 

The reason for the potential debacle? The Affordable Connectivity Program (ACP), which provides a $30 per month subsidy for broadband to over 16 million households (with the number continuing to grow) will run out of funds. 

Congress established the ACP in the Infrastructure Investment and Jobs Act (IIJA) of 2021. That law correctly observed that “a broadband connection and digital literacy are increasingly critical to how individuals participate in the society, economy, and civic institutions of the United States; and access health care and essential services, obtain education, and build careers.” 

To assure that all were connected, the law appropriated $65 billion to broadband. Congress devoted most of the funds to network deployments in unserved and underserved areas, but there was another $14.25 billion allocated to the ACP to assure that broadband would be affordable to all. The program is projected exhaust all its funds sometime in the first half of 2024. 

The end of the program would be a disaster for families who generally have little savings or discretionary income and will suddenly face monthly broadband charges of $30 or more. It would also rob the broader economy of an opportunity to grow faster due to universal connectivity. As demonstrated by a 2021 study on the employment effects of subsidized broadband for low-income Americans, such programs increase employment rates and earnings of eligible individuals due to greater labor force participation and decreased probability of unemployment, with a benefit of $2,200 annually for low-income households. 

Ending the program would also limit the enormous potential for savings in critical services that broadband can deliver. For example, in health care, data from Cigna Healthcare shows that patients save an average of $93 when using non-urgent virtual care instead of an in-person visit. Similarly, patients save an average of $120 when the virtual visit involves a specialist, and $141 with a virtual urgent-care clinic over an in-person one. Given that the Medicaid-eligible population and the ACP-eligible population overlap significantly, the savings for the government in assuring all can afford telehealth likely pays for itself. In addition, as Brookings Metro has previously noted, widespread broadband access also leads to improved outcomes in education, jobs, and social services, which would be lost if the ACP elapses. 

The ACP’s expiration will also create problems for the Broadband Equity, Access, and Deployment (BEAD) Program—the $42.5 billion network deployment program Congress created in the IIJA. A study reviewing the ACP’s impact on BEAD concluded that it reduces the subsidy needed to incentivize providers to build in rural areas by 25% per household, writing: “The existence of ACP, which subsidizes subscriber service fees up to $360 per year, reduces the per-household subsidy required to incentivize ISP investment by $500, generating benefit for the government and increasing the market attractiveness for new entrants and incumbent providers.” As the National Urban League has observed, that study demonstrates that “if Congress fails to reauthorize ACP, the federal government likely will end up overpaying for broadband deployments. As a result, the federal dollars will end up funding deployments to significantly fewer unserved and underserved homes and businesses.”   

The obvious solution is for Congress to continue funding the program. That is possible, as it enjoys bipartisan support. For example, former Republican FCC Commissioner Michael O’Rielly penned an op-ed titled “A Conservative Case for the Affordable Connectivity Program.” EducationSuperhighway, a national nonprofit with the mission of closing the digital divide, identified 28 governors who have prioritized implementing the ACP, including those from deep-red states such as Alabama, Idaho, and Mississippi. And polling suggests the program is widely popular among the public, with a January poll showing a “strong bipartisan majority of voters (78 percent) support continuing the ACP, including 64 percent of Republicans, 70 percent of Independents, and 95 percent of Democrats.” 

But despite the ACP’s importance and popularity, it is questionable whether the Republican-controlled House will continue funding it, given the party’s attacks on other social safety net programs.  

Should ACP funding be discontinued, there are alternatives—but all come with their own concerns. The FCC could fund the program itself, through the mechanism by which it funds universal service programs. That framework, however, is already under stress from legal challenges to its constitutionality and a shrinking revenue base, which has declined by 63% in the last two decades. States could design their own programs, such as New York did by requiring providers to offer a $15 broadband service to low-income residents. But in 2021, a judge ruled that the program violates federal law. Moreover, it is questionable whether the country’s universal service ambitions are best served by a fragmented set of state programs. 

The National Urban League proposed a promising alternative in its Lewis Latimer Plan for Digital Equity and Inclusion. (Disclosure: The author of this piece assisted the National Urban League in its development of the Latimer Plan and its analysis of the implications of the ACP on the BEAD program.) Noting the cost savings demonstrated through telehealth, the plan proposed allowing Medicaid to enable states to provide broadband vouchers, like what the ACP offers, to eligible persons. This is similar to the way health insurance providers offer non-medical benefits that, over time, reduce the cost of health coverage. Of course, such a plan would require an administrative process to determine if and how to proceed. But it offers an alternative that would provide a sustainable source of funding.  

The ACP, like any new program, could use some incremental fixes. As a Government Accountability Office review of the program noted, the FCC could improve performance goals and measures, consumer outreach, and fraud risk management. The FCC is working to do so. 

But those reforms should not take our eyes off the crisis close at hand. Two years ago, the government came together in an unusually bipartisan way to assure that all could afford the broadband service they need in their homes to fully participate in the economy and society. Since then, the importance of broadband for accessing essential services has only grown. We should make the years ahead be the ones when we finally close the digital divide—not allow it to grow even more. 

[ivygorgon]

AN OPEN LETTER to THE U.S. CONGRESS

Fund the Affordable Connectivity Program NOW!

130 so far! Help us get to 250 signers!

I’m a concerned constituent writing to urge you to fund the Affordable Connectivity Program or ACP. Digital connectivity is a basic necessity in our modern world and the internet must be treated as a public utility. We use the internet to apply for jobs, perform our jobs, receive telehealth medical treatment, and pay bills, and students use it to complete homework assignments. But for millions of people in rural and urban areas, and Tribal communities, the internet is a luxury they cannot afford. Failure by Congress to fund this program will force millions of households already on tight budgets to choose between being able to stay online or potentially losing access to this essential service. If Congress doesn’t act fast, funding for the Affordable Connectivity Program will run out and more than 22 million Americans -- 1 in 6 households -- will lose this vital service. The implications of this will be devastating. In 2019, 18% of Native people living on Tribal land had no internet access; 33% relied on cell phone service for the internet; and 39% had spotty or no connection to the internet at home on their smart phone. The ACP has enrolled 320,000 households on Tribal lands -- important progress. The largest percentage gains in broadband access are in rural areas. Nearly half of military families are enrolled in ACP, as are one in four African American and Latino households. Losing access and training on using computers and the internet will have devastating impacts on all these communities as technology becomes increasingly integral to work, education, health, and our everyday lives. Without moves to address tech inequality, low-income communities and communities of color are heading towards an “unemployment abyss.” The Affordable Connectivity Program has broad bipartisan support because it is working. As your constituent, I am urging you to push for renewed funding for the ACP before it runs out in the coming weeks.

▶ Created on April 11 by Jess Craven

📱 Text SIGN PJXULY to 50409

🤯 Liked it? Text FOLLOW JESSCRAVEN101 to 50409

lol. lmao, even

[nrsnursing]

NRS Nursing also offers telehealth services in Nepal. Our objective is to offer individuals in rural regions with access to health care and medical solutions. Not only that, but we want to be the most accessible, competitively priced, and trustworthy health care provider in Nepal.

[businesplanning]

Fostering Equity: Ensuring Accessibility to Services for Vulnerable Groups

The concept of accessibility extends far beyond physical spaces. It encompasses the fundamental right of every individual to reach and benefit from essential services, regardless of their background or circumstances. However, certain sections in society face various barriers that bar them from accessing critical series. Some of the challenges faced by vulnerable communities and innovative approaches that can be applied to solve them have been explored below:

Understanding Vulnerability and Access

Vulnerable groups encompass a diverse array of individuals who may face heightened risks or disadvantages due to various factors such as socioeconomic status, disability, age, ethnicity, or gender. These groups often encounter systemic barriers that restrict their access to healthcare, education, housing, employment opportunities, and other essential services. For instance, persons with disabilities frequently encounter physical obstacles, lack of accessible transportation, and inadequate communication support when seeking healthcare or educational services.

Moreover, economic disparities can exacerbate these challenges, with marginalised communities experiencing limited financial resources that further restrict their access to quality services. Language barriers also play a significant role, making it difficult for immigrants or non-native speakers to navigate bureaucratic processes or obtain necessary information.

These barriers become much harder to cross during crises and emergencies and can cost livelihoods and lives of vulnerable communities.  Ensuring access to services for vulnerable groups is therefore of critical importance. The first step for this is understanding the nature of barriers faced by vulnerable communities.

Barriers to Access

1. Physical Barriers: Infrastructure and facilities that are not designed with accessibility in mind can exclude individuals with disabilities. Lack of ramps, elevators, or appropriate signage can render spaces inaccessible.

2. Financial Constraints: High costs associated with services such as healthcare or legal assistance can prevent economically disadvantaged groups from seeking help when needed.

3. Information and Communication: Inadequate provision of information in accessible formats excludes individuals with sensory impairments or limited literacy skills.

4. Discrimination and Stigma: Social prejudices and discriminatory practices based on race, ethnicity, gender identity, or sexual orientation can deter vulnerable groups from seeking services due to fear of mistreatment or rejection.

5. Geographical Isolation: Rural or remote communities often face challenges in accessing basic services due to limited infrastructure and transportation options.

Innovative Solutions

Addressing these barriers requires a multifaceted approach that involves collaboration between governments, NGOs, businesses, and communities. Here are several innovative strategies that can enhance service accessibility for vulnerable groups:

1. Technology and Digital Inclusion: Leveraging technology to provide virtual services, telehealth options, and online education can mitigate geographical barriers and enhance access for remote communities.

2. Community Outreach and Engagement: Establishing community-based service centres staffed with culturally competent professionals can improve trust and accessibility among marginalised groups.

3. Policy Reform and Advocacy: Advocating for inclusive policies and enforcing anti-discrimination laws can create a legal framework that protects the rights of vulnerable individuals and ensures equal access to services.

4. Education and Training: Providing training programs for service providers on diversity, inclusion, and accessibility can enhance their ability to cater to the diverse needs of vulnerable populations.

5. Collaborative Partnerships: Forming partnerships between government agencies, nonprofit organizations, and private sector entities can pool resources and expertise to develop comprehensive solutions.

6. Accessible Infrastructure: Investing in universal design principles to ensure that public spaces, buildings, and transportation systems are accessible to individuals with disabilities.

The Road Ahead

As we strive for a more inclusive society, it is imperative to recognize that enhancing service accessibility for vulnerable groups is not just a moral imperative but also a social and economic necessity. By breaking down barriers and promoting equal access to services, we empower individuals to fulfil their potential and contribute meaningfully to their communities.

Governments, businesses, and civil society organizations must continue to collaborate and innovate to ensure that no one is left behind. By investing in accessible infrastructure, promoting education and awareness, and fostering a culture of inclusivity, we can create a future where every individual, regardless of their circumstances, has the opportunity to thrive. Through continuous research and custom data collection firms, organisations and communities can work together to address the specific needs of vulnerable communities and build an equitable future for all.

In conclusion, achieving equal access requires collective action and a commitment to upholding the rights and dignity of all individuals. By embracing diversity and prioritising inclusion in our policies and practices, we can build a society where everyone has the chance to live a life of dignity, opportunity, and empowerment. Let us work together to create a world where access to essential services is a reality for everyone, leaving no one behind.

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In case you had paywall issues or found the ads on the site made your computer crash, here's the article:

By Judy Stone

Telehealth will end on December 31 unless Congress takes urgent action to pass the Telehealth Moderniztion Act of 2024.

Before COVID, Medicare provided limited coverage for telehealth and mainly limited it to rural patients. It required them to go to a local hospital or clinic to interact with a specialist until early 2020. At the beginning of the COVID-19 pandemic, Medicare greatly expanded coverage to include patients anywhere, allowing them to access specialty care from home. Expanded services also included physical and occupational therapy, emergency department visits, and nursing facility care via telehealth. This expansion provided care to Medicare’s 64 million enrollees and broadened pre-existing access for 76 million low-income Americans on Medicaid.

It’s not just patients on Medicare/Medicaid who need to worry if this bill isn’t renewed. Private insurers often follow Medicare’s lead regarding what services they will cover.

Congress.gov summarizes the H.R. 7623 Telehealth Modernization Act of 2024 as follows: “This bill modifies requirements relating to coverage of telehealth services under Medicare.

Specifically, the bill permanently extends certain flexibilities that were initially authorized during the public health emergency relating to COVID-19. Among other things, the bill allows (1) rural health clinics and federally qualified health centers to serve as the distant site (i.e., the location of the health care practitioner); (2) the home of a beneficiary to serve as the originating site (i.e., the location of the beneficiary) for all services (rather than for only certain services); and (3) all types of practitioners to furnish telehealth services, as determined by the Centers for Medicare & Medicaid Services.”

Why Does Telehealth Matter?

Being able to access medical remotely has been a huge boon to many, particularly in rural areas or those who are disabled.

Jessica Offir, PhD, is a disabled health care advocate and social psychologist for whom telemedicine is a priority issue. She observed that a stumbling block to the renewal of the bill is that “insurance companies didn't want to pay the same amounts as they were for in-person care, but providers have been insisting on it.” She added, “Trump is also wanting to reduce Medicare & Medicaid payouts, and this is one way to make that happen, as telehealth greatly increased the healthcare access of the elderly and disabled. Take away access, and payments decrease. The only entities who benefit are insurers.”

My own family are ardent supporters of access to telemedicine. We live in western Maryland, a three-hour drive to the university hospitals in Washington/Baltimore. I’m unable to drive that far, so increasingly rely on remote services, particularly for specialties that are poorly represented in our town. If telemedicine services are cut, I will be unable to access some specialties I need. Someone drives me twice a year for in-person examinations. These increasingly feel hazardous to my health for two reasons—one is the worsening traffic and trucking on the interstate. The other is that while my family still recognizes that the COVID-19 pandemic has not ended, our providers have not. They have stopped masking and even turned off HEPA filters in exam areas and waiting rooms, leaving them abandoned and useless. I take an Aranet CO2 monitor with me everywhere and try to educate people. On one recent visit, the CO2 level went from 600 ppm when I entered the exam room, to 1704 ppm before I left! That’s a level that can make you sleepy and show poorer judgment. I explained to the physician that each breath that he took had 3.4% rebreathed air from someone else, per SN Rudnick and Don Milton’s study, popularized by David Elfstrom’s reference table. That caught his attention and recognition of his potential risk of a Covid or other respiratory tract infection.

My experience is not unique. A recent article found that more than 17 percent of older Medicare beneficiaries similarly report difficulty traveling to doctor’s offices. Those over 65 averaged about 17 contact days that year for ambulatory care. That rose to 30 contact days per year for the 14 percent of patients with ten or more chronic illnesses—a considerable time and energy burden.

Another study of cancer patients found (73.8%) rated their first telemedicine visit as good as or better than an in-person visit, and 4606 (18.9%) rated it superior. In another striking example, those who received care through telehealth with peer assistance were almost seven times more likely to be treated for hepatitis C and four times more likely to achieve viral clearance after six months.

One bit of good news is that on November 15, the U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) announced they will extend telemedicine flexibilities through 2025. This is an important win for access to medication in end-of-life care. More than 40,000 comments were submitted to the DEA.

Paying for telehealth is a major concern now, although there has been bipartisan support for the bill. A House Republican staffer explained that “Medicare beneficiaries are on a cliff, losing tele services after December 31 2024.” Congress is negotiating how long another extension could look like and where the funding will come from, with the two parties not yet in agreement.

There have been higher per-person costs where more telehealth is used. On the other hand, telemedicine might improve patient compliance with medications and reduce costly emergency room visits.

One can argue about relative costs, but the bottom line is that there are people behind these numbers—largely disabled, elderly and rural. There are some concerns about ensuring quality of care, but that appears to be minor.

The Action Network is encouraging people to write their Congressional representatives to urge them to pass this Telehealth Modernization Act before the end of the year. It’s the only chance of saving it. With the news of planned slashes to government spending, there is no time to waste.

As Offir reminds us, “Once again, the people who will be most harmed are the vulnerable populations that can least afford to be.”

You can contact your House representatives here, and Senators here.

Please contact your Congresspeople about this one. It's vital.

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