The following transcript has been edited for length and readability. Listen to the entire discussion here on The Broadband Bunch.
Craig C.:
Welcome to The Broadband Bunch, a podcast about broadband and how it impacts all of us. Our guest today is a long-time and well-known veteran of the communications world who provides broadband and telehealth strategy consulting, helping communities improve economic development, healthcare delivery, education, and local government operations. It is a pleasure to welcome industry analyst, presenter, author, and host of the Gigabit Nation radio show, Craig Settles. Craig, welcome to The Broadband Bunch.
Craig S.:
Thank you very much for having me again. It’s very good to be back and definitely talking about these issues that are so prevalent these days in the midst of all the pandemic craziness.
Craig C.:
I look at our past conversations with regard to industry trends and how telehealth is important. Now because the past nine months have placed an even greater importance on that across the board. We’re not talking about something that I think in many views was more a rural America conversation point, to everybody from coast-to-coast.
Broadband for Urban and Rural Communities
Craig S.:
I would say that when I got into this community broadband business in 2005, there was no distinction between rural and urban. Broadband was a problem across the board. It’s only been since, I would say 2010/2011, where we really got focused on the rural areas,- which is fine because they need help getting broadband to those communities. At the same time, we have very much deemphasized the value, the need and even the nature of the need of urban America. This is unfortunate and this needs to be addressed.
Craig S.:
But because the initial flashpoints for the pandemic were in Chicago, New York, and other major urban areas, all of a sudden now the lack of broadband in urban America was front and center. Now, as we have moved through the pandemic to where it is more of a rural focus, it will bring the topics and discussions back to rural America. Ultimately, what we need is an understanding across the board that the problems that plague rural areas do indeed impact the urban areas and probably more so. This is because in the urban areas, there are three times as many homes that are not connected to any kind of broadband and some millions of others who have a less robust … okay, we’ll just call it pathetic … excuse for broadband.
2020 Pandemic brings Telehealth Front and Center
Craig C.:
Just about a year ago, you contributed an article to Government Technology entitled Broadband Can Alleviate the Healthcare Crisis. You dealt with the topic of how the lack of physicians in rural areas could be offset by telehealth delivered by community-based digital networks. You were very much on the cusp of what within just a few months would be a crushing need for telehealth.
Craig S.:
I started focusing on telehealth, initially because of a personal issue – I had a stroke and telehealth was the factor in my treatment and in my recovery. Since then, in the last three years, I’ve delved into it greatly. Ironically, because of the pandemic, telehealth issues started to be addressed. For example, there were regulations that were somewhat asinine in terms of the position they put doctors in where they couldn’t get reimbursed. There were issues where you had to go to a facility to get treatments, which pretty much defeats the key benefit of having the ability to getting your healthcare at home.
Craig S.:
As we look into the pandemic, across the board, there was clearly a need for telehealth because no one wanted to go to a doctor’s office where there was a potential for getting infected. Also, what happened is it was particularly relevant that African Americans and other people of color were being affected most by the pandemic. People were getting sicker and people were dying at greater rates in the African American communities than in other groups.
Craig S.:
Partly this is due to the poor quality of healthcare that these communities receive, and so the discussion went very quickly to the urban needs. We started looking at a healthcare crisis, and then we started delving further when we looked at telehealth as the way to get good healthcare in a pandemic situation, but then everyone started to realize, “Oh, even in the urban areas, the broadband is so bad that they won’t be able to get telehealth.”
Bad Broadband = Bad Telehealth
Craig S.:
In some respects, it emphasized and highlighted both areas, the low quality of broadband and health services. It changed the discussion. It changed the emphasis that we have or have not put on broadband funding in urban areas. Where we are now, is that we have a problem. We understand that we have this problem and where are we have this problem. Now someone has to start coming up with the solutions for these problems, and quickly.
Craig C.:
Our guest today, Mr. Craig Settles, industry analyst, author, and host of Gigabit Nation Radio talk show. In that article that you wrote on telehealth you had one section that was titled Telehealth and Community Broadband Symbiotic Partners, and you referenced a study that was done by JD Power, the well-known marketing information services firm, that at that point I think it was just less than 10% consumers have used telehealth in lieu of a doctor’s office visit. Those numbers have most likely skyrocketed in the last nine months. When you referenced a moment ago the need to do it quickly, the onus is on providers everywhere to make sure that they are giving an opportunity for their consumers, their customers, to have the availability for telehealth, if you would address that.
Disparity in Federal Spending for Broadband
Craig S.:
We have what, I consider, a redlining issue in that basically because of the economics of broadband and the big carriers, they only focus on where they can get a return for their money. The problem is low-income folks can’t afford those packages. They can barely afford $20 or $30 a month, so you have a situation where you have areas which are not upgraded. We had an article just a couple of weeks ago about AT&T basically abandoning low-income areas. We have to deal with that.
Craig S.:
We have to worry about the issue of even if there is a subsidy, where are you going to actually use that subsidy? Will it be used for people that have poor broadband services, poor customer support services, and so forth? Some of the remedies for the problem aren’t really remedies at all because the economics of supporting poor folks is basically a bottom-line issue. That has to be addressed. No one likes to talk about this. Even the word redlining gets people upset, but it’s the reality of our situation. It is the reality of the situation. What are we going to do about that?
Craig S.:
Now, you couple that, the redlining issue with a disparity in our federal spending for broadband. We will put $4-5 billion in rural areas for broadband, which, again, is fine because they have the need, but we basically give peanuts to urban America and it sucks. I mean, actually, I’m being very polite. It’s ridiculous when you have communities where millions of homes don’t have broadband and they get next to nothing for their broadband spending.
Craig S.:
That has to be addressed because when you look at the issue of incumbents and their redlining, and you look at the federal government and the fact that our tax dollars are what’s funding the broadband efforts of the FCC, USDA and so forth, and then you look our bills, our phone bills, our cable bills, where money is taken from us, in these little fees that they have, and that money goes to the incumbents who are supposed to be rectifying the problem.
Craig C.:
Talk a little bit about how you have worked with municipalities and co-ops building the case for community-wide telehealth.
Craig S.:
I’ve worked with cities such as Benicia and Glendale in California, and Ottumwa, IA where I worked through a needs analysis. Which I consider to be somewhat different than a feasibility study, because a feasibility study kind of says, “Would broadband help?” which is kind of a silly question because obviously it will help. In a needs assessment, I’m looking at who needs broadband, what they can do with broadband, how can they improve their operations by using broadband… We look at the schools, we look at businesses and look at government entities and so forth and how they can be helped by broadband.
Craig S.:
When I started to look at doing a needs analysis for telehealth, some of the questions are the same [as a needs analysis for broadband]. Who has broadband? Who has good telehealth? Who is susceptible for chronic diseases and where are they most susceptible? Well, with broadband, we’re looking at who needs the broadband the most, where are there infrastructures that can help people in low-income communities that we can then help and weave into some sort of an action plan.
You Can’t Have Telehealth Without Broadband
Craig S.:
You look at telehealth, it’s a similar kind of thing. What kinds of healthcare do we have available? What types of emergency care is available? How do we look at this from an economic perspective? How do we look at it from which parts of town are most affected? You look at your refugee population. Should that be factored in both the broadband discussion and the telehealth discussion? There’s many types of areas where there is overlap. What I’m trying to do is outline that to show where these needs are and then how to use a combination of creativity and dollars and volunteers and other types of resources to address both the broadband and the telehealth need.
Craig S.:
When I refer to them as being in a symbiotic relationship, you can’t have telehealth without broadband. If you have broadband, especially if the community has built a network or a co-op has built a network, at some point you need the marketing uplift that you can get by having and offering telehealth to your subscribers. There is a monetary benefit. There is a quality of life benefit for both telehealth and broadband and they need to be looked at more because I think that we have silos, right? The people in the telehealth world, they’re not … I mean, they understand they need broadband, but how do you get broadband? How do you impact meeting the need for broadband?
Craig S.:
If you’re looking at the broadband side of the equation, they tend to want to build it and be done with it when in reality, you incorporate telehealth into your marketing of your broadband, you can go very far with this, because ultimately, everyone gets sick or is responsible for someone who is ill. The universality of healthcare and the need for healthcare is a winning shot from the marketing perspective.
GIS Enables Better Broadband Deployment
Craig C.:
I’m always curious, you are constantly on the go, busy with reports and analyses and surveys. Tell us about the recent work that you did, sponsored by ETI Software, (and the sponsor of The Broadband Bunch).
Craig S.:
I worked with ETI on a survey last year, and issued a report, on GIS and how GIS impacts broadband in a number of ways. With the GIS report, I generally talk to a lot of people where technology is not their main thing. They’re not necessarily responsible for that, but they need to understand how the technology works. With the GIS equation, if you will, there are ways that you use GIS for your needs assessment. All of the types of marketing research data can be pulled together and then be used to plan out where broadband needs to be, where telehealth health needs to be, the demographics and the issues that are uncovered with the GIS products. It makes a lot of sense.
Craig S.:
When you look at how quickly you can deploy broadband, you see where wireless ISPs in particular, which is a big part of ATI’s market, right, those entities, those enterprises, right, with GIS tools, they can deploy faster. This became a big thing with the beginning of the pandemic when we sent all of our kids home, our college students’ home, and we sent the employees home and then all of a sudden, the infrastructure of the home and the neighborhood needed an upgrade quickly, and so GIS tools enable that to happen.
Grant Writing Guidebook Assisting Organizations
Craig C.:
Another big part of the process in assisting organizations looking for funding is knowing how to approach the grant writing aspect of the business. So you have compiled a grant writing guidebook.
Craig S.:
That was the most recent report I’ve worked on. The pandemic has changed a number of aspects with how people get money. Typically, you would go to the FCC for E-rate money, which facilitates schools and libraries. You can also go to the Department of Education for various grants that can be used for broadband. You have Health & Human Services, which you would normally go to for healthcare-related projects and telehealth-related projects and so forth. It was somewhat stratified where you would go for your money. Now we have distance learning, where both the teachers and the students are at home, so where does the money come to support those broadband efforts when we’re talking about home delivery of broadband? That’s a policy issue, but it’s also a mechanical issue.
Craig C.:
Craig, would you agree that it’s so vitally important, given the number of organizations looking for grants, that grant writing now is at an all-time high as far as needing guidance as to how to effectively approach that process? That’s where I see your guidebook as incredibly important for organizations.
Craig S.:
Yes, because one of the issues is that we have these grant exercises. Over the summer we had the CARES Act. That was a lot of money, at least a $1.5 billion given to every state, but you had to create a project and finish it by the end of the year. We’re talking about four to six months for the entire execution. In order to plan, you need some assistance to try to figure out how do we structure a proposal so that we can get the most amount of benefit in terms of how these programs get funded.
Craig S.:
You want to have partnerships. How do you form partnerships? How do you deal with the benefits of broadband and telehealth? How do we pull those together in a proposal? The report that I did looks at how you as a community can quickly pull together the elements that are important when you have almost no time to execute. Six months to execute a broadband program is extremely difficult.
Craig S.:
You have to have the right partners, and peoples need to be doing this now. Even though we’re talking about the next package of broadband grants, which is a $10 billion, it’s going to be released in the same way. It’s basically you have a deadline and in that deadline, you have to identify your need, create a proposal to meet that need, create whatever kind of partnerships that you need in order to implement the program and then you just got to make it happen by, I would guess by the end of summer 2021, if we look at how things were done with CARES in the summer of 2020.
Craig C.:
As we began to wind down, most importantly, if folks are interested in finding that guidebook for grant writing, how would they most easily be able to find it?
Craig S.:
The ETI Software is number one. Then my site, which is CJSpeaks.com. Then our other sponsor, Transcending Healthcare, is a systems integrator that is also a sponsor of the report, and their website will also be a site where people can download the report. Thank you for having me. It’s always a pleasure working with you guys.
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