Introduction to Telehealth Blackouts
BRANCHLAND, W.Va. — Ada Carol Adkins lives with her two dogs in a trailer tucked into the timbers off Upper Mud River Road. “I’m comfortable here, but I’m having health issues,” said the 68-year-old, who retired from her job as a school cook several years ago after having a stroke. “Things are failing me.” Her trailer sits halfway up a ridge miles from town and the local health clinic. Her phone and internet are “wacky sometimes,” she said. Adkins — who is fiercely independent and calls herself a “Mountain Momma” — worries she won’t be able to call for help if service goes out, which happens often.
The Struggle for Reliable Internet
To Frontier Communications, the telecommunications company that owns the line to her home, Adkins says: “Please come and hook me right.” But she might be waiting years for better service, frustrated by her internet provider and left behind by troubled federal grant programs. A quarter of West Virginia counties — including Lincoln, where the Mud River bends its way through hollows and past cattle farms — face two barriers to health care: They lack high-speed internet and have a shortage of primary care providers and behavioral health specialists, according to a KFF Health News analysis.
Flawed Federal Programs
Years of Republican and Democratic administrations have tried to fix the nation’s broadband woes, through flawed attempts. Bad mapping, weak standards, and flimsy oversight have left Adkins and nearly 3 million other rural Americans in dead zones — with eroded health care services and where telehealth doesn’t reach. Blair Levin, a former executive director of the Federal Communications Commission’s National Broadband Plan, called one rural program rollout during the first Trump administration “a disaster.” It was launched before it was ready, he said, using unreliable federal maps and a reverse-auction process to select internet carriers.
The Consequences of Inaction
The fund initially announced awards of $9.2 billion to build infrastructure in 49 states. By 2025, $3.3 billion of those awards were in default and, as a result, the program won’t connect 1.9 million homes and businesses, according to a recent study. A $42 billion Biden-era initiative still may not help Adkins and many others shortchanged by earlier federal broadband grants. The new wave of funding, the Broadband Equity, Access, and Deployment Program, or BEAD, has an anti-waste provision and won’t provide service in places where previous grants were awarded — even if companies haven’t delivered on their commitments.
Personal Stories of Struggle
Adkins keeps spiral-bound notebooks and calendars filled with handwritten records of phone and internet outages. In January, while bean soup warmed on the stove, she opened a notebook: “I got books full. Hang on.” Her finger traced the page as she recounted outages that occurred about once a month last year. Adkins said she lost connectivity twice in November, again in October, and in July, May, and March. Each time she went for days without service. Adkins pays Frontier Communications $102.13 a month for a “bundle” that includes a connection for her house phone and wireless internet access on her cellphone.
The Impact on Healthcare
Adkins, a widow, spends most of her time at home and said she would do video calls with her doctors if she could. She said she still has numbness on one side of her body after the stroke. She also has high blood pressure and arthritis and uses over-the-counter pain patches when needed, such as after she carries 30-pound dog food bags into the house. The neighbors have all seen Adkins’ line. The pale-yellow cord was tied off with green plastic ties around a pole outside her trailer. As it ran down the hill, it was knotted around tree trunks and branches, frayed in places, and, finally, collapsed on the ground under gravel, snow, and ice at the bottom of the hill.
Alternative Solutions
David and Billi Belcher’s double-wide modular home sits near the top of the ridge past Adkins’ home. Inside, an old hunting dog sleeps on the floor. Belcher pointed out a window toward where he said Frontier’s cable has remained unrepaired for years: “It’s laying on the ground in the woods,” he said. The Belchers needed better internet access for work and could afford to pay $700 for a Starlink satellite internet kit and insurance, they said. Their monthly Starlink bill is $120 — a price many cannot manage, especially since Congress sunset an earlier program that helped offset the cost of high-speed plans for consumers.
The Future of Broadband Expansion
The National Telecommunications and Information Administration, which administers the program, in April announced a 90-day extension for states to finalize their plans during a “comprehensive review” of the program. West Virginia Gov. Patrick Morrisey, a Republican, announced his state would take an extension. The move, though, doesn’t make a lot of sense, said Evan Feinman, who left the agency in March after directing the broadband program for the past three years. Calling the work already done in West Virginia an “incredible triumph,” Feinman said the state had completed the planning, mapping, and the initial selection of companies.
Conclusion
The struggle for reliable internet in rural America is a pressing issue that affects not only the daily lives of residents but also their access to healthcare. Flawed federal programs and the lack of investment in broadband infrastructure have left millions of Americans in dead zones, unable to access telehealth services. The story of Ada Carol Adkins and her community highlights the need for urgent action to address this issue and ensure that all Americans have access to reliable and affordable internet.
FAQs
Q: What is the main issue affecting rural Americans in terms of healthcare?
A: The main issue is the lack of access to reliable and affordable internet, which prevents them from accessing telehealth services.
Q: What is the Broadband Equity, Access, and Deployment Program (BEAD)?
A: BEAD is a $42 billion Biden-era initiative aimed at providing funding for broadband infrastructure in rural areas.
Q: Why is it difficult for internet service providers to build fiber-optic lines in rural areas?
A: It is difficult due to the high cost of installation, which can be over $5,000 per connection in some areas, and the lack of federal subsidies to support the construction.
Q: What is the impact of lack of internet access on healthcare in rural areas?
A: The lack of internet access limits the use of telehealth services, which can lead to delayed or inadequate healthcare, and exacerbate existing health disparities.
Q: What is the role of the National Telecommunications and Information Administration in addressing the broadband issue?
A: The National Telecommunications and Information Administration administers the broadband program and is responsible for overseeing the distribution of funds and ensuring that the program meets its goals.
