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Empower Rural Iowa - Connecting Task Force Minutes - October 2019

Governor’s Empower Rural Iowa Initiative

Connecting Rural Iowa Task Force Meeting Minutes

 Iowa Specialty Hospital

Clarion, Iowa

Wednesday, October 9, 2019

2:00 p.m.

  1. Roll Call:

Present:       Lt. Governor Gregg         Sandy Ehrig         Maison Bleam for Sec. Naig

                Hollee McCormick           Ryan Boone        Steve Simons

                Chris Ball                              Danna Larson     Kevin Cabbage

                Patty Manuel                     Katie LaBree       Dave Duncan

  1. Approval of Minutes:

Draft minutes from the September 13, 2019, meeting had been previously distributed for review. Dave made a motion to approve the minutes and Hollee seconded the motion, which was unanimously approved.

  1. Welcoming Remarks from Lt. Governor Gregg:

Lt. Governor thanked representatives from Iowa Specialty Hospital for hosting and the tour, it was very informative. He hasn’t seen another hospital partnering with a school on telehealth and appreciates the flexibility for parents. Appreciates of the positive benefits of telehealth, the quality doctor visit, no necessity for nurses to wake up the doctors, and the quick turnaround. Using for language services and mental health services is a plus. Thanks too, to Goldfield Access Network and Comm 1 for sponsoring lunch today.

Last meeting was at the Driving Simulator and we are continuing conversation today on what connectivity means for healthcare and education. There will be an update from Liesl on the grants and ERI website, then we will hear from our panelists. We will also look at the Discussion Draft of possible recommendations.Gave an update on other task force discussions. Growing will be in Belleview on the 16th discussing community visioning. Investing was in Hawarden on the 4th discussing abandoned homes. Toured his old school which has been made into city offices and a community center, and their old city hall which has been saved but not completed.Discussed how to make similar government programs more efficient and workable.

  1. Remarks from Co-Chair Sandy Ehrig:

Thanked Iowa Specialty Hospital for hosting and for the informative tour highlighting the different uses of connectivity in healthcare. The Empower Rural Iowa Initiative is a blending of all three task forces, and the partnership with IRDC has helped expand opportunities to provide information on both groups.Patty Manual joined her at the recent Iowa Ideas Conference, along with the Lt. Governor, Mark Reinig and Jennifer Crall. On December 18, the IRDC will hold a joint meeting with ERI in Perry, like what was held this summer in Mount Ayr. Also, save the date for the Iowa Rural Summit, April 29-May 1 at the Kirkwood Hotel at Kirkwood Community College.

  1. ERI Initiative Update:

The Broadband Grant Program currently underway and closes next Friday. There are 13 applications in process, none yet submitted.Continue to reach out to networks to push for applications. Five million is available for this round. The draft on the procedures and policies for rural grants is out to the grants subcommittee for review. Will be presented to IEDA board next Friday for approval.

Website: Working with IRDC which is doing a website update and that will be main landing page for resources. Will highlight housing, leadership, connectivity, other. There will be an area for best practices and resources. ERI landing page will shift from Governor’s website to IEDA website, which will be basic for agendas, minutes, link to IRDC, task force members etc. and information on the two new building rehab/demo program. Might be able to show something in December.

  1. Panel Discussion on Broadband in Healthcare & Education

Dave facilitated panelists: Ashley Recknor, Specialty and Outreach Clinic Leader with Iowa Specialty Hospital; Dr. Bob Olson, Superintendent of Clarion-Goldfield-Dows CSD; TJ Martin, Dean of Distance Education with Iowa Central Community College, and asked panelists to provide info on themselves.

Ashley: One of her roles is leading the telehealth committee. The facility uses telemedicine in many ways, including mental health, telehealth, and in school districts. Looking to expand into workplaces to offer similar services.ISH has locations across the region, and they have issues with this technology in smaller towns.

TJ: He comes from farm background and has been at ICCC for 20 years. There is a need for students to have connectivity at home to do projects. If they are a working adult, it’s difficult to stay on campus to complete assignments. They have 5,000 students, with Fort Dodge as main campus and branches in Webster City and Storm Lake.Most students are commuters who need to do course work at home so need broadband.

Dr. Bob: Has been with school district for 36 years and has seen many changes in poverty and demographics.He is Chair of Rural School Advocates of Iowa. His CSD is 362 sq. miles and they have challenges with transportation. When there are limited resources at home it is an issue. Elementary students eat free, over 50% of students qualify for free and reduced. The CSD is a 1:1 provider of devices but with no broadband at home it is an issue. There is also more and more movement to electronic textbooks that include links to deeper content info. Forest City CSD has been cleared for three days of work-at-home for snow days, but need to have broadband. As we rely more on tech, there is more demand on infrastructure. Through the ICN they have access to 1 GB, but they still need to stagger some things to make sure connectivity is there. Housing is an issue, daycare is an issue, and 1,000 people are leaving Clarion to work and 2,000 coming in. Now turning away preschoolers as they are out of room.

Q)Where are commuters coming from?

TJ – come from Clarion about 55 minutes. Fort Dodge geography includes Humboldt, Gowrie, Manson and Eagle Grove. Tier 1 radius is a 45 to 1-hour distance. After that, students must determine if they want to live on campus or not. The issue is how to give all students the same experience educational-wise. Iowa Central Community College is a 1:1 school, which was a challenge but has been good. Trying to equal the playing field for those who can’t afford devices. This is new for colleges, not so much for school districts. For online classes, connectivity is necessary. If you can’t take an online class that cuts out an entire level of students.

Dr. Bob: They roll over laptops about every three years. In cooperation with ICCC distance learning can provide concurrent classes with Flexnet. His girls were able to skip one and two years of college because of credits received in high school. Connectivity is a challenge for those not in the buildings. Dows has challenges, has seen families outside the public library to tap into wireless.

Ashley: Dr. Bob talked about staggering to ensure connectivity. One of the delays they experienced was in Belmond because when the school was testing it affected them trying to have patient access. Another issue is equal access. Right now, for school telehealth parents pay $35 in cash as insurance won’t cover. There are families that can’t pay the $35 to be seen.

Q) If you had unlimited broadband, what opportunities would that open?

Dr. Bob:Could continue to coordinate more services. First responders would like to tap into systems in school. Mental health is a big issue so being able to get those specialists in rural Iowa is huge for patients.

TJ: At ICCC they have discussed how to emulate closer learning experience of the rural learner to give them what they can get at campus. They miss the connection of other students. Would like to use Zoom software to help create environments where the class can be streamed. Fear is that students won’t have connectivity or might be issues with how tech savvy they are.

Ashley: More efficiencies and better patient education; move servers to cloud base and have real time backup. The telehealth committee has many ideas, but without enough access they are not able to implement, so can’t emulate larger hospital offerings.

Question from Task Force:

Lt. Gov: Dr Bob, can you give details on student assessments? A) The past year was the first using online. There was a lot of prep required and once they started testing there were glitches from Pearson.They don’t have info back from last spring’s testing. Would be nice to get it back sooner to impact curriculum. For those who needed it, they could take tests in Spanish. There were challenges in keeping tests running.Some students would be bumped out and must log back in, etc. Hoping the next round better.

Q) What’s the argument that this technology is important or makes things better?

TJ: It prepares students for the workforce and if we don’t do it, others are and we’re not competitive as a community. Who wants to do it like we’ve always done it?

Ashley: Reduce unnecessary clinic visits and keep kids in schools and parents at work. It takes fifteen minutes at school vs losing half a day of school. Improves efficiencies. If they don’t provide it at school, someone else well. There is already a lot of pressure on rural hospitals so need to have technologies to be innovative.

Dr. Bob: “Preparing students today for tomorrow” is their mission statement. Need to look to where students will be. They need to be innovative. Need to be ready to prepare students for the challenges they will get.

TJ: In education, we are always second or third to adopt, business is first, so they feed off them to learn what their students are missing.

Dr. Bob:Schools have trouble just hiring teachers. Used to get hundreds of applications and now only get a handful. There is a great consortium of schools in the region, so they use old Armory in Eagle Grove to grow their own teachers. Twenty-eight of his current teaching staff graduated from his district, but still need to find a way to fill the pipeline.

TJ: Same for us. We try to also grow local as they are more likely to stay, and we want to see students stay in Iowa. All important. Career academy and partnerships is part of goal to keep them here. They need broadband or they will leave.

Q)Is the issue that when the student goes home there is a lack of access or is it lack affordability?

All three panelists say both are the issue.

Q) As a broadband provider, if there is one thing they could do, what would help? Dr. Bob: How do we get hotspots, which would help high risk students? Ryan: You have a lot of students qualifying for free and reduced – is there a way a provider could work within program so if they qualified for that and were not a current subscriber, maybe they could be eligible for reduced broadband? TJ: Work with school district to identify which students might benefit.  

Q) How to identify locations after school hours for provider to provide hotspots or wifi that is a safe zone, and that is an extension of the CSD? Dr. Bob: They are looking at equipping a school bus. In Goldfield, there is no library, so maybe they could equip a bus and park it at a location. If the location is being used in some other community way, the school district can work with them to add to network.

Ashley - Final comments: We have issues with patients in the home that don’t have access, so working together to make that work and make it affordable would be helpful. Still working on how funding sources work so it is not just cash pay in the schools. Need to get the insurance to allow payment.

TJ: During snowstorms they cancel classes for safety. With devices, is there no such thing as no school? Looking at how to mediate the number of days off. K-12 must make up days, but the community colleges can’t make those up. Every day missed is instruction being missed. Likely they will miss two weeks of school per year, so how to lower that and keep students safe.

Dr. Bob: Consolidation of schools happens since they can be connected. First responders want to be more involved so they can be on the school system for any issues. Rural Iowa has quality people, but not enough. Must share resources among all and broadband is the mechanism to do this.

  1. Discussion of Draft Recommendations:

Lt. Gov: In reference to the discussion draft, we need to provide recommendations to the Governor, and this is the initial draft on continuing to support expanding broadband throughout rural Iowa. We don’t need the official language today, just your thoughts and then we will provide a draft for final review at our November meeting, which will be a conference call.

Sandy: We want to include healthcare to top of list, and as Patty had to leave early, she thinks there should be comments that Iowa should lead the nation on connectivity.

Lt. Gov: Would like feedback on grant program as it stands. The 15% match might not be enough. Should we add looking at structure of grant to ensure it is workable? If grants aren’t enough, they might not go as far or be as impactful.

Ryan:They have talked about it and discussed with other providers. The 15% match is pretty light.All the easy-to-serve areas are already done, those are least expensive. Key - we want to provide broadband to those who don’t have service and have it affordable. Just had an individual outside of their service area berate them for not providing service, but it would cost $7,200 for half of a mile to get there. People don’t understand how expensive it is. Other states, MN, SD, IL, WI, NE – all have programs at or around a 50% match and have seen significant demand. Not sure where the 15% match came from. Lt. Gov: This was from 2014 or 2015. Before other states had programs.50% would increase demand and could look at areas hardest to serve.

Katie:Can only service providers apply? One of the grant winners was a community along with a provider. What if the community wants to apply but doesn’t have a provider? Windstream and Mediacom aren’t interested. Lt Gov: He will look. If you look at the original idea submissions – it’s to put the currency with the communities to get different providers to compete.

Bill:Illinois just approved $420 million in August.

Chris: At a 50% match is there justification? It would be hard to set criteria that you have to serve at what speed and what price. 100 MB for $5 is better than 100M at $500, the first would score better.

Ryan: Mapping side – who is providing what and where? Economics make sense in towns, but the far rural is not feasible.

Lt. Gov: So, an increased match, not sure of level, but an increase? AGREED

Ryan: By increasing the percentage, does that help us in asking for more money from the legislature? Lt Gov: Not sure, they could say “x” amount of dollars would leverage “x” amount of investment. But if the 15% isn’t leveraging that much, then maybe.

Ryan: Other thought – the more skin in the game the more score you get.Might create natural competition.

Kevin: Limiting the amount of applications. There are still communities that have 25/3, but poorly served throughout the community. But when you look at a map that community is served so makes it ineligible for new service. Why not put on more speed requirements?

Dave: Maybe have a speed threshold for funding and speed threshold for a buildup.

Kevin: They have 100% FTTH in his region.Have built up some business outside of area but can’t serve homes. Homeowners ask why they can’t apply, but they can’t serve because the region is already marked as served. The 25/3 is limiting communities that have providers not serving them.

There was discussion on the challenges of mapping. There is a new map on the OCIO website which used the most updated data and gave public 30 days to self-report a challenge.Lt. Gov:The FCC maps were based on 25/3, and if we went away from that would we need new maps. That might be why we are keeping the levels.

Dave: The legislation in 2019 gave OCIO the ability to raise the buildout threshold.

Ryan: Federal government talking about doing performance testing in peak hours to see if 25/3 is available and report on 477 form. Wonders if OCIO can enhance our data, even if the Feds are not.

Sometimes customers perspective is skewed as there are many elements involved outside of the service. How many devices on network, old routers, etc.

Lt. Gov: On recommendations, we want to increase match more in line with neighboring states. The Governor asked for $20 million and got $5 million for one year. We should at least ask for additional $15M. Kevin again: In the scope of how large a project, the legislature is not taking a serious look at cost. How to portray to legislature to what realistically needs to be done. If easy, already solved.

Sandy – we need to lobby to healthcare an education to have them help with legislature education.

Ryan – map is always an area that can be improved.

Recommendations:

  • Add healthcare and telehealth
  • Keep Iowa at the forefront
  • Discussion of level of incentive
  • Maintain $20M overall, additional $15
  1. Public Comment: 

Bill:  The USDA ReConnect program is only eligible if service is less than 10/1, not 25. There is a full gap between 10 and 25.

  1. Wrap up and next Steps:

Next meeting will be a conference call the afternoon of November 6 to review the final recommendation draft. There will be a joint meeting with IRDC on December 18 in Perry. The Governor will be attending from 2:00-3:00. Details to come.
 

  1. Adjourn

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