Since the Federal Communications Commission's Rural Health Care Program launched in 1997, the FCC has never assessed rural healthcare providers' telecommunications needs, according to the Government Accountability Office. Without such assessments, determining the success of the program--which provides telecommunications and information services discounts for rural healthcare providers (primary program) and, as a pilot program, funds broadband infrastructure and services--is difficult, wrote the GAO in a Nov. 17, 2010 report.

Despite the fact that no needs assessment has been conducted for the program, the FCC wants to change parts of the primary program to focus on broadband services because it says the primary program is underutilized, wrote the GAO. According to the report, FCC has a yearly funding cap of $400 million for the program, but it has disbursed only $327 million in total, over the 12 years of the primary program.

"Without a needs assessment, FCC cannot determine how well the current program is targeting those needs--and whether the program is, in fact, underutilized--or ensure that a new program will target needs any better," said the GAO report.

The FCC began the pilot program because it thought, without any formal assessment, the primary program was underutilized. However, GAO found design and implementation of the pilot program lacking.

According to the report, FCC sought no comment from the public or relevant stakeholders on the pilot program design, it also called for applicants to participate in the pilot program before it fully formed program requirements, and then added requirements once the program began. While feedback has been positive despite these problems, according to the GAO report, the pilot has been delayed and requirements were not met because they were poorly defined at the onset. It has also failed to set any performance measures for program success, wrote the GAO.

The GAO recommends that the FCC:

• Assess rural health care providers' needs,
• consult with knowledgeable stakeholders,
• develop performance goals and measures, and
• develop and execute sound performance evaluation plans.

The FCC did not agree or disagree with reports' assessment and recommendations. Instead, Sharon Gillett, chief of the Wireline Competition Bureau summarized planned and ongoing actions to address issues raised by the report. "We agree that the Commission should continue to examine and work to improve the Rural Health Care Program," wrote Gillett.

For more:
- see the GAO report (.pdf)

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