On Monday, President Biden announced a deal with 20 Internet service providers, such as AT&T and Comcast, to provide high-speed broadband to low-income households for no more than $30-a-month. That’s less than half the average 2021 cost of $61 and far less in many areas. That initiative, and an even bigger companion program to build out broadband in communities that do not have it, will be hugely important for older adults and younger people with disabilities.
While much of the attention on expanded broadband is focused on how it will help young families with children, it also will improve access to medical care and monitoring as well as social supports and services—critical benefits for older adults who have difficulty leaving their homes.
Just a few examples:
Telehealth: For people with a limited ability to access in-person health care and supportive services, telehealth has the potential to be a major advance in medical care. It allows doctors and other medical professionals to diagnose and monitor medical conditions remotely and order treatment without patients having to leave their homes.
For some chronic conditions, telehealth can deliver care faster and at less cost than in-person visits. Patient satisfaction appears to be as high for telehealth as in-person care. It may be able to prevent avoidable emergency department visits and even hospital admissions. However, we still are learning about quality of care delivered remotely.
But many older adults are unable to visit a primary care doctor, either because they are too frail to leave their homes, because they have no source of transportation, or because there is no medical care in their communities. For them, the choice may be between telehealth or no care at all. But older adults remain skeptical of telehealth, in part because of their limited ability to access it.
The health and long-term care systems still are optimizing telehealth. But technology has dramatically improved in recent years. And during the pandemic, the federal government became much more willing to pay for this service. It is especially important in those rural or low-income urban areas where access to medical care is limited.
But in many of these communities, there either is no Internet or patients cannot afford it. For them, technical and regulatory advances in telehealth will make no difference until they have access to broadband.
Remote monitoring. This is a subset of telehealth but an important one to call out. It has been possible for years to remotely monitor a patient’s weight, blood pressure, and other vital signs. It can be especially valuable for people with chronic conditions, such as diabetics whose blood glucose can be checked remotely or people with congestive heart failure whose weight can be monitored daily. But widespread use of these technologies has been limited by payment issues and, yes, by lack of reliable high-speed Internet.
The technology has improved. Many of the regulatory and payment barriers are being dismantled. But none of it will matter for those patients with slow or no Internet.
Virtual services and programming. The pandemic forced senior service providers to get creative with their offerings, often moving from in-person to virtual. Many of these changes in service delivery will long outlive the pandemic.
For example, The Jewish Council for the Aging of Greater Washington, where I serve on the Board, shifted its social model adult day program from in-person to virtual in early 2020. It was extremely successful for the adult day participants, all of whom have early-stage memory loss, and their families.
But JCA’s virtual programming was inaccessible to many simply because they did not have Internet that could accommodate Zoom. I suspect many community-based non-profits like JCA tried to find funding to support Internet access for low-income older adults. But it was a big challenge.
The money for Biden’s initiative comes from the big infrastructure bill Congress passed last year. It included $65 billion to build out broadband in communities that don’t have it, but also set aside about $14 billion to subsidize access where high-speed Internet is available but too costly for many consumers.
Households are eligible for the new program if their income is less than 200 percent of the federal poverty level ($27,180 for a single or $36,620 for a couple in 2022), if they are on Medicaid or Supplemental Security Income (SSI), or if they already are eligible for their ISP’s discount service. You can check to see if you are eligible by calling 877-384-2575.
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