News

As the Lakelands slowly creeps out of the novel coronavirus pandemic, a task force in Greenwood County is looking to solve an infrastructure problem that was highlighted during the pandemic.

“We failed you, in that we did not have what you needed,” Sen. Billy Garrett told superintendents of each of Greenwood County’s three school districts. “This hit us, we’re going to fix that.”

Garrett was addressing the need for rural broadband internet access, a challenge that was even more transparent last year as schools transitioned to e-learning to avoid the person-to-person contact that could spread COVID-19.

On Monday, leaders of Greenwood from city and county government, the Upper Savannah Council of Governments, state legislators, and school administrators met at the Greenwood Genetic Center’s Curry Conference Center to hear from the state Office of Regulatory Staff about the state of broadband in South Carolina.

“The focus has shifted,” said Nanette Edwards, executive director of the Office of Regulatory Staff. “I’ve had folks tell me that they see access to the internet the same way you would have access to water, sewer, same way you’d have access to electric utility electric service.”

She said broadband is an area where state law does not have a lot of regulation, which has provided opportunities to meet the needs in communities.

“The focus now shifting to broadband and giving consumers the access they need for telework, telehealth, and most significantly for our education,” Edwards said.

The Office of Regulatory Staff is the state’s office that is working with rural communities to develop paths to building rural broadband infrastructure in the most needed areas. While broadband does not have its own office, Regulatory Staff employs a broadband coordinator, Jim Stritzinger, who gave a presentation to the task force.

Stritzinger’s connection with Greenwood goes back to late 2014 when he worked with former Greenwood Partnership Alliance CEO Heather Simmons Jones to establish Greenwood County as one of the first certified connected communities, he said.

Stritzinger said when looking at broadband an evaluation has to be made of three areas: access, adoption and use. He presented a number of maps to the task force showing broadband access and capabilities in the state using the 2015 minimum criteria of 25 Mbps download speed and 3 Mbps upload speed, the speed that it takes to stream a video without buffering.

Using that information, he identified 10 target areas representing about 36 square miles in Greenwood County where people live that do not have access to internet service.

“It’s not affordability, it doesn’t exist,” Stritzinger said.

Stritzinger said 556 similar target areas exist across the state.

He said the state has 35 internet service providers and praised one that was represented in the room. Stritzinger said WCTEL – whose CEO Jeff Wilson was in attendance — made a visionary move in 2008 to rebuild infrastructure in Abbeville County to make broadband fiber internet service available throughout the county.

Much of the southern parts of Greenwood County outside of Greenwood city limits are areas where there is no internet available.

“That means the people that live there have no choice for an ISP, candidly, there’s nothing there,” Stritzinger said.

Stritzinger said a lot of the data he obtains on internet speeds come from the Ookla Speed Test, a service available by website and mobile app that tests the speed of an internet connection.

He said the state will also see some federal money — $122 million — help with broadband initiatives. Charter Spectrum has been awarded a grant to expand broadband in the state as well as Elon Musk’s SpaceX Starlink program, a satellite-based internet provider.

Edwards said coordination is the biggest issue. The task force hopes to help with that.

“Our task force was formed in order to assess areas of Greenwood, McCormick, in portions of adjacent counties which needed broadband coverage,” Garrett said.

Garrett said Upper Savannah COG will help with writing grants the group may want to seek.

“I’m really heartened by what Vision Greenwood has done,” Stritzinger said.

Vision Greenwood, formerly GPA’s Foundation for a Greater Greenwood, has been coordinating broadband taskforce meetings even before the organization is ready to fully introduce itself.

“Vision Greenwood is all about community development, providing leadership to enhance the quality of life in Greenwood through long-term vision and strategic community development initiatives,” Kay Self, executive director of Vision Greenwood, said. “It’s a continuation of some of the efforts that we’ve started for the past 10 years. Bringing in new fresh ideas, taking on some of the gaps and shortfalls in our community.”

Collaboration is the key to success for Vision Greenwood and its broadband efforts.

“Let’s work together,” Self said. “We are going to need your help to collaborate and make this happen for our community.”

Contact staff writer James Hicks at [email protected] or on Twitter @jameshicks3.

Health May 24, 2021 4:51 PM EDT

Health May 24, 2021 4:51 PM EDT

Thousands of people in the Upstate could get faster Internet access by the end of the year from a new broadband company, Upcountry Fiber, launched by two utility cooperatives.

The company’s $150 million expansion is a large investment, and the state of South Carolina has set aside $30 million for broadband expansion programs in the most recent budget.

The program is a great trend and has a lot of promise for the Upstate, said Jim Stritzinger, South Carolina’s state broadband coordinator.

He said that both companies partnering, Blue Ridge Electric Co-Op and Western Carolina Telecommunications Cooperative, have well-earned reputations.

The electric cooperative brings a larger base of people and geography as well as easements while the telecommunications cooperative has been a pioneer in broadband in the state, building a network in Abbeville a dozen years ago, Stritzinger said.

About a half million people in South Carolina can’t get the Internet speeds that make digital learning, remote work and telehealth possible.

It will go into Pickens, Oconee, Anderson, Greenville and Spartanburg counties.

Rural areas will be a challenge to reach for broadband, going out to rural homes is often not profitable, said Ann Eisenberg, an associate law professor at the University of South Carolina whose work includes rural economic opportunities.

That’s the challenge that the new company, Upcountry Fiber, believes it has cracked.

Jim Lovinggood, president and CEO of Blue Ridge Electric Co-Op, said the economic model is working and has worked in a pilot program.

The program was in the Stillwood neighborhood in Oconee County, and 85 of 130 homes participated in the pilot, which was finished in February.

The next expansions would be in parts of Seneca and Central and would continue outward this year.

The new broadband offers speeds up to 1 gigabyte of both upload and download speed, lower speed packages start at $40 a month.

There is a federal program that can give students up to $50 a month to pay for broadband in many cases and that would cover the cost to get the new service into a large number of homes in the Upstate, company officials said.

People do not have to be serviced by the cooperatives to qualify.

The $150 million is coming from federal and regular loans, said Jeff Wilson, CEO of Western Carolina Rural Telecommunications Cooperative.

The only other all-fiber network is in Abbeville County and was built by Western Carolina Rural Telecommunications Cooperative, which is partnering with Blue Ridge Electric Cooperative in launching the standalone broadband company.

Source:  Greenville News

By Eric Wicklund on May 14, 2021

The American Academy of Neurology is joining the effort to compel Congress to extend telehealth coverage past the pandemic, saying connected health will continue to be a valuable tool to help people with neurologic conditions.

The AAN issued a 22-page telehealth position statement this week in advance of next week’s annual “Neurology on the Hill” conference in Washington DC. At that event, the organization will meet with lawmakers to press for permanent telehealth policy.

“People with neurologic conditions like Alzheimer’s disease, migraine, multiple sclerosis, Parkinson’s disease, ALS or epilepsy often must visit their neurologist many times a year to monitor the progression of disease and to have medications adjusted,” AAN President Orly Avitzur, MD, MBA, FAAN, said in a press release. “However, this can be challenging due to mobility issues, lack of reliable transportation and cost. The COVID-19 pandemic has led to neurology practices dramatically reshaping the delivery of care for their patients. The American Academy of Neurology is asking members of Congress for a permanent expansion of telehealth services to improve safety and access to care and to reduce health care costs for people with neurologic disease.”

The position statement updates a 2014 document that also called for more telehealth coverage, but adds in a considerable amount of evidence accrued over the last few years – and particularly during the pandemic – that telehealth is benefitting both providers and their patients.

“Prior to the pandemic, telehealth programs were restricted, mostly available only to people in rural areas or a limited number of specified locations who did not otherwise have access to specialized care, or in small pockets of contracted services, often outside of Medicare or other insurance coverage,” Bruce Cohen, MD, FAAN, who chairs the AAN’s Advocacy Committee, said in the release. “Neurologists have been asking for an expansion of telehealth for many years. Now it is clear, telehealth is an essential and effective method of delivering care. This has only been possible due to the policy flexibilities enacted by the federal government, along with the broad interpretation of these provisions by the Centers for Medicare & Medicaid Services, and with cooperation from the states and commercial payers. It is important to neurologists and their patients that after the pandemic, telehealth continues to play an essential role in medical care.”

Just two years ago, the AAN released an analysis of roughly 100 studies that indicated telehealth treatments address some of the barriers to access to patients, including availability of specialists and travel issues, and are considered just as good as in-person care by those patients. But that document also pointed out the lack of studies on the ability of telehealth to make an accurate diagnosis, and urged more research on clinical outcomes.

“We need to conduct further studies to better understand when virtual appointments are a good option for a patient,” senior author Raghav Govindarajan, MD, of the University of Missouri, who served as a chair on the American Academy of Neurology’s Telemedicine Work Group and is a Fellow of the American Academy of Neurology, said at that time. “Keep in mind that telemedicine may not eliminate the need for people to meet with a neurologist in person. Rather, it is another tool that can help increase people’s access to care and also help lessen the burden of travel and costs for patients, providers and caregivers.”

Now, with COVID-19 providing more evidence and Congress facing pressure from many interested parties to permanently extend telehealth freedoms, the AAN is ramping up its lobbying efforts.

“Telehealth won’t replace all in-person neurologic care, but for people with neurologic conditions, it has been shown to complement it,” Jaime Hatcher-Martin, MD, PhD, of SOC, one of the authors of the position statement, sad in the release. “It is also important that people have options. In addition to video visits, telehealth visits by phone are essential to ensure access to care for people who either cannot afford or who do not have access to high-speed broadband internet.”

“The AAN predicts that telehealth will continue to play an essential role in the care of patients with neurologic conditions,” the document concludes. “We will best serve our patients and our members by advocating for increased access; broader insurance coverage; fair reimbursement; reduced regulatory and legislative barriers; and expanding the telehealth evidence base by promoting research on its proper roles and value in neurologic care and on the costs associated with providing telehealth services.”

Researchers examined more than 300,000 virtual visits for patients older than 60 over the course of three years.

By Kat Jercich

Dr. Raed Azzam, an epileptologist with the Cleveland Clinic Neurological Institute, talks with a patient during a telemedicine appointment at his office at the Cleveland Clinic Akron General Wellness Center in March. While telehealth appointments aren’t new, they’re being used with greater frequency because of the COVID-19 pandemic, especially for mental health services, and are likely here to stay.

After a year of talking with patients via Zoom, phone and sometimes FaceTime, some mental health providers are confident that telemedicine is here to stay, even after the pandemic goes away.

Kristen Carpenter, director of ambulatory services at Ohio State Harding Hospital, said the hospital did some telehealth services before the pandemic, but it mostly was used to connect different emergency rooms and to provide emergency psychiatric care. But with COVID-19, the hospital went from providing “almost 100 percent in-person care to almost 100 percent care via telehealth” almost immediately, she said.

Now, with about 90 percent of Harding’s outpatient care still provided via telehealth, Carpenter said she foresees a future where patients can choose how they’d like to receive their care.

“Our patients have experienced almost no interruption in their care,” she said. “We have been able to provide care that we never thought we could do via telehealth.”

Harding currently offers individual counseling and psychiatry services in person and via telehealth. Its partial hospitalization and intensive outpatient program — a structured three- to four-week treatment program that typically requires patients to attend full-day group sessions in the hospital — now takes place over Zoom.

John Dawson, interim president and CEO of Community for New Direction in Columbus, Ohio, also sees telemedicine in the nonprofit group’s future — even though it had offered no telehealth services before the pandemic.

“We have a higher show rate. There’s so many barriers to mental health and substance use disorder patients getting to appointments that telehealth has helped tremendously in that area,” he said.

A new study finds during the first few months of the pandemic, patients were more likely to use telehealth services for behavioral health treatment than physical conditions, according to a January study published recently by RAND Corp. The study shows that 53.6 percent of patients with a behavioral health condition sought treatment via telehealth from mid-March to early May of 2020. By comparison, 43.2 percent of patients with a chronic physical condition used telehealth to receive care during the same period.

Providing services via phone or video conferencing has broken down many barriers including unreliable access to transportation and work conflicts, Carpenter said. At Harding, for example, there are fewer emergency cancellations and lower no-show rates because of telehealth appointments, she said.

As with other things provided remotely, however, there are some drawbacks.

Linda Jakes, executive director of Concord Counseling Services in Westerville, Ohio, said the nonprofit group found it a bit more difficult in particular o treat young children and older adults remotely. Both groups tend to be more difficult to engage, she said, and older adults sometimes have more trouble navigating technology than other patients.

“It could be difficult when you’re just having a phone conversation with someone to really see the body language associated,” Jakes said. “There’s a lot of things that we use our eyes for.”

There are other challenges as well, said Dawson of Community for New Direction.

Having reliable internet and access to a private space for appointments are privileges that some people simply don’t have, he said.

To address telehealth accessibility, he said his agency is working to provide funding for data cards and phones for patients in need.

Aside from accessibility, some patients must be seen in person, Dawson said. Those include individuals with severe opiate use disorder or personality disorders, for instance, who require closer assessment. All patients, he added, come into the office for their intake paperwork and subsequent drug tests, if it is part of their treatment plan.

Concord Counseling has established safety protocols such as staggered appointment times and alternating days that employees come in, but otherwise is letting individual clinicians decide when they want to bring patients into the office, said Mike Preston, director of clinical operation. He said most providers have in-person appointments with patients for whom “telehealth is just not working for them.”

Carpenter said having mostly virtual appointments has been draining for providers, who sit in front of computer screens for hours at a time without breaks. And though mental health treatment lends itself to telehealth, the social interaction that in-person care provides is lost in virtual appointments.

“As the year has progressed, we’ve focused a lot on how coming into the office can actually be a kind of intervention for behavioral health, to draw them back out into the world,” she said.

Jakes said telehealth has been invaluable and she can’t imagine returning to offering only in-person care. But she said many clinicians are looking forward to certain milestones that they didn’t appreciate before the pandemic.

“I was talking to one of our therapists the other day and she goes, ‘Oh my God, it’s going to be so exciting to come back,’ because she has a chunk of her caseload that she’s never even met, she’s only done telehealth,” Jakes said. “She goes, ‘If I passed them on the street, I wouldn’t even know who they are.’”