1. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis The FCC Rural Healthcare Pilot Program: Access to Advanced Broadband Services for Rural Hospitals in the Florida Panhandle Christopher B. Sullivan, Ph.D. Agency for Health Care Administration Second Congressional District’s Healthcare Council Meeting February 18, 2009

2. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis FCC Rural Health Care Pilot Program In November 2007 the Federal Communication Commission awarded $9.6 million to Big Bend Health to build a broadband network to not-for-profit health care facilities in the Florida Panhandle under the Rural Health Care Pilot Program. The Agency for Health Care co-directs the project and provides administrative and governance support to build the Florida Panhandle Health Care Network.

3. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Objective of the FCC RHCPP To create pilots to examine how the rural health care funding mechanism could be used to enhance public and non-profit health care access to advanced broadband services. Many rural health care providers are unable to access telemedicine services without the construction of new broadband facilities, so the RHCPP supports construction of transmission lines, including associated non-recurring and recurring costs of connection. Big Bend Health will operate the new network.

4. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Provides funding for 85% of the costs of constructing a dedicated broadband network connecting health care providers in rural and urban areas in the Florida Panhandle. Provides funding for up to 85% of the costs of connecting the regional network to the National Lambda Rail and Internet2. The remaining 15% of costs to construct the broadband network must come from matching contributions. FCC Rural Health Care Pilot Program Funding:

5. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis State-Level Network of Health Care Facilities

6. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis

7. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Rural Health Care Pilot Construction Plan In 2009 Big Bend Health plans to run optical fiber from Florida LambdaRail interface points to a Point of Presence (POP) in each rural county. From the POP, optical fiber will be run the last mile to complete the broadband connections to the nine rural hospitals and one VA clinic in the project. The project proposes to connect the rural hospitals to urban hospitals in Tallahassee and Pensacola.

8. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis FCC Rural Broadband Pilot Project Connecting Nine Rural Hospitals in the Florida Panhandle

9. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Hospitals Included in the FCC Pilot Project oCalhoun-Liberty Hospital, Blountstown, Calhoun County oGeorge Weems Memorial Hospital, Apalachicola, Franklin County oSacred Heart Hospital, Port St Joe, Gulf County oDoctor’s Memorial Hospital, Bonifay, Holmes County oCampbellton-Graceville Hospital, Graceville, Jackson County oJackson Hospital, Marianna, Jackson County oMarianna Veterans Clinic, Jackson County oMadison County Memorial Hospital, Madison, Madison County oDoctor’s Memorial, Perry, Taylor County oNorthwest Florida Community Hospital Emergency Department, Washington County oProposed New Hospital, Quincy, Gadsden County

10. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Target Rural Areas in Florida’s Panhandle In all, 13 hospitals and a VA clinic will be connected to the Florida Panhandle Health Care Network and will be eligible for health information exchange services from Big Bend Health.

11. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Big Bend Health is Anchored in the Community Board members are the decision-makers in local health care facilities. Big Bend Health is a partner with the Tallahassee Chamber Commerce Tallahassee Community College is represented on the Board, as well as the local Capital Health Plan which covers 37% of patients in the Tallahassee area. Big Bend Health operates the broadband Private Medical Area Network (pMAN), currently providing high speed connectivity to health care providers.

12. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Big Bend Health Will Own the Network Big Bend Health, will act as an Internet Service Provider, offering Voice Over IP service, secure messaging and secure broadband Virtual Private Network access through the Florida LambdaRail. Hospitals will be able to connect to the Tallahassee-based pMAN and Tallahassee Memorial Hospital and to Baptist and Sacred Heart Hospitals in Pensacola. Hospitals will be eligible for Big Bend Health Regional Health Information Network Services.

13. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis 13 Big Bend RHIN

14. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Big Bend Health Applications Available Now Clinical data display including: labs, radiology reports, allergies, problems, providers, and medication history e-Prescribing and Medication History

15. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Rural Health Care Pilot Construction Plan The construction plan for 2010 is to implement a broadband wireless network in each rural county to connect clinics and physicians to the Florida Panhandle Health Care Network. Access to the wireless network will also be provided to offered to businesses and homes in each community, to contribute to the economic development of each rural county.

16. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Connecting Calhoun-Liberty Hospital in Calhoun County Calhoun-Liberty Hospital Point of Presence

17. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Rural Health Care Pilot Construction Timeline Construction Years Construction TimelineWho Benefits 2009 Conduct network design, lay optical fiber to point of presence in each county, connect hospitals, begin delivery of Big Bend Health services Not-for-profit hospitals 2009-2010 Complete wireless network construction, provide broadband access to clinics and physicians, begin delivery of Big Bend Health services to physicians Health care providers, city and county offices, small businesses and domestic users 2010-2012 Broadband network complete, Big Bend Health services delivered to all providers, e- commerce supported Health care providers, city and county offices, small businesses and domestic users

18. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Rural Health Care Pilot Construction Funding Construction Years 85% FCC Funding 15% Matching Funds Total Construction Funds FY 2008-2009 $6,400,000$1,129,412$7,529,412 FY2009-2010 $3,200,000$564,706$3,764,706 Total $9,600,000$1,694,118$11,294,118

19. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Strategies to Generate 15% Match Funding Big Bend Health is a certified participant in the Community Contribution Tax Credit Program. oFor-profit businesses can donate time, dollars, equipment or products for tax credits. Big Bend Health is also a certified participant in the Enterprise Zone Community Contribution Tax Credit program. oAny business in Florida can take a tax credit of up to 50% of the value of donations and apply it to the FL Corporate Income Tax, Insurance Premium Tax or the Sales and Use Tax.

20. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Strategies to Generate 15% Match Funding The Agency for Health Care Administration has worked with Enterprise Florida, Opportunity Florida and the Governor’s Office of Tourism, Trade and Economic Development to write a Rural Infrastructure Grant for support in constructing the Florida Panhandle Health Care Network. The Rural Infrastructure Grant will provide up to $1,000,000 to initiate the construction of the broadband network and will leverage $5.6 million in funding from the FCC.

21. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Rural Health Care Pilot Construction Funding FCC Match - 85% of Total Rural Infrastructure Grant - 15% of Total Total Amount Available to Invest in Construction FY 2008- 2009 Funding Available $5,666,666$1,000,000$6,666,666 FCC Match - 85% of Total Alternative Funding - 15% of Total Total Amount Available to Invest in Construction $733,334$129,412$862,746 Total$6,400,000$1,129,412$7,529,412

22. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Florida Panhandle Health Care Network Sustainability Plan In order to draw down funding from the FCC the Florida Panhandle Health Care Network has to demonstrate its ability to maintain operations. All Rural Health Care Pilot Projects must submit a Sustainability Plan to the Universal Service Administrative Company (USAC). When USAC approves the sustainability plan, it will release the funding for the project. This has become a problem for many projects nation-wide.

23. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Florida Panhandle Health Care Network Governance Council The Agency for Health Care Administration convenes two stakeholder groups to provide oversight for the Rural Health Care Pilot Project: oLocal stakeholders from AHCA, DOH, Big Bend Health, Enterprise Florida, Opportunity Florida, Florida LambdaRail, Office of Tourism, Trade and Economic Development and Tallahassee Chamber of Commerce. oThe CEOs of the rural hospitals.

24. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Benefits of Connecting Rural Hospitals to the Florida Panhandle Health Care Network Delivering high speed broadband connectivity to the rural hospitals in the RHCPP will create opportunities for telehealth services that are not available today and improve access to health care services for Floridians in the Panhandle. The economic health of the rural communities should also improve with access to advanced broadband services. Updates are available at: http://www.fhin.net/FHIN/HITinitiatives/RHCPP.shtml http://www.fhin.net/FHIN/HITinitiatives/RHCPP.shtml

25. Second Congressional District’s Healthcare Council Meeting, February 18, 2009 Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Christopher B. Sullivan, Ph.D. Administrator, Office of Health IT Florida Center for Health Information and Policy Analysis Agency for Health Care Administration 2727 Mahan Drive Tallahassee, FL 32308 sullivac@ahca.myflorida.com