Capitol Correspondence - 07.19.21

Big Picture: Counties Use COVID-19 Funding to Remedy Broadband Disparities

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Our members have often shared with us their challenges ensuring stable internet access for telehealth purposes, and to help isolated individuals socialize throughout the pandemic. We anticipate this article from InsideHealthPolicy could inform their advocacy at the local and federal levels.

“Counties say the COVID-19 relief Congress has sent them so far has allowed them to address social determinants of health by investing in clean drinking water, providing food and rental assistance, and improving broadband availability and affordability — a key component to telehealth. The National Association of Counties takes issue with the Federal Communication Commission’s broadband map, arguing internet is not as available as FTC says and speeds are significantly lower in practice, impacting the ability to do telehealth visits.

The Trump HHS last August defined social determinants of health as the conditions where people are born, live and work that affect someone’s health, risks and quality-of-life outcomes. Specifically, the department said in its Healthy People 2030 plan certain factors like housing, education and employment contribute to health disparities and inequities making it imperative for public health organizations to work with other sectors like education, transportation and housing.

The Trump HHS said it hoped to address the social determinants of health by reducing the number of families who spend more than 30% of their income on housing, improving drinking water and increasing the number of adults with internet access. HHS said expanding broadband would improve health as more providers are using internet-based health care tools.

The Biden administration has made improving health equity a policy priority. Earlier this year, COVID-19 Health Equity Task-Force Lead Marcella Nunez-Smith said health equity is key to building systems that address social determinants of health.

NACo highlighted during its five-day conference beginning Friday (July 9) how COVID-19 relief funds from the CARES Act and American Rescue Plan have helped counties improve broadband and address other social determinants of health. NACo President Larry Johnson and his colleagues told reporters Saturday (July 10) COVID-19 provided several positive revelations around what constitutes as public health.

‘We found out that health is not just for doctors and nurses, it was transportation. It was the teachers. It was the food deserts. It was the mental health,’ Johnson, a county commissioner from Decatur, Georgia, said.

He added this realization has led counties like his to increase coordination and data sharing among local agencies as families could have up to 10 caseworkers helping them with housing or the judicial process.

Johnson said his county is using COVID-19 relief for food and housing assistance in addition to retention bonuses for county staff like social workers. Other commissioners said they’re using COVID-19 relief to retrain workers who lost their jobs due to the pandemic, improve their water and sewer systems, and contract with internet service providers to make broadband more affordable or available to residents.

Gary Moore, NACo immediate past president and county judge from Burlington, KY, said his county is working to get high-speed broadband to every resident in the next two to three years. He said the FCC connectivity maps were way off and what the agency considered high-speed internet wasn’t once the pandemic hit.

“Once we got in the pandemic and you have multiple children trying to learn at home, Mom or Dad or both, or whatever, the parents working from home and then somebody needs do an e-health visit — I mean the speeds were nowhere close to enough,” Moore said.

The NACo Broadband Task Force, which formed in October, suggested in its report published Monday (July 12) the FCC set a minimum standard for broadband and measure internet speeds off-network to account for situations like Moore mentioned. NACo also recommends the federal government and states begin regulating internet providers as a utility and remove bans on municipal broadband, which would let localities invest in broadband networks and expansion projects.


House Speaker Nancy Pelosi (D-CA) told the National Association of Counties during its conference Monday (July 12) the latest version of the bipartisan infrastructure package would allocate $65 billion for broadband, including $40 billion specifically for expansion in rural areas.

In addition to providing more funds, Sens. Chuck Grassley (R-IA) and Amy Klobuchar (D-MN) introduced a bill Tuesday (July 13) that would let localities that previously received state funding apply for Department of Agriculture rural broadband programs. It also would let states use COVID-19 relief to fulfill their obligation in most applications to match federal dollars.”