    [House Hearing, 116 Congress]
    [From the U.S. Government Publishing Office]

    BUILDING OPPORTUNITY IN RURAL AMERICA THROUGH AFFORDABLE, RELIABLE, AND
                              HIGH-SPEED BROADBAND

    =======================================================================

                                    HEARING

                                   BEFORE THE

            SUBCOMMITTEE ON COMMODITY EXCHANGES, ENERGY, AND CREDIT

                                     OF THE

                            COMMITTEE ON AGRICULTURE
                            HOUSE OF REPRESENTATIVES

                         ONE HUNDRED SIXTEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                 JULY 11, 2019

                                   __________

                               Serial No. 116-15

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Printed for the use of the Committee on Agriculture
                             agriculture.house.gov

                                   __________

                        U.S. GOVERNMENT PUBLISHING OFFICE
    37-193 PDF                  WASHINGTON : 2019

    --------------------------------------------------------------------------------------

                            COMMITTEE ON AGRICULTURE

                    COLLIN C. PETERSON, Minnesota, Chairman

    DAVID SCOTT, Georgia                 K. MICHAEL CONAWAY, Texas, Ranking
    JIM COSTA, California                Minority Member
    MARCIA L. FUDGE, Ohio                GLENN THOMPSON, Pennsylvania
    JAMES P. McGOVERN, Massachusetts     AUSTIN SCOTT, Georgia
    FILEMON VELA, Texas                  ERIC A. ``RICK'' CRAWFORD,
    STACEY E. PLASKETT, Virgin Islands   Arkansas
    ALMA S. ADAMS, North Carolina        SCOTT DesJARLAIS, Tennessee
        Vice Chair                       VICKY HARTZLER, Missouri
    ABIGAIL DAVIS SPANBERGER, Virginia   DOUG LaMALFA, California
    JAHANA HAYES, Connecticut            RODNEY DAVIS, Illinois
    ANTONIO DELGADO, New York            TED S. YOHO, Florida
    TJ COX, California                   RICK W. ALLEN, Georgia
    ANGIE CRAIG, Minnesota               MIKE BOST, Illinois
    ANTHONY BRINDISI, New York           DAVID ROUZER, North Carolina
    JEFFERSON VAN DREW, New Jersey       RALPH LEE ABRAHAM, Louisiana
    JOSH HARDER, California              TRENT KELLY, Mississippi
    KIM SCHRIER, Washington              JAMES COMER, Kentucky
    CHELLIE PINGREE, Maine               ROGER W. MARSHALL, Kansas
    CHERI BUSTOS, Illinois               DON BACON, Nebraska
    SEAN PATRICK MALONEY, New York       NEAL P. DUNN, Florida
    SALUD O. CARBAJAL, California        DUSTY JOHNSON, South Dakota
    AL LAWSON, Jr., Florida              JAMES R. BAIRD, Indiana
    TOM O'HALLERAN, Arizona              JIM HAGEDORN, Minnesota
    JIMMY PANETTA, California
    ANN KIRKPATRICK, Arizona
    CYNTHIA AXNE, Iowa

                                     ______

                          Anne Simmons, Staff Director

                  Matthew S. Schertz, Minority Staff Director

                                     ______

            Subcommittee on Commodity Exchanges, Energy, and Credit

                         DAVID SCOTT, Georgia, Chairman

    JEFFERSON VAN DREW, New Jersey       AUSTIN SCOTT, Georgia, Ranking
    FILEMON VELA, Texas                  Minority Member
    STACEY E. PLASKETT, Virgin Islands   ERIC A. ``RICK'' CRAWFORD,
    ABIGAIL DAVIS SPANBERGER, Virginia   Arkansas
    ANTONIO DELGADO, New York            MIKE BOST, Illinois
    ANGIE CRAIG, Minnesota               DAVID ROUZER, North Carolina
    SEAN PATRICK MALONEY, New York       ROGER W. MARSHALL, Kansas
    ANN KIRKPATRICK, Arizona             NEAL P. DUNN, Florida
    CYNTHIA AXNE, Iowa                   DUSTY JOHNSON, South Dakota
                                         JAMES R. BAIRD, Indiana

                   Ashley Smith, Subcommittee Staff Director

                                      (ii)

                                 C O N T E N T S

                                  ----------
                                                                       Page
    Conaway, Hon. K. Michael, a Representative in Congress from
      Texas, opening statement.......................................     5
    Kirkpatrick, Hon. Ann, a Representative in Congress from Arizona,
      submitted letter; on behalf of James D. Ogsbury, Executive
      Director, Western Governors' Association.......................    63
    Scott, Hon. Austin, a Representative in Congress from Georgia,
      opening statement..............................................     3
    Scott, Hon. David, a Representative in Congress from Georgia,
      opening statement..............................................     1
        Prepared statement...........................................     3

                                   Witnesses

    Hengel, David, Executive Director, Greater Bemidji, Inc.,
      Bemidji, MN....................................................     8
        Prepared statement...........................................    10
    Mollgaard, Neela, Executive Director, Red Wing Ignite, Red Wing,
      MN.............................................................    14
        Prepared statement...........................................    16
        Submitted question...........................................    70
    Hess, M.D., David C., Dean, Executive Vice President of Medical
      Affairs and Integration, Presidential Distinguished Chair, and
      Professor of Neurology, Medical College of Georgia, Augusta
      University, Augusta, GA........................................    19
        Prepared statement...........................................    21
    Watahomigie-Corliss, Hon. Ophelia, Councilwoman, Havasupai Tribe,
      Supai, AZ......................................................    27
        Prepared statement...........................................    29
    Hurst, C. Blake, President, Missouri Farm Bureau Federation;
      Board Member, American Farm Bureau Federation, Tarkio, MO......    33
        Prepared statement...........................................    34
        Submitted questions..........................................    71

    BUILDING OPPORTUNITY IN RURAL AMERICA THROUGH AFFORDABLE, RELIABLE, AND
                              HIGH-SPEED BROADBAND

                                  ----------

                            THURSDAY, JULY 11, 2019

                      House of Representatives,
       Subcommittee on Commodity Exchanges, Energy, and Credit,
                                      Committee on Agriculture,
                                                       Washington, D.C.
        The Subcommittee met, pursuant to call, at 10:00 a.m., in
    Room 1300 of the Longworth House Office Building, Hon. David
    Scott of Georgia [Chairman of the Subcommittee] presiding.
        Members present: Representatives David Scott of Georgia,
    Van Drew, Vela, Spanberger, Delgado, Craig, Kirkpatrick, Axne,
    O'Halleran, Austin Scott of Georgia, Crawford, Rouzer,
    Marshall, Johnson, Baird, Hartzler, Allen, and Conaway (ex
    officio).
        Staff present: Carlton Bridgeforth, Emily German, Matt
    MacKenzie, Isabel Rosa, Ashley Smith, Paul Balzano, Patricia
    Straughn, Dana Sandman, and Jennifer Yezak.

      OPENING STATEMENT OF HON. DAVID SCOTT, A REPRESENTATIVE IN
                         CONGRESS FROM GEORGIA

        The Chairman. This hearing of the Subcommittee on Commodity
    Exchanges, Energy, and Credit entitled, Building Opportunities
    in Rural America through Affordable, Reliable, and High-Speed
    Broadband, will come to order.
        Good morning, and welcome to today's hearing on broadband
    Internet connectivity and the great opportunities it presents
    for our rural communities. This is an extraordinarily important
    and very timely and very necessary hearing, and this issue is
    an important one because it lets us shine light on those rural
    areas that have seen what broadband investment can do, and are
    thriving because of their access to broadband. Rural broadband
    is a prime example of how government investments, coupled with
    private innovation, can create a ripple of success and increase
    the quality of life for Americans in our rural communities.
        We are going to hear today from a cross-section of very
    knowledgeable people who have worked hard to increase access to
    and success in healthcare, agriculture, local communities,
    education, and small businesses. We are going to hear from them
    on their successes in leveraging broadband connectivity to
    enhance the services they provide to our communities. And it is
    my hope that through these stories, their reports to us this
    morning, that we can have a conversation, a meaningful,
    productive, beneficial conversation for our rural communities
    about those steps that we still need to take, because there are
    many, many rural communities that are crying out for our help
    and for broadband.
        In my home State of Georgia, for instance, we have lost
    seven rural hospitals since 2010. I want to repeat that so you
    see it: 2010, just 9 years ago, and we have lost seven rural
    hospitals. And this is third most in our nation. There are so
    many of our states who are suffering an impact with the loss of
    hospitals and the absence of those hospitals and broadband
    access, in many cases, means this. It means the ability to
    access telehealth, which \1/4\ of rural adults say that they
    have used.
        Let's go to the field of education. The gap between rural
    and urban adults with a college degree continues to widen.
    Broadband connectivity opens up a range of possibilities for
    online continuing education and degree completion at an
    increasing range of schools, including comprehensive state
    universities, and our land-grant colleges and universities, as
    well as regional schools with more specialized programs.
        Our farmers, for example, continue to use broadband to
    expand their toolbox and their knowledge base to make the most
    of their precision agricultural applications. And small
    businesses, they can leverage broadband to access a world's
    worth of consumers outside their own communities. But, not if
    we do not make and expand this investment. Our Subcommittee
    Members here are committed to making sure that we expand this
    investment.
        Now, I wanted to have this hearing so that we can see what
    is being done well. What of those successes can be done in
    other communities and also, what work remains for us to do? And
    I also know that the Federal Communications Commission Chairman
    Pai plans on releasing an order, very soon, for requiring
    increased reporting in an effort to improve the current failing
    broadband map system.
        It is very important that rural America weigh in on these
    policy changes at the FCC, and here in the halls of Congress,
    as we continue to talk about proposals to rebuild our crumbling
    infrastructure. This is the key that will open the door when
    Congress moves and puts forward the rebuilding of our crumbling
    infrastructure program. And we can't wait for that to start.
        I know that all of us on this Subcommittee agree, both
    Democrats and Republicans, that it is essential that rural
    broadband is an integral part of any infrastructure package,
    and we are going to make sure that rural broadband is a major
    centerpiece of our rebuilding of our infrastructure package.
        I am eager, as all of us are, to hear from our witnesses
    and how they tackled the challenges in rural America to give
    communities the access and tools they need to thrive through
    our broadband technology. We have to work together to make sure
    that our policies encourage growth and success in our rural
    communities nationwide.
        [The prepared statement of Mr. David Scott of Georgia
    follows:]

     Prepared Statement of Hon. David Scott, a Representative in Congress
                                  from Georgia
        Good morning, and welcome to today's hearing of the Subcommittee on
    Commodity Exchanges, Energy, and Credit on broadband Internet
    connectivity and the opportunities it presents for our rural
    communities.
        This issue is an important and timely one because it lets us shine
    light on those rural areas that have seen what broadband investment can
    do and are thriving because of their access to broadband.
        Rural broadband is a prime example of how government investments
    coupled with private innovation can create a ripple of success and
    increase the quality of life for Americans in rural communities.
        We're going to hear today from a cross-section of people who have
    worked to increase access to and success in healthcare, agriculture,
    local communities, education, and small business, on their successes in
    leveraging broadband connectivity to enhance the services they provide
    to their communities.
        And it's my hope that through those stories we can have a
    conversation about those steps we still need to take, because there are
    many.
        In my home State of Georgia, we've lost seven rural hospitals since
    2010, which is third most in the nation. In the absence of those
    hospitals, broadband access in many cases means the ability to access
    telehealth, which \1/4\ of rural adults say they've used.
        Within the field of education, the gap between rural and urban
    adults with a college degree continues to widen. Broadband connectivity
    opens up a range of possibilities for online continuing education and
    degree completion at an increasing range of schools including
    comprehensive state universities and our land-grant colleges and
    universities, as well as regional schools with more specialized
    programs.
        Our farmers continue to use broadband to expand their toolbox and
    knowledge base to make the most of their precision agriculture
    applications, and small businesses can leverage broadband to access a
    world's worth of consumers outside their own communities, but not if we
    do not make and expand this investment.
        I wanted to have this hearing so that we can see what's being done
    well, what of those successes can be done in other communities and what
    work remains. I also know that Federal Communications Commission
    Chairman Pai plans on releasing an order very soon requiring increased
    reporting in an effort to improve the current failing broadband map
    system. It is very important that rural America weigh in on these
    policy changes at the FCC and here in the halls of Congress as we
    continue to talk about proposals to rebuild our crumbling
    infrastructure. I know that all of us on this Subcommittee agree, both
    Democrats and Republicans that it is essential that rural broadband is
    an integral part of any infrastructure package.
        I am eager to hear from our witnesses and how they tackled
    challenges in rural America to give communities the access and tools
    they need to thrive through broadband technology. We have to work
    together to make sure our policies encourage growth and success in our
    rural communities nationwide.
        Now I'd like to recognize the Ranking Member Austin Scott of
    Georgia for any opening comments he would like to make.

        The Chairman. And now, in the consultation with our Ranking
    Member and pursuant to Rule XI(e), I want to make Members of
    the Subcommittee aware that other Members of the full Committee
    may join us today.
        And now, it gives me great pleasure to recognize my
    distinguished Ranking Member, Mr. Austin Scott, whom I refer to
    affectionately as my cousin Scott, for his opening statement.
    Mr. Scott?

      OPENING STATEMENT OF HON. AUSTIN SCOTT, A REPRESENTATIVE IN
                         CONGRESS FROM GEORGIA

        Mr. Austin Scott of Georgia. Thank you, Chairman Scott. We
    have been good friends for a long time, 23, 24 years, somewhere
    in there.
        This is an important hearing on a subject that resonates
    with all Americans, specifically it resonates with me and my
    wife and my children. We live 15 miles north of high-speed
    Internet access, and we live 15 miles south of high-speed
    Internet access. And there are many times in our life where the
    fastest access that we have is through connecting to our
    iPhone. It is extremely important to us and to the industries
    that try to operate in areas like those that I live in with my
    family.
        I want to thank our distinguished witnesses that are here
    today to discuss how affordable, reliable, high-speed broadband
    can bring our communities into the 21st century.
        For more than 24 million Americans who live in rural
    communities, as I do, that do not have broadband Internet
    access and lack the infrastructure for reliable and affordable
    connection, as we will hear from our witnesses today, having
    reliable, affordable broadband is not about having modern
    conveniences. That is certainly important for us, but for most
    Americans, broadband access is about access to information,
    options, choices, and quite honestly, it is virtually
    impossible to run a business without it today.
        Whole conversations happen entirely online, and the only
    participants are those who have broadband access. Information
    of all forms is created, shared, and consumed entirely through
    a broadband Internet connection, and much of the machinery
    today is dependent upon these Internet connections to function.
    It enables new tools that can't be replicated in any other way,
    shape, or form. Big data and artificial intelligence, cloud
    storage and computing, the Internet of Things and data
    analytics, telemedicine--something else that is extremely
    important to those of us in the rural parts of the country--and
    other modern tools simply cannot be replicated without
    broadband access.
        Broadband access has become a dividing line between those
    24 million rural Americans and the modern broadband-dependent
    information services most urban and suburban Americans take for
    granted. It is not just rural Americans who suffer from this
    divide, though. Suburban and urban Americans are equally cut
    off from the voices and talents and ideas of their rural
    neighbors.
        So, for me, all options are on the table when it comes to
    providing our rural communities with the technological
    resources they need to grow and thrive. This includes
    strengthening effective programs that are already in place at
    the USDA and FCC, advocating for robust broadband support in an
    infrastructure package, and even encouraging innovative
    technologies like TV white spaces.
        This Committee did great work last Congress in the 2018
    Farm Bill to ensure that the USDA has the tools it needs to
    bridge the digital divide in rural America. Included were two
    amendments which originated in our office that I am very happy
    to have the support of this Committee that addressed the
    accountability measures and expanded our U.S. loans and grants
    to the middle mile infrastructure projects.
        Now, some might say quality broadband infrastructure
    investments will connect rural America to the rest of the
    world. I would suggest that it connects the rest of the world
    to the benefits of rural America. By bridging this digital
    divide, it will enable access to a wealth of economic
    opportunities for all parts of America, and it is in
    everybody's best interest.
        With that, Mr. Chairman, I yield back.
        The Chairman. Thank you very much, Mr. Scott.
        And now, I recognize our distinguished Ranking Member of
    the full Committee, Mike Conaway, for any opening statements he
    would like to make.

    OPENING STATEMENT OF HON. K. MICHAEL CONAWAY, A REPRESENTATIVE
                         IN CONGRESS FROM TEXAS

        Mr. Conaway. Well, thank you, Mr. Chairman. I appreciate
    your kindness and forbearance. Thank you for scheduling this
    hearing. It is an important topic, one that has been on the top
    of the minds of most Members for a long, long time. As the
    Ranking Member noted in his opening statement, broadband access
    is not about convenience. It is about being able to participate
    in modern life and the economy, which is rapidly moving onto
    the Internet.
        For those who lack access, their lives are fundamentally
    different than those who do have access. As Ms. Mollgaard noted
    in her written testimony, broadband is a platform, a generic
    technology that is powerful because it enables the creation of
    other tools and technologies.
        The importance of broadband is one of the many reasons that
    I am so proud of the farm bill we passed last December. We
    worked together across the aisle and across the Capitol to take
    the best ideas for how to build broadband infrastructure into
    our rural communities. We not only provided a new grant program
    to build broadband where it is needed, but also new
    requirements to build what is needed for the long haul. The
    forward-looking standards that we passed will make sure that
    new broadband projects provide high quality Internet service
    for long into the future.
        Because of the 2018 Farm Bill, USDA has the ability to
    better target its limited resources to the rural communities
    most in need. By prioritizing projects, incentivizing
    investments in more rural territories, and requiring better
    assessments for proposed service territories, we will be able
    to help our most rural and least equipped communities while
    protecting taxpayers.
        And finally, we also worked closely with the Energy and
    Commerce Committee to strengthen the cooperation between the
    USDA, FCC, and the Department of Commerce. One important
    product of this cooperation will be a comprehensive report on
    the long-term connectivity needs of rural communities, and the
    technology available to meet those needs.
        The 2018 Farm Bill broadband provisions represent a real
    success story that the Members of this Committee should be
    rightly proud of, but that success will be for naught if our
    appropriators--folks with the money--don't actually appropriate
    the funds that we authorized under our bill. I am hopeful that
    before the ink is dry on the 2020 appropriations package that
    it includes robust funding for the programs we worked so hard
    on.
        Let me also add my thanks to our witnesses for their
    diligence, preparation, and travel to be with us today. I look
    forward to your testimony.
        Mr. Chairman, thank you for calling this hearing and
    building out a record of how important broadband is for our
    constituents. I look forward to working with you and Chairman
    Peterson, Ranking Member Scott, and the rest of the Committee
    in advancing this good work.
        With that, I yield back.
        The Chairman. Thank you, Ranking Member Conaway.
        Now the chair would request that other Members submit their
    opening statements for the record so the witnesses may begin
    their testimony, and to ensure that there is ample time for
    questions.
        Now, I know that Chairman Peterson wanted to introduce our
    first witness, but as he is stuck in the Veterans' Committee's
    markup, I am happy to introduce our first witness for him, and
    that would be Mr. David Hengel. Mr. Hengel is Executive
    Director of the Greater Bemidji an economic development
    organization in Bemidji, Minnesota. Good to have you, sir.
    Thank you for coming.
        And now, I would like to turn to Ms. Craig? Is Ms. Craig
    here?
        Ms. Craig. Yes, sir, Mr. Chairman.
        The Chairman. Oh, I thought so.
        Now I would like to recognize the gentlewoman from
    Minnesota, Ms. Craig, to make an introduction of our second
    witness.
        Ms. Craig. Excellent. Thank you so much, Mr. Chairman.
        It is my great pleasure to introduce Neela Mollgaard from
    Red Wing, Minnesota, here with us this morning. She is the
    Executive Director of Red Wing Ignite, which is an incubator
    for students, tech entrepreneurs, and local businesses.
        As the Executive Director of Red Wing Ignite, Neela
    harnesses the power of broadband connectivity and new
    technologies to create educational opportunities and foster
    innovation in our region. Prior to joining Red Wing Ignite,
    Neela led and helped create Red Wing's Care Clinic, a free
    medical clinic serving uninsured and low-income residents of
    Goodhue County, Minnesota. Neela has a long track record of
    leadership, serving our community on numerous charitable
    organization boards and committees. She played a pivotal role
    in forming Minnesota's broadband infrastructure priorities as a
    member of the Governor's Broadband Task Force. She is a
    graduate of the University of West Virginia's School of
    Medicine where she received a Master of Science in Community
    Health, and the University of Wisconsin at Madison, where she
    received a Bachelor of Science in Consumer Affairs in Business.
        Neela, it is an honor to have you here with us today.
        The Chairman. Our third witness hails from my beloved State
    of Georgia, and now I recognize the gentleman from Georgia, Mr.
    Allen, for the introduction.
        Mr. Allen. Thank you, Chairman Scott, for this opportunity
    to introduce Dr. David Hess here today. I congratulate this
    Committee on having this hearing, which is critical to
    survival, really, of rural America.
        Dr. Hess serves as the Dean and Executive Vice President of
    Medical Affairs Integration as well as the Presidential
    Distinguished Chair of Neurology at the Medical College for
    Georgia at Augusta University, located in my hometown of
    Augusta, and the 12th District of Georgia.
        A graduate of Johns Hopkins University and the University
    of Maryland School of Medicine, Dr. Hess is board-certified in
    internal medicine, neurology, and vascular neurology. Along
    with his passion for teaching, Dr. Hess's major area of
    interest is stroke and treatment for stroke and dementia. With
    over 185 reviewed publications, Dr. Hess has been involved in
    basic, pre-clinical, and clinical stroke research. He played a
    major role in developing the REACH Telestroke Network at
    Augusta University, which you will hear more about in his
    testimony today. This well-recognized telemedicine service now
    serves over 30 hospitals in rural Georgia. Additionally, Dr.
    Hess cofounded a telestroke company known as the REACH Health
    Incorporated, and served as Chairman of the Board of Directors
    from 2008 to 2018. Throughout his career, Dr. Hess has won many
    distinguished teaching awards and has been named to America's
    Top Doctors and Best Doctors in America every year since 2000.
        As my colleagues know, Augusta is well-known for his
    contribution to the great game of golf, and as you will see
    witnessed by the ties that Dr. Hess and I are wearing today,
    that we honor that tradition. But I will tell you this. Augusta
    is known through the efforts of Dr. Hess and his colleagues as
    the cutting-edge, high-tech medical center of this nation.
        Dr. Hess, thank you for being here today to share your
    testimony with my colleagues and for all the work you do for
    Augusta University in Georgia and this nation.
        And with that, sir, I yield back.
        The Chairman. Thank you, Mr. Allen.
        And now, I recognize the gentleman from Arizona, Mr.
    O'Halleran, to introduce our fourth witness.
        Mr. O'Halleran. Thank you, Chairman Scott and Ranking
    Member Scott, for having this meeting today.
        It is my great pleasure to introduce Councilwoman Ophelia
    Watahomigie-Corliss of the Havasupai Tribe.
        Just a brief little thing, if you ever want to go someplace
    beautiful, go down to the Havasupai Tribe. You can't get down
    there by car. You have to take a helicopter or hike down, but
    it is one of the most beautiful places on Earth.
        It is my honor to represent the Havasupai Tribe and to work
    in partnership with the Tribe to bring access to what I believe
    is the most remote community in the lower 48 states.
        I have been working with the Tribe to improve Internet
    access by assisting the Tribe to obtain a permanent educational
    broadband service license from the FCC, which has improved
    access to the Internet. I look forward to hearing more about
    how Internet access has improved access to information for
    members of the Tribe.
        I also want to follow up on Ranking Member Scott's comment
    about introducing the rest of the world to rural America. They
    better get introduced, because without rural America and the
    people in rural America that we have to have there, urban areas
    wouldn't exist.
        I welcome the Councilwoman here today. Thank you.
        The Chairman. Thank you very much, Mr. O'Halleran.
        Next, I will recognize the gentlewoman from Missouri, Mrs.
    Hartzler.
        Mrs. Hartzler. Yes.
        The Chairman. Sorry, excuse me. Please introduce our final
    witness, please.
        Mrs. Hartzler. Thank you, Chairman Scott and Ranking Member
    Scott, for holding this hearing and allowing me to be part of
    this Subcommittee hearing today. I am not a part of this
    Subcommittee normally, but what an important topic. It is so
    important to Missouri, and I am so proud to introduce our next
    guest.
        We have Mr. Blake Hurst that I have known for many years,
    but he is certainly a champion of agriculture in Missouri. He
    is President of the Missouri Farm Bureau, where he has been a
    leader for years, as well as other agricultural organizations
    in the state. But Blake knows what he speaks. He is a lifelong
    farmer. He and his family raise corn, soybeans, and they also
    have a greenhouse operation where they raise flowers.
        Besides being involved in organizations, he is also a very
    talented and prolific writer, which takes the message of rural
    America to such publications as The Wall Street Journal,
    Reader's Digest, Today's Farmer, among others, and he has been
    very involved in leading efforts in Missouri, dealing with
    broadband development, as well as in the nation. He was part of
    a working group on a nationwide basis a few years ago, one of
    only two members from the American Farm Bureau representatives
    to help look at connectivity and data, and other issues that
    are important to precision farming.
        We are very proud that you are here today, and have the
    opportunity to share your expertise with us, and we appreciate
    all that you do for agriculture and look forward to hearing
    your testimony. Welcome to our Subcommittee, and thank you, Mr.
    Chairman and Ranking Member, for allowing me the privilege of
    introducing such a fine individual to you today.
        The Chairman. Well, thank you very much. And certainly, I
    want to say, Mr. Hurst, to please give this Committee's warmest
    regards to your President, Mr. Zippy Duvall. Please do that. He
    is a good friend of ours.
        Thank you all for those introductions. We will now proceed
    to hearing from our witnesses. Each of you will have 5 minutes.
    When 1 minute is left, the light will turn yellow signaling
    time is close to expiring.
        Mr. Hengel, please begin when you are ready.

    STATEMENT OF DAVID HENGEL, EXECUTIVE DIRECTOR, GREATER BEMIDJI,
                           INC., BEMIDJI, MN

        Mr. Hengel. Chairman Scott, Ranking Member Scott, and
    Subcommittee Members, it is a great honor to be testifying
    today. I am Dave Hengel, Executive Director of Greater Bemidji
    in Bemidji, Minnesota, a public-private partnership formed to
    drive development and promote prosperity in our region. We have
    three staff people and an operating budget of $300,000, a
    majority of which is provided by private businesses. I recently
    completed my 30th year in economic development.
        Bemidji is a rural regional center located 200 miles north
    of Minneapolis. With 65,000 residents, it is one of Minnesota's
    fastest growing areas, but it is also one of Minnesota's
    poorest. Over the past 7 years, we have created 1,700 jobs and
    wages have grown 26 percent, yet one in five of our residents
    still live in poverty. Despite a historic low, our unemployment
    rate remains higher than the national average.
        The economic development world has changed dramatically in
    recent years, the primary driver of which has been broadband.
    Broadband can level the playing field between urban and rural
    as never before.
        In the past, our nation has made bold decisions to ensure
    our rural areas are competitive: from ensuring access to
    telephone services, to building the interstate highway system.
    I believe broadband is the interstate highway system of our
    generation. Without strong broadband, rural communities will be
    left behind.
        National policy has called for telecom services in rural
    areas to be comparable in both price and quality to urban
    areas. If rural America is to play a role in the global
    economy, it is essential that national commitment remain.
        Bemidji has been blessed. Our rural telephone cooperative,
    Paul Bunyan Communications, took a visionary approach of laying
    one of the nation's largest all-fiber networks. As a result,
    nearly every home, every farm, and every business in our region
    has access to gigabyte broadband. Moreover, MidCo, a private
    regional provider serving the upper Midwest, also provides
    high-speed broadband services to the Bemidji area. With these
    two leading-edge companies serving our community, our broadband
    services rival any in the nation.
        Drawing on my experience in economic development, I believe
    broadband's economic impact is especially significant in the
    following areas; first, in corporate recruitment efforts. For a
    majority of my career, when companies considered our region,
    they would focus on three things: access to cheap land, cheap
    capital, and cheap labor. Now they look to access talent,
    quality of life, and availability of high-speed broadband.
        Delta Dental is our most recent example. They are
    constructing a new $15 million operation center in Bemidji,
    creating 165 very good paying jobs. They chose Bemidji in large
    part due to the broadband services offered by Paul Bunyan
    Communications. Their leadership shared: ``The broadband
    services we can get in Bemidji are far superior to what we can
    get in our corporate headquarters in downtown Minneapolis''
    They are just one example of broadband playing a central role
    in our corporate recruitment and expansion efforts.
        Second, high-speed broadband is essential to winning the
    race to talent. In today's labor market, companies are looking
    to locations that have a quality of life to entice the best
    employees. As baby boomers retire, companies are investing in
    locations that appeal to the younger generation, for which
    high-speed broadband is a must-have. They simply will not live
    in a community that does not allow them to be connected.
        Finally, high-speed broadband is central to our efforts to
    support emerging entrepreneurs. Three years ago, Greater
    Bemidji opened the LaunchPad, a one-stop shop for
    entrepreneurs. We provide co-working space, business
    assistance, finance, training, peer-to-peer networking, and
    mentoring. The most important resource we provide our
    entrepreneurs is gigabit broadband, which allows them to be
    connected to the world. Our LaunchPad has successfully launched
    51 new startups.
        I am not an expert in broadband policy or deployment, but I
    can testify to the impact high-speed broadband can have on the
    economy. For rural communities to be competitive, they must
    have the infrastructure to support the transforming economy.
    Historically, the infrastructure we focused on was great roads
    and highways, waters and sewer systems, and industrial parks.
    Those are equally important today, but they simply are not
    enough. High-speed broadband is now essential for rural America
    to compete.
        Because of bold decisions made by broadband leaders in my
    region, my community has a gold standard of high-speed
    broadband services. The impact has been clear. Companies are
    choosing our area over other potential locations; young,
    talented people are moving to our region; and businesses are
    starting up at an unprecedented rate.
        I encourage you to do all you can to help other parts of
    rural America reap the same benefits we have felt in Bemidji.
    Thank you.
        [The prepared statement of Mr. Hengel follows:]

        Prepared Statement of David Hengel, Executive Director, Greater
                           Bemidji, Inc., Bemidji, MN
    Introduction and Background
        Chairman Scott, Ranking Member Scott, and Members of the
    Subcommittee, thank you for this opportunity to testify today on the
    essential role of high-speed broadband in fostering rural economic
    development. I am David Hengel, Executive Director of Greater Bemidji
    in Bemidji, MN--a public-private partnership created to drive
    development and promote prosperity in the greater Bemidji region.
    Greater Bemidji has three staff and an annual operating budget of
    $300,000--a majority of which is provided by 70+ businesses in our
    region. I just completed my 30th year in economic development--first at
    a regional level at the Headwaters Regional Development Commission, and
    now as the Executive Director of Greater Bemidji.
        Bemidji is the regional center for the lakes and pines country of
    north-central Minnesota. Surrounded by three Native American
    reservations, our economy is dominated by health care, retail sales and
    services, and tourism--with a very modest manufacturing base. With an
    area population of 65,000 residents, it is Minnesota's fifth fastest-
    growing community and yet also one of its poorest. Over the past 7
    years, our population has increased by 2,000 people with over 1,700 new
    jobs, wage levels are up 26.5 percent, and overall economic activity
    has increased over 25 percent. Despite the growth, incomes typically
    range from 65-70 percent of the state and national averages and over 20
    percent of Bemidji area residents live in poverty. Despite currently
    being at a historic low, our unemployment rates still exceed both the
    state and national averages.
        Greater Bemidji's mission is to help drive the positive economic
    numbers even higher, and high-speed broadband is intricately woven into
    our economic initiatives. Greater Bemidji has earned a reputation in
    Minnesota as an innovator in economic development through the success
    of our industry-led training center--the Minnesota Innovation
    Initiative--that provides timely, relevant, cost-effective
    manufacturing training to job seekers. In only 4 years, the initiative
    has trained well over 1,000 job seekers, 80% of whom have been placed
    in good jobs in our region. Another successful economic development
    innovation was the creation of Greater Bemidji's LaunchPad. The
    LaunchPad is a one-stop-shop for entrepreneurs, providing the co-
    working space, technical support, financial support, business planning,
    peer-to-peer mentoring and one-on-one mentoring they need to start
    their businesses. In its 3 year existence, the LaunchPad has spun off
    51 new companies.
    Broadband Has Been a Critical Component of Our Economic Development
        The world of economic development has changed dramatically in the
    last 5 years. Technology, and more specifically broadband, has been an
    essential part of our strategy and our success. Broadband has the
    potential to level the playing field between urban and rural as never
    before in history. One could even say that there are two kinds of rural
    regions in the U.S.--those that have the broadband infrastructure to
    compete in our new information and innovation economy, and those that
    do not.
        In the past, our nation has made bold decisions to ensure our
    nation's rural areas are competitive--from ensuring everyone has access
    to telephone services to building the interstate highway system. Based
    on my experience, broadband is the ``interstate highway system'' of our
    generation. Without a strong, fiber backbone, rural communities will no
    doubt be left behind.
        Thankfully, national policy calls for telecom service in rural
    areas to be reasonably comparable in quality and price to what is
    available in urban areas. Based upon this policy, the Federal
    Government has recognized that broadband is an essential service by
    providing support for the construction and ongoing operation of rural
    networks through programs overseen by the Federal Communications
    Commission (FCC) and the U.S. Department of Agriculture (USDA). If
    rural America is to have any hope of playing a role in the global
    economy, it will be essential to ensure that these programs are
    positioned for the future to provide predictable, reliable support to
    operators committed to providing high-speed broadband in sparsely
    populated areas where there is no business case for telecom service
    otherwise.
        Moreover, Minnesota has a state broadband office called the Office
    of Broadband Development that is the envy of other states. The
    Minnesota Office of Broadband works in concert with the Federal
    programs to support robust broadband deployment in rural areas and
    develops reliable broadband availability maps to ensure that the
    government resources are distributed efficiently and with maximum
    effectiveness. Even with the available Federal and state resources, a
    rural area still needs a broadband provider that is committed to
    serving the area with reliable, robust broadband.
        Bemidji has been blessed. Our rural telecommunications cooperative,
    Paul Bunyan Communications, took the bold and visionary approach of
    laying one of the nation's largest all-fiber broadband networks in the
    nation. As a result, nearly every home, farm or business in our region
    has access to gigabit upload and download broadband speeds. The
    broadband services we have in Bemidji and surrounding rural areas rival
    any in the nation, and they come at affordable prices. Why? Because
    Paul Bunyan Communications understands the impact broadband will have
    on the economic development of its region.
        Paul Bunyan Communications is not alone in providing exceptional
    broadband services in our region. MidCo, a regional broadband provider,
    serves the upper Midwest and provides high-speed broadband services in
    parts of the Bemidji area. Having two leading-edge companies serving
    our rural community is certain not typical.
        Drawing on my experience in rural economic development, I've
    observed that broadband's economic impact in rural areas is especially
    significant in the following three areas:
    Corporate Recruitment and Business Expansion
        Recruiting companies and corporate expansions to an area is an
    ongoing mission for any economic development office. For the first
    twenty years of my career, when a company was considering our region,
    they would focus on three things: access to cheap capital, cheap labor
    and cheap land. Today, when I'm recruiting companies to Bemidji, I'm
    asked different questions: (1) Can I find the talent I need?; (2) Is
    Bemidji a great community to live in?; and (3) Does the region provide
    the broadband infrastructure to support my company?
        Delta Dental is our most recent success story. Delta Dental is
    currently developing a new, $15 million operations center in Bemidji
    that will employ 165 residents at wages significantly higher than the
    average wage in the region. Delta Dental chose Bemidji in large part
    due to the fiber broadband infrastructure offered by Paul Bunyan
    Communications. When announcing their decision to expand in Bemidji,
    Delta Dental's head of technology said, ``the broadband services we can
    get in Bemidji are far superior to what we can get in our corporate
    headquarters in downtown Minneapolis.'' Delta Dental is not alone, as
    our area's broadband infrastructure has been central to several
    corporate recruitment and expansions in our region.
    Winning the Race for Talent
        Increasingly, economic development is a race for talent, not a race
    for companies. In a tightening labor market, companies are expanding in
    places that have the quality of life and amenities that provide them
    the ability to recruit the best employees. As we baby boomers look
    toward retirement, companies are investing in communities that appeal
    to the younger generations for whom high-speed broadband is a ``must
    have''--they simply will not move to or stay in a community that does
    not allow them to be connected to the rest of the world.
        Bemidji's recent growth is certainly due in part to our natural
    amenities, Bemidji State University, our vibrant downtown, and our
    expanding arts and cultural scene. But there can be no doubt that we
    would not have grown at the rate we have without our broadband
    infrastructure.
    Start-up Communities
        Finally, economic developers are increasingly focused on creating
    what we call ``start-up communities.'' Great start-up communities focus
    on ensuring their area has the foundational resources to help
    entrepreneurs start and prosper. Typically, anywhere from 50-70 percent
    of new jobs are created by local entrepreneurs.
        Greater Bemidji dove into start-up community work 3 years ago with
    the opening of our LaunchPad, a one-stop-shop for entrepreneurs that
    includes access to technical and business assistance, financial
    support, training and peer-to-peer networking. To date, 51 new
    companies have been supported by the LaunchPad. My personal favorite
    service at the LaunchPad is what we call ``Office Hours'', where
    retired CEOs from throughout the region provide free, one-on-one
    mentoring to aspiring entrepreneurs. The LaunchPad also provides co-
    working space, where at any one time 50 young businesses are operating
    their companies.
        The single most important service the LaunchPad offers its
    entrepreneurs is access to gigabit broadband service. Every
    entrepreneur using the LaunchPad today--as well as the 51 companies
    that spun off from the LaunchPad--required access to robust broadband
    services. Unfortunately, during the start-up stage, that broadband can
    be financially out of reach. The LaunchPad connects our rural
    entrepreneurs to the world, but we can only do this because of the
    fiber infrastructure in our region provided by Paul Bunyan
    Communications.
        NTCA--The Rural Broadband Association--the national trade
    association for small, rural broadband providers like Paul Bunyan
    Communications--has its own program designed to highlight innovation
    called Smart Rural Communities that recognizes broadband providers and
    communities that deploy and use robust fiber networks to jumpstart
    economic growth and improve access to first-rate education, healthcare,
    and government services. Paul Bunyan Communications received NTCA's
    Smart Rural Community Showcase award in 2015 for its work in Bemidji.
    Rural Economic Development Successes
        In rural areas, as discussed earlier, broadband connectivity
    presents a unique challenge due to geographical barriers--barriers that
    broadband can help break down and overcome. Indeed, in rural and urban
    areas alike, broadband availability and adoption strongly correlates
    with increased economic opportunity and prosperity. A 2016 government
    study found that just 41 percent of adults with household incomes less
    than $20,000 had home broadband access, while 90 percent of adults with
    household income higher than $100,000 had access.\1\ Other studies
    reveal that the availability of broadband services, regardless of
    adoption, added as much as 1.4 percent to the U.S. employment growth
    rate.\2\
    ---------------------------------------------------------------------------
        \1\ Digital Inequality and Low-Income Households (https://
    www.huduser.gov/portal/periodicals/em/fall16/highlight2.html), HUD
    Office of Policy Development and Research (2016).
        \2\ Galperin and Viecens, Connected for Development? Theory and
    evidence about the impact of Internet technologies on poverty
    alleviation (https://annenberg.usc.edu/sites/default/files/2017/03/12/
    Galperin_et_al-2017-Development_Policy_Review.pdf), Development Policy
    Review (2017).
    ---------------------------------------------------------------------------
        Investing in rural broadband has far-reaching effects for both
    urban and rural America, creating efficiencies in healthcare,
    education, agriculture, energy, and commerce, and enhancing the quality
    of life for citizens across the country. A report released in 2016 by
    the Hudson Institute in conjunction with the Foundation for Rural
    Service underscores the nationwide benefits that arise from rural
    broadband; this study found that investment by rural broadband
    companies contributed $24.2 billion to the economies of the states in
    which they operated in 2015.\3\ Of this amount, $8.3 billion accrued to
    the benefit of rural areas, while nearly $16 billion accrued to the
    benefit of urban areas. In addition, better broadband access in rural
    America is helping to drive growth in online transactions--a recent
    survey found, for example, that rural consumers account for more than
    10.8 billion Internet-driven transactions annually, representing
    approximately 15% of the national total.\4\
    ---------------------------------------------------------------------------
        \3\ The Economic Impact of Rural Broadband (https://
    s3.amazonaws.com/media.hudson.org/files/publications/
    20160419KuttnerTheEconomicImpactofRuralBroadband.pdf), The Hudson
    Institute, Washington, D.C. (2016).
        \4\ A Cyber Economy: The Transactional Value of the Internet in
    Rural America (https://www.frs.org/sites/default/files/documents/2018-
    03/A-Cyber-Economy_The-Transactional-Value-of-the-Internet-in-Rural-
    America.pdf), White Paper, iGR (2018).
    ---------------------------------------------------------------------------
        The benefits of rural broadband, however, go beyond sheer numbers--
    it is helpful as well to understand the productive uses of broadband
    and what they mean to those communities that get and stay connected.
    Rural America needs broadband not only to help farmers efficiently
    produce the crops that are sold around the world, but to help rural
    small businesses participate in the global economy and help all rural
    citizens experience the potentially life-changing healthcare,
    educational, and employment benefits of broadband.
        A major benefit of rural broadband, for example, comes in the form
    of distance learning. With a shortage of teachers in many areas of
    rural America, many schools must rely on high-speed connectivity to
    deliver interactive-video instruction for foreign language, science,
    and music classes. For example, one rural South Dakotan teaches Level 1
    and 2 Spanish to over 100 students in over a dozen high schools from a
    small office located on her farm. Her broadband connection enables her
    to instruct hundreds of students who otherwise would not have the
    opportunity to learn Spanish. In Minnesota, Fergus Falls Public Schools
    use a high-capacity connection between the various school buildings
    located throughout the city. This broadband connection enables staff to
    access and share files seamlessly across the network, and supports iQ
    Academy Minnesota, an accredited public-school program offering
    Minnesota students in grades K-12 an innovative, high-quality
    alternative to the traditional learning experience.
        Access to healthcare is a critical issue for rural areas, where the
    lack of physicians, specialists, and diagnostic tools normally found in
    urban medical centers creates challenges for both patients and medical
    staff. Telemedicine applications help bridge the divide in rural
    America, enabling real-time patient consultations and remote
    monitoring, as well as specialized services such as telepsychiatry. A
    small broadband provider in Georgia partnered with the county public
    school system to deploy telehealth equipment to connect the school
    nurses' offices with physicians at a regional hospital. Through this
    partnership, the hospital, the school system, and the rural broadband
    provider facilitate better healthcare for students who might not
    otherwise see a physician in an area where parents can ill afford to
    miss a half or full day of work for a doctor visit.
        High-speed broadband helps first responders foster safer
    communities. The Perham Fire Department in Minnesota serves 164\2\
    miles and five townships. Relying on broadband and LTE, each volunteer
    firefighter's smartphone includes a mobile app that allows the
    firefighter to view reported fires, use GPS to find the fire's
    location, and confirm the availability of each team member. The app
    also identifies the location of nearby fire hydrants. And in Melrose,
    MN all police department vehicles are equipped with WiFi and GPS,
    providing officers immediate access to data and improving overall
    community safety. The broadband network provided by a small, rural
    carrier also assists local ambulance services with a traffic-signal-
    prioritization system to manipulate traffic signals for emergency
    vehicles in transit.
        Finally--in part by improving access to quality healthcare,
    education, and public safety--fast, high-capacity broadband in rural
    areas also creates jobs. In Sioux Center, Iowa, a major window
    manufacturer built a 260,000\2\ plant to employ 200 people. The
    company considered more locations throughout the Midwest, but selected
    Sioux Center in part because the rural broadband provider enabled this
    plant to connect with its other locations throughout the U.S.
    Similarly, in Cloverdale, Indiana, a rural broadband provider met with
    developers and helped bring an industrial park to its service area.
    Powered by this provider's broadband, the facility created more than
    800 jobs in the area. These stories are repeated throughout those rural
    areas with access to robust broadband.
    Conclusion
        The title of this hearing is ``Building Opportunity in Rural
    America through Affordable, Reliable, High-Speed Broadband.'' I am not
    an expert in broadband policy or deployment, but I can testify to the
    impact high-speed broadband can have on our nation's economy,
    particularly in rural America.
        For our nation's rural communities to be competitive, they must
    have the foundational infrastructure to support a transforming economy
    that is increasingly driven by technology. Historically, great roads
    and highways, water and sewer systems, and industrial parks were the
    foundational infrastructure for communities. Today, these are as
    necessary as ever before, but they are not sufficient. High-speed
    broadband is now required for rural America to compete.
        As I said earlier, I have been blessed. Because of bold decisions
    made by broadband leaders in our community and surrounding rural areas
    several years ago, my community of Bemidji, Minnesota has the gold
    standard of high-speed broadband service. Since then, the impact has
    been clear and observable. Because Bemidji has gigabit broadband
    service, companies are choosing our area over other potential
    locations. Young, talented people are moving to our region in part due
    to the available high-speed broadband. Finally, we are churning our new
    business start-ups at an unprecedented rate due to the broadband-
    focused Greater Bemidji LaunchPad. I would encourage the Congress to do
    all it can to help other parts of rural America reap the benefits we
    have in Bemidji. Thank you.
                                   Attachment
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        The Chairman. Thank you very much, Mr. Hengel.
        Now, Ms. Mollgaard, we will now hear from you.

      STATEMENT OF NEELA MOLLGAARD, EXECUTIVE DIRECTOR, RED WING
                          IGNITE, RED WING, MN

        Ms. Mollgaard. Chairman David Scott, Ranking Member Austin
    Scott, and Members of the Subcommittee, thank you for allowing
    me to testify today. I am Neela Mollgaard, the Executive
    Director of Red Wing Ignite, located in the small town of Red
    Wing, Minnesota, nestled along the bluffs of the Mississippi,
    only 50 miles south of St. Paul. We have a diverse economy of
    advanced manufacturing, agriculture, and tourism.
        Red Wing Ignite is a hub and a facilitator of community
    innovation, advancing students, entrepreneurs, and businesses
    to compete in the 21st century economy. That entails a co-
    working space, startup support, maker space, and programs to
    prepare our youth for the future workforce.
        We have cold winters, lots of eagles, people who work hard
    and want the best for their kids. And through Ignite, I get to
    help our community stay competitive.
        The City of Red Wing formed a partnership with Hiawatha
    Broadband Communications to invest in broadband infrastructure
    with fiber. That investment has made it possible for the
    stories I will share with you today.
        Red Wing Ignite launched in 2013, leveraging our gig
    network and our partnership with U.S. Ignite, initially
    supported by the White House and the National Science
    Foundation. We are the only rural city in U.S. Ignite's network
    of 28 smart gigabit communities, a program providing tools to
    build smart communities, driving new services, startups, and
    technologies.
        For us, broadband is like electricity. We turn it on and it
    works. Yet, you need more than the gig to grow an economy.
    Rural communities require a different strategy, one that builds
    density of talent, expertise, and resources.
        Ignite is both a physical and virtual hub for innovation.
    Broadband was the essential first step, but so is an
    organization like Ignite, bringing opportunity, exposure, and
    access to students, entrepreneurs, and businesses.
        I would like to share stories highlighting our three focus
    areas. First, growing our talent pipeline. We plant the seeds
    to grow future innovators, the employers of tomorrow. We
    provide leadership to create STEM learning inside and outside
    the classroom, college tech internships, and worksite learning
    by convening schools and manufacturers.
        Tony was a high school senior participating in a tech
    entrepreneur class where students solved problems using
    technology, culminating in the opportunity to pitch to
    investors. Tony said ``I was exposed to people and curriculum
    that heightened my knowledge of coding and entrepreneurism. Now
    I am launching my own startup!''
        Second, advancing entrepreneurs. With U.S. Ignite and
    regional partners, we convened a statewide Ag Tech Challenge to
    solve problems facing agriculture. The winner was Jack Kilian
    with Poultry Patrol, a robot for turkey farms. It collects data
    and may increase the weight, decrease mortality, and Salmonella
    rates amongst turkeys. Kilian said, ``This opportunity gave me
    a reason to explore an idea. With Red Wing Ignite's help, I was
    quickly able to get in contact with investors, customers, and
    mentors. Now I feel confident I can make Poultry Patrol a
    reality.''
        Currently, though, finding turkey farms with broadband has
    been challenging. It is costly for farmers to implement this on
    their own.
        Third, supporting rural innovation. People want to choose
    where they live and bring their careers with them. We have seen
    this locally with people leaving urban areas for the benefits
    of small-town living. In response, Ignite has created a co-
    working space, maker space, start-up support, and other
    resources. The strongest network we have, even in the world of
    fiber, is the human network.
        How did we get here? I have one word, collaboration. Red
    Wing Ignite forges partnerships with government, academia,
    corporate partners, and individuals to grow our innovative
    ecosystem. As a result of our work, we were recently one of
    nine communities nationwide selected by the Center on Rural
    Innovation to receive technical assistance funded by the
    Economic Development Administration to support our efforts to
    create an innovation-based economy.
        Through perseverance, we have learned these lessons.
    Communities without broadband are in jeopardy. Broadband access
    alone is not enough for economic vitality. Economic success
    should be evaluated by talent attraction, retention, and
    development, not only the number of new jobs. Public-private
    partnerships are critical for success and sustainability, and
    local champions are needed, because it doesn't happen quickly.
        In closing, the African proverb says it best. ``If you want
    to go fast, go alone, if you want to go far, go together.''
    This work can't happen in isolation. We want to thank our
    local, state, and national partners.
        Thank you for the opportunity to testify, and I look
    forward to your questions.
        [The prepared statement of Ms. Mollgaard follows:]

      Prepared Statement of Neela Mollgaard, Executive Director, Red Wing
                              Ignite, Red Wing, MN
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        Chairman David Scott, Ranking Member Austin Scott, and Members of
    the Subcommittee, thank you for allowing me to testify today.
    Introduction
        I am Neela Mollgaard, the Executive Director of Red Wing Ignite, a
    hub and facilitator of community innovation located in the small town
    of Red Wing, Minnesota.
        Red Wing is nestled along the Bluffs of the Mississippi River only
    50 miles from Minneapolis/St. Paul. Red Wing supports a diverse economy
    of advanced manufacturing, agriculture and tourism. Downtown
    preservation efforts have resulted in Red Wing being identified as one
    of the top 25 historic towns to visit in the U.S.A.
        We have cold winters, lots of eagles, people who work hard and want
    the best for their kids. Through Ignite, I get to help keep our
    community competitive.
        We have built partnerships and initiatives with schools,
    government, businesses and nonprofits. We have more than 18 businesses
    and organizations at our co-working space. Last year, we hosted more
    than 150 community and business meetings enhanced with high-definition
    video conferencing facilities. We created and launched a Makerspace in
    partnership with Minnesota State College Southeast. We have also
    recruited and supported almost 40 startups in 2019 alone.
    Broadband Infrastructure
        The City of Red Wing was forward thinking and formed a partnership
    with a local provider, Hiawatha Broadband Communication (HBC) to invest
    in broadband infrastructure as an economic growth strategy. That
    investment has made it possible for the stories I will share today.
        To leverage the gigabit network, and our partnership with U.S.
    Ignite (initially supported by the White House Office of Science and
    Technology Policy and National Science Foundation), Red Wing Ignite was
    launched in 2013. We are the only rural city in U.S. Ignite's network
    of 28 Smart Gigabit Communities. U.S. Ignite helps communities expedite
    adoption of services, develop innovative practices that stimulate job
    growth, the startup environment, and real estate investment.
        Broadband is like electricity for us--we turn it on and it works.
    Unlike colleagues still struggling to secure broadband, we can spend
    time maximizing it.
        But you need more than just the Gig to grow an economy. To be
    competitive in a global economy, rural communities require a different
    strategy--one that builds density of talent, people and resources to
    drive innovation.
        Since then, the Red Wing area received two Minnesota Border to
    Border Grants, funds provided by the state legislature, to deploy
    better broadband. These grants are awarded on a competitive basis to
    unserved or under-served communities to help all of Minnesota reach the
    statutory speed goals of 100 Mbps down and 20 Mbps up by 2026. I served
    on the Governor's Task Force on Broadband at this time and had to
    compromise with speed goals, I feel they should have been faster.
        Red Wing Ignite also received a grant from the Blandin Foundation
    to focus on broadband adoption. Blandin supports Red Wing with
    strategic consulting and seed money for broadband-fueled programs. The
    Blandin Foundation introduced us to the Intelligent Community Forum
    (ICF) model. The model measures community competitiveness in the
    broadband economy based on four indicators: ensuring broadband
    infrastructure, developing a knowledge-based workforce, supporting
    innovation, redressing the digital divide, and effectively using
    marketing and advocacy to tell the community's technology story.
        Two years ago, Blandin released a report on five Minnesota
    broadband success stories--including Red Wing and Goodhue County. They
    found that broadband had increased residents' economic benefit more
    than $32 million per year (Or $1,850 annual benefit per household with
    broadband.) Real Estate values had also increased by more than $100
    million.
    Recent Accomplishments
        It has taken Red Wing Ignite more than 5 years to build the
    foundation needed for an innovative ecosystem working to advance
    students, entrepreneurs and our business community. Broadband is
    essential but so is an organization like Ignite--bringing opportunity,
    access and exposure to the skills required in the 21st Century economy.
    Growing the Talent Pipeline
        We plant the seed to grow future innovators--the employers of
    tomorrow. We provide:

       Leadership to create a K-12 career pathways on STEM learning
            with aligned curriculum and worksite learning to be prepared
            for future careers. The flight paths focus on four areas:
            advanced manufacturing, health sciences, business/
            entrepreneurship and human services.

       College tech internships, that matches college students from
            the region with businesses needed technology help to advance
            their business.

       A coder dojo site, is a free, volunteer-led, community-based
            computer programming clubs for students.

       A collaboration with school districts, our college and
            manufacturers to provide work site learning and a certification
            through our local college.

        Tony, a high school senior, participated in our tech entrepreneur
    class where students solve problems using technology culminating with
    the opportunity to pitch to investors. Tony said, ``It's cool Ignite
    has brought so many opportunities. I was exposed to people and
    curriculum that heightened my knowledge of coding and entrepreneurism.
    Now I'm actually launching my own startup!''
    Advancing Entrepreneurs
        With assistance from U.S. Ignite and regional partners, we convened
    a statewide Ag Tech Challenge seeking new hardware or software to
    improve agriculture. The winner was Jack Kilian, with the Poultry
    Patrol, a robot for turkey farms. The robot collects data and is
    projected to possibly increase weight, decrease mortality and
    Salmonella among turkeys.
        Kilian received $15K in awards and said, ``This opportunity gave me
    a reason to explore an idea. With Red Wing Ignite's help, I was quickly
    able to get in contact with investors, customers, and mentors. Now I
    feel confident I can make Poultry Patrol a reality.''
        Jack Buendor a cofounder also shares, ``Poultry Patrol is focused
    on Giving farmers access to the data collection technologies will
    increase the efficiency of the U.S. agricultural industry and help make
    farming more reliable, sustainable and safe. Everything from watershed
    monitoring, yield estimation, crop health, row alignment, and livestock
    monitoring will need data analysis, and the best ways to reliably
    collect, process, and present that data require through stable
    broadband.''
        Currently, finding turkey farms with broadband has been
    challenging; it's costly for farmers to implement on their own.
    Supporting Rural Innovation
        Now and in the future individuals will choose where they want to
    live and bring their careers with them. We have seen this locally with
    people choosing to leave urban areas for the benefits of small town
    living. In response Ignite has created a co-working space, makerspace,
    business incubator and other resources to meet this need.
        The strongest network we have--even in the world of fiber is that
    human network.
    How We Got Here
        People ask--how did we get here. I have one word, collaboration.
        Red Wing Ignite forges partnerships with government, academia,
    corporate partners and individuals to grow our innovative ecosystem to
    advance entrepreneurs, businesses and students.
        I'd like to highlight partners that believe in this work: U.S.
    Ignite, Blandin Foundation, City of Red Wing, Goodhue County, MN DEED,
    MN State College SE, Xcel Energy, Red Wing Shoes, Jones Family
    Foundation, and Southern MN Initiative Foundation.
        As a result of our work, we were recently one of nine communities
    nationwide selected by the Center on Rural Innovation to participate in
    the Rural Innovation Initiative, an effort funded by the U.S. Economic
    Development Administration to provide technical assistance and support
    to rural communities working to create digital economy jobs and
    businesses.
        Our strength as an organization is the ability to connect our
    students, entrepreneurs and/or businesses with the needed resources in
    Red Wing, Minnesota or national opportunities. We are continuously
    learning and bringing best practices back to the region, for a lasting
    and sustainable impact.
    Looking Forward
        We believe our model will catalyze a regional innovation cluster
    that will strengthen and elevate our region and Minnesota's global
    competitiveness by focusing on three key areas:

      1.  Advance Innovators and Entrepreneurs by creating a hybrid
                incubator using virtual and in-person education, mentoring
                with top talent, technical assistance funds, access to
                investors and individual coaching.

      2.  Enhance Regional Connectivity by convening ecosystem builders and
                stakeholders in southern MN to implement the Entrepreneur
                First (E1) Collaborative. Creating a concentration of
                talent, people and resources to directly benefit
                entrepreneurs and the organizations serving them by
                simplifying the way individuals navigate the
                entrepreneurial ecosystem.

      3.  Cultivate the Workforce of the Future by convening industry,
                education and workforce development to attract, retain, and
                develop the talent needed to meet employer demand. RWI will
                advance students through worksite learning and hybrid
                courses in high demand, high growth fields.

        Broadband establishes a platform for success that communities must
    have to be able to provide opportunities, access and exposure of
    virtual and physical networks to advance future innovators,
    entrepreneurs and their business.
        Through perseverance we have learned these lessons:

      1.  Communities without broadband are in jeopardy.

      2.  Broadband access alone is not enough for economic vitality. It is
                critical to grow a knowledgeable workforce, increase
                digital literacy, foster innovation and market the efforts.

      3.  Measurement of economic success should evaluate talent
                attraction, retention and development not number of new
                jobs.

      4.  Trusted partnerships with government, corporate, academic and
                community partners are critical for success and
                sustainability.

      5.  Cities and organizations need to look beyond their geopolitical
                boundaries and proprietary tendencies in support of
                collaborative, regional economies.

      6.  Perseverance by local champions because it doesn't happen
                quickly.

        In closing, the African Proverbs say it best, ``If you want to go
    fast, go alone, if you want to go far go together.'' This work can't
    happen in isolation, we thank our local, state and national partners.
        Thank you for the opportunity to testify. I look forward to your
    questions.

        The Chairman. Thank you very much.
        Now, Dr. Hess, please begin your testimony.

        STATEMENT OF DAVID C. HESS, M.D., DEAN, EXECUTIVE VICE
             PRESIDENT OF MEDICAL AFFAIRS AND INTEGRATION,
     PRESIDENTIAL DISTINGUISHED CHAIR, AND PROFESSOR OF NEUROLOGY,
      MEDICAL COLLEGE OF GEORGIA, AUGUSTA UNIVERSITY, AUGUSTA, GA

        Dr. Hess. Thank you. Good morning. First, I would like to
    thank the Chairman, the Ranking Member, Congressman Rick Allen,
    and the Members of this Subcommittee for the opportunity to
    testify today. I am David C. Hess, Dean of the Medical College
    at Georgia. I am here to recount my experiences as a physician
    providing telestroke services in rural Georgia.
        Back in 2004, the early days of telestroke, I was coaching
    a Little League baseball team and I was called about a 45 year
    old man with a stroke at Emmanuel County Hospital in
    Swainsboro, Georgia, a 25 bed hospital in Congressman Rick
    Allen's district. There were only two of us covering our
    telestroke network in those days. The baseball field was 25
    minutes to my home, but only 5 minutes to Taco Bell. I handed
    the scorebook to another dad, jumped in my car, and sped to
    Taco Bell and used their hotspot. I logged in with my password,
    but the camera repeatedly froze when I zoomed in to watch the
    patient move their eyes. The consult was dropped twice, and I
    was starting to sweat, as every second counts in stroke. I was
    finally able to make the decision to administer the drug TPA,
    and fortunately, the patient did well. But it was stressful for
    me, even more stressful than coaching my last place Little
    League team.
        Now, fast forward to April of 2019, where I delivered 12
    telestroke consults in 24 hours to a number of rural hospitals
    in both Congressman Allen's and Congressman Austin Scott's
    district. The cameras never froze and there were no major
    technical issues.
        Three things have changed in the last 15 years. First, the
    bandwidth and technology have vastly improved, and I no longer
    have to drive to Taco Bell, except to eat their tacos. Second,
    demand for telestroke services has increased. Third, I don't
    take calls often, as there are nine others who share the call
    burden.
        Georgia is situated in the Stroke Belt, and there is a
    slide in your handout, a region of high stroke incidents in the
    Southeast United States. In 1996, a drug called tissue
    plasminogen activator, or TPA, was approved for the treatment
    of ischemic stroke by the FDA. The drug works by breaking up
    blood clots that could cause stroke.
        There are two types of stroke. The most common one is
    ischemic, caused by a blockage of blood flow to the brain. The
    other type, hemorrhagic, is caused by bleeding into the brain.
    TPA is effective for ischemic strokes, but can be harmful or
    fatal if given for hemorrhagic strokes. This caused many
    emergency medicine physicians to be very reluctant to use TPA,
    and they require neurologists like myself to assist them in the
    treatment decisions.
        One of the problems is a lack of neurologists in smaller
    hospitals. During a stroke, 32,000 brain cells die every
    second, so every moment matters when administering TPA. To
    address this problem, back in 2002, we in the Department of
    Neurology at the Medical College of Georgia began to developed
    a web-based telestroke system to help treat stroke patients in
    rural hospitals. There was no system available, so we built our
    own. This involved three components: two-way audio video so we
    could see the patient. We could communicate with the family. We
    could read the CT scan, and we had decision support software
    that helped us make the correct treatment decision. It was a
    web-based system, so we didn't have to sit and wait for calls
    in a specific wired room in the hospital. We could be at home
    or anywhere that we could have access to the Internet. We
    called this program REACH. We have now performed over 13,000
    acute stroke consultations in Georgia, and have treated more
    than 1,800 with TPA, many of whom have never been treated with
    TPA. Telestroke has now become the standard of care with the
    American Stroke Association endorsing its use. Studies show
    that telestroke has expanded and improved stroke care in rural
    and super rural areas.
        When we first started REACH back in 2003, we had a lot of
    problems with Internet connections to our rural hospitals. The
    video would often freeze and the consults would be delayed, and
    occasionally dropped. Bandwidth in rural Georgia is certainly
    much better today than it was 10 to 15 years ago, but
    requirements of at least 1.2 megabits will usually be needed
    for seamless operation. We also have improved technologies that
    allow us to operate in low bandwidth environments. We still
    experience problems with the video freezing and downloading
    imaging files. This problem is related to the people and
    resources necessary to adequately manage the bandwidth within
    the hospital.
        Even if rural hospitals have access to broadband, they do
    not have the technology or IT budget. Congressman Scott
    recounted all the rural hospitals closing in Georgia--to
    support the infrastructure inside a facility, much less support
    a full-time IT person. The common example is the hospital guest
    network being allowed to use the same Internet connection as
    the clinical applications. A better-informed professional IT
    manager can set up restrictions on network use to prioritize
    clinical applications.
        Now, current connectivity in rural America is not adequate
    to provide telehealth consults to patients in homes and small
    clinics. Lack of access to physicians is a problem. There are
    eight Georgia counties without any physicians, 11 without
    family physicians, 75 without an OB/GYN, and 78 without a
    general surgeon. This is only likely to worsen as the shortage
    of physicians is getting worse in rural Georgia. Much of this
    monitoring will be done by nurses and advanced practice
    providers, such as nurse practitioners, using tablets, but
    bandwidth is still a limiting factor.
        We have proved this model works with stroke, but
    telemedicine could be used to address many other health needs
    in rural Georgia.
        Thank you very much.
        [The prepared statement of Dr. Hess follows:]

        Prepared Statement of David C. Hess, M.D., Dean, Executive Vice
          President of Medical Affairs and Integration, Presidential
      Distinguished Chair, and Professor of Neurology, Medical College of
                    Georgia, Augusta University, Augusta, GA
        Good morning. First, I would like to thank the Chairman, the
    Ranking Member, and all the Members of the Subcommittee for the
    opportunity to testify today. I am Dr. David C. Hess, Dean of the
    Medical College of Georgia and Presidential Distinguished Chair of
    Neurology at the Medical College of Georgia at Augusta University. I am
    here to recount my experiences as a physician providing telestroke
    services, a form of telemedicine, to stroke patients presenting at
    hospitals in the rural Southeastern United States.
        Georgia is situated in the ``Stroke Belt'', a region of high stroke
    incidence in the southeastern U.S. I work at the Medical College of
    Georgia, the only public medical school in the state of Georgia. We are
    the Joint Commission certified Advanced Comprehensive Stroke Center
    that serves patients in rural southeastern Georgia and South Carolina,
    areas that are in the ``buckle of the Stroke Belt''. In 1996, a drug
    called tissue plasminogen activator (TPA) was approved for the
    treatment of ischemic stroke by the Federal Drug Administration (FDA).
        For background, there are two types of stroke--ischemic stroke is
    caused by a blockage of blood flow to the brain and hemorrhagic stroke
    caused by bleeding into the brain. TPA is effective for ischemic
    strokes but can be harmful if given for hemorrhagic strokes. The only
    way for a physician to tell the difference is to perform and review a
    CT scan of the brain. While TPA is very effective for ischemic stroke,
    in about 3% of patients it can cause bleeding into the brain which can
    be fatal. This complication caused many Emergency Medicine physicians
    to be reluctant to use TPA and they required stroke specialists
    (Neurologists) to assist them in making the decision.
        After TPA was approved by the FDA, only about 2% of stroke patients
    were receiving TPA. Nationwide, 64% of U.S. hospitals were not using
    TPA and most of them were small hospitals in the rural South.\1\ There
    was a geographic penalty for stroke care--rural patients in small
    hospitals in the South that were not receiving TPA, the only drug that
    could reduce their chance of being disabled from a stroke.
        One of the problems that led to low usage of TPA was the lack of
    neurologists and stroke specialists in the smaller hospitals to consult
    and help with the treatment decisions. Neurologists and stroke
    specialists tend to work in larger cities like Augusta and Atlanta and
    there were none in rural Georgia. Moreover, the time to treatment with
    TPA is a major determinant of how well the patient does; shorter time
    to treatment equates to better outcomes. Stroke is a ``time sensitive
    disease'' and it is estimated that during a stroke, 32,000 brain cells
    die per second so every second and minute delay matters when
    administering TPA. There is no time for the physician to get in their
    car and drive to a rural hospital. To make a decision to use TPA, the
    stroke specialist needs to see the patient and examine them and also
    review the CT scan of the brain. We would often get phone calls from
    our rural hospitals with questions about treating stroke patients with
    TPA. However, we could not see the patient or review their CT scan of
    the head, thus could not make safe decisions. The problem is that we
    had a very effective drug for stroke, but we did not have a healthcare
    system with the organization and tools to administer it.
        To address this problem, back in 2002, we in the Department of
    Neurology at the Medical College of Georgia began to develop a web-
    based telestroke system to help treat stroke patients at rural
    hospitals in Georgia. There was no system available, so we developed
    our own. This involved three components--two-way video (we can see the
    patient and the patient can see us), ability to read the CT scan of the
    brain, and decision-support software that helped us make the correct
    treatment decision and allowed us to complete a note to provide a
    consultation to the physicians at the site.2-4 (Fig. 1) The
    other important feature was that the system was ``site independent.''
    We did not have to sit and wait for calls in a specific ``wired'' room
    in the hospital. We could be at home or anywhere that we had access to
    the Internet. We called this program REACH (Remote Evaluation of Acute
    isCHemic stroke). After building a prototype and testing it within our
    own hospital, we began a pilot program in 2003 with McDuffie Regional
    Hospital in Thomson, Georgia and Emanuel County Hospital in Swainsboro,
    Georgia. Both these hospitals had administrators, nurses, and
    physicians supportive of the telestroke program. Internet connectivity
    was poor on both ends--the hospital and on our end. For example, if I
    was coaching a Little League game, I would have to drive to the Taco
    Bell and ``use'' their hotspot as that was closer than my home.
    Fig 1. REACH Telestroke System
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Patient presents in rural hospital (lower left) Consultation
            done at home by Stroke specialist (lower right) and patient
            transferred to Comprehensive Stroke Center (top) after TPA
            given or if complex care needed.

        We demonstrated that that we could accurately examine the patient
    and measure the severity of the stroke and that we could safely and
    effectively guide treatment with TPA. Once we demonstrated (in the
    medical literature and to our peers) that we could do this, we expanded
    our network to nine rural hospitals over the next few years and now
    serve over 30 hospitals today throughout Georgia and one in South
    Carolina.3-4 (Fig. 2) We have performed over 13,000 acute
    stroke consultations and have treated more than 1800 stroke patients
    with TPA. Most of these patients would have never been treated with TPA
    without a telestroke system.
    Fig 2. MCG-AU Health REACH Network
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Red dot is AU Health, Comprehensive Stroke Center. Small
            yellow dots are small rural hospitals (<50 beds); purple dots
            are hospitals >100 beds. Large yellow dots are larger hospitals
            >200 [] beds.

        Telestroke is now used almost everywhere in the nation and almost
    every large health system has a telestroke program. Telestroke has
    become the ``standard of care'' with position statements written by
    expert panels from the American Stroke Association endorsing its
    use.5-8 Telestroke became a disruptive technology that
    changed how we manage stroke patients. Studies show that telestroke has
    expanded and improved stroke care in rural and ``super-rural''
    areas.\9\
        We have expanded the use of telestroke to include acute
    teleneurology (other neurological conditions beyond stroke) and to
    triage and select stroke patients for mechanical thrombectomy (MT). MT
    uses catheters and clot retrieval devices to mechanically remove blood
    clots from vessels in the brain and this is a life-saving treatment for
    patients with large strokes (blockage of large arteries such as the
    middle cerebral artery.) We currently use telestroke to triage patients
    from all over Georgia and fly them by helicopter to the few
    Comprehensive Stroke Centers (there are four in Georgia) where this
    procedure can be performed.
        In 2006, a group of us licensed the REACH technology through our
    University and in 2006 we founded a company called REACH Health in
    Augusta Georgia. The company later moved to Alpharetta, Georgia, and it
    provided telestroke services to over 150 hospitals in the United
    States, including hospitals in South Carolina, New York, Pennsylvania,
    Louisiana, Massachusetts and Alaska. I was Chairman of the Board from
    2006 to 2018 when the company was sold to InTouch. REACH health is now
    a division of InTouch Health, the leading developer of telestroke
    systems in the U.S. and around the world.
        When we first started REACH back in 2003 to 2004, we had a lot of
    problems with Internet connections to our rural hospitals. The video
    would often ``freeze'' and the consults would be delayed and
    occasionally dropped, and we would have to resort to using the
    telephone. Fortunately, this improved over the years. Access to
    bandwidth in rural Georgia is certainly much better than it was 10-15
    years ago. There are also improved technologies that allow us to
    operate in a low bandwidth environment. This is stated in our
    Scientific Statement on ``Telemedicine Quality and Outcomes in Stroke''
    from the American Stroke Association and endorsed by the American
    Telemedicine Association \7\ ``The Scalable Video Coding extension of
    the H.264/MPEG-4 Advanced Video Coding standard (H.264/AVC) is the
    latest development for this successful specification, enabling high-
    resolution performance at the relatively low-bandwidth environments
    often available at more rural hospital sites. New communication (Web
    Real-Time Communication) and compression and decompression standards
    (VP8) are also emerging that promote the use of a Web browser as the
    primary audio/video platform while maintaining equal or better quality
    at half the bandwidth cost. Accordingly, technological advances on the
    horizon coupled with increasing access to high-speed bandwidth continue
    to accelerate the implementation of telemedicine services. Depending on
    the technology used, bandwidth requirements can range from as little as
    64103 bits per second to in excess of 1.2106 bits per second.
    However, bandwidth >512103 bits per second or closer to 1.2106 bits
    per second will usually be needed for seamless operation. The quality
    of the connection is affected by many factors, including bandwidth
    (connection capacity and speed), distance (which introduces latency),
    network throttling (introduced by network configuration), and
    congestion (hospital systems will be `saturated' at peak times,
    limiting the available bandwidth). The cell structure of mobile
    telecommunications may lead to low bandwidths during peak times of
    mobile Internet use. This becomes an issue in hospitals and busy
    emergency departments where competing for limited bandwidth leads to
    degradation of quality. Other variables affecting the conferencing
    experience include the number of participants in a videoconference,
    video resolution, and video size. Recently developed technologies, such
    as Scalable Video Coding1, provide better performance in low-bandwidth
    environments by making adjustments to frame rate, the area of the image
    to be refreshed, and video quality based on network environment.'' \7\
        However, we do still experience problems with the video freezing
    and downloading imaging files. The problem is related to the people and
    resources necessary to adequately manage that bandwidth within the
    hospital. While most of these hospitals have access to broadband, they
    do not have the technology/IT budget to support much infrastructure
    inside the facility, much less support a full time IT person. The
    common example is the hospital guest network being allowed to use the
    same Internet connection (un-throttled) as the clinical applications. A
    better informed, professional IT manager can set-up restrictions on
    network use to prioritize clinical applications.
        While Internet connectivity is adequate for most of the rural
    hospitals, it is not adequate to provide telehealth consults to
    patients in homes and at small clinic sites in rural areas. Telehealth
    is able to reinvent ``doctor house calls'' and is moving to monitoring
    and consulting with the patient in their home. In addition to
    physicians, much of this monitoring will be done by nurses and advanced
    practice providers. Lack of access to physicians is a problem in many
    parts of rural Georgia. According to the Georgia Board for Physician
    Workforce (https://gbpw.georgia.gov/), there are eight Georgia counties
    without any physicians, 11 counties without a Family Medicine
    Physician, 63 counties without a Pediatrician, 75 counties without an
    Obstetrician-Gynecologist and 78 counties without a general surgeon.
    Just as there are few stroke specialists in rural areas, there is a
    dearth of all types of medical specialists such as cardiologists,
    nephrologists, etc. This is likely to worsen as there is a looming
    shortage of physicians in the U.S. and major shortages in rural areas.
    One of the best ways to address these geographic disparities is through
    the use of telemedicine--to the patient's home and to health clinics.
        There is also another need for stroke care where there is
    insufficient broadband--that is the poor connectivity to ambulances in
    rural areas. There is increasing interest in providing telestroke
    services in the ambulances transporting patients to the hospitals. This
    is presently not feasible in many rural areas.
        Thank you again for the opportunity to testify before the
    Committee. I am available to answer any questions you may have.
    [Endnotes]
        1. Kleindorfer D., Xu Y., Moomaw C.J., Khatri P., Adeoye O.,
    Hornung R. US geographic distribution of rt-PA utilization by hospital
    for acute ischemic stroke. Stroke 2009; 40: 3580-4.
        2. Hess D.C., Wang S., Gross H., Nichols F.T., Hall C.E., Adams
    R.J. Telestroke: extending stroke expertise into underserved areas.
    Lancet Neurol. 2006; 5: 275-8.
        3. Wang S., Gross H., Lee S.B., et al. Remote evaluation of acute
    ischemic stroke in rural community hospitals in Georgia. Stroke 2004;
    35: 1763-8.
        4. Wang S., Lee S.B., Pardue C., et al. Remote evaluation of acute
    ischemic stroke: reliability of National Institutes of Health Stroke
    Scale via telestroke. Stroke 2003; 34: e188-91.
        5. Schwamm L.H., Audebert H.J., Amarenco P., et al. Recommendations
    for the implementation of telemedicine within stroke systems of care: a
    policy statement from the American Heart Association. Stroke 2009; 40:
    2635-60.
        6. Schwamm L.H., Holloway R.G., Amarenco P., et al. A review of the
    evidence for the use of telemedicine within stroke systems of care: a
    scientific statement from the American Heart Association/American
    Stroke Association. Stroke 2009; 40: 2616-34.
        7. Wechsler L.R., Demaerschalk B.M., Schwamm L.H., et al.
    Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for
    Healthcare Professionals From the American Heart Association/American
    Stroke Association. Stroke 2017; 48: e3-e25.
        8. Wechsler L.R., Tsao J.W., Levine S.R., et al. Teleneurology
    applications: Report of the Telemedicine Work Group of the American
    Academy of Neurology. Neurology 2013; 80: 670-6.
        9. Zhang D., Wang G., Zhu W., et al. Expansion Of Telestroke
    Services Improves Quality Of Care Provided In Super Rural Areas. Health
    Aff. (Millwood) 2018; 37: 2005-13.
                                   Attachment
    REACH Network
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

    REACH Hub & Spoke Telestroke Model
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Hess D.C., et al. Lancet Neurol. 2006; 36: 5:275-8.
           [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

    The Two Georgias: Rural Health Care
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        The Chairman. Thank you, Dr. Hess.
        And now we will hear from Councilwoman Watahomigie-Corliss.
    Please proceed.

     STATEMENT OF HON. OPHELIA WATAHOMIGIE-CORLISS, COUNCILWOMAN,
                       HAVASUPAI TRIBE, SUPAI, AZ

        Ms. Watahomigie-Corliss. Good morning. Thank you, Chairman
    Scott and Ranking Member Scott, for the invitation to speak
    today. My name is Ophelia Watahomigie-Corliss. I am a member of
    the Havasupai Tribe. I am here in my official capacity as an
    elected leader. During my first term, I established a working
    relationship with MuralNet to help the community bridge the
    digital divide.
        The Havasupai Reservation is the most isolated American
    Indian Tribe in the lower 48 states. The Village of Supai is
    located on the floor of the Grand Canyon, where the only way in
    or out is an 8 mile hike by foot, horse, or helicopter.
    Currently, the village receives Internet access by microwave
    point-to-point radio link providing 10 megabits for Tribal
    administration. Using an email browser and submitting grant
    reports have been the most successful use of that SM system.
    The current health clinic, run by the Indian Health Services,
    has obtained 1.5 megabits for its electronic medical records.
    Doctors lose the connection and file, refusing to use the
    electronic system, choosing paper charts instead.
        In 2015, Coconino Community College partnered with the
    Tribe to establish the first GED program. The only available
    Internet was in the village center. Many of the students had
    jobs, and lacking home Internet access that year, the program
    had no graduates. To help bridge the homework gap the GED
    students experienced, the Council gave permission in 2017 to
    pursue high-speed Internet through private LTE network.
    MuralNet and the Tribe filed a request with the Federal
    Communications Commission for a special temporary authorization
    permit to use educational broadband service spectrum over the
    Village of Supai under its educational burden of proof
    guidelines. Within 5 days of the license approval, we received
    customer premises equipment for homes and established our first
    high-speed Internet connection. Things changed with the newly
    approved STA permit. CPEs could connect to Internet at home.
    Our Head Start teachers came into compliance with new OHS
    standards, and teachers at our local Bureau of Indian Education
    School could lesson plan, research, and do continuing education
    from their homes.
        In September 2018, our GED students signed onto their first
    live math class taught 168 miles away. This was a historical
    moment in 2018, because it marked the Tribe's first
    opportunities in online education.
        While we have had successes, we have more needs. The
    Tribe's BIE school only goes to 8th grade. To receive a high
    school diploma, students must leave their families at 14 years
    old to attend a boarding school out of state. A percentage of
    these children are unable to adjust to leaving their families
    and return to the village, never going back to their studies. A
    Credit Recovery Program and online education school are needed.
        Over the years, agencies have supplied us with failed
    telemedicine equipment. Telemedicine is important because of
    our isolation, and we are still living without this capability.
    Our community is suffering from a suicide cluster, and we are
    left with no in-person professional services for up to 3 weeks
    every month. The reservation sees 35,000 tourists a year. We
    need better emergency communications to the furthest gorge.
    Their safety is our responsibility. Navigating the canyon can
    sometimes be a life or death situation, and for these reasons,
    the Havasupai Tribe must move forward with upgrading this new
    pilot network. Seven homes in the village center with direct
    line of sight have broadband speeds. The planned network
    expansion will bring broadband coverage to the whole village.
    To make our network financially sustainable, Internet access
    can be sold to tourists in the campgrounds. The Tribe has
    decided its people deserve the opportunities afforded by
    broadband. The ruralness and population size of our community
    means there is no return-on-investment from outside Internet
    service providers or major telecoms to consider building the
    infrastructure. The benefits we have seen from this project are
    like none we have ever seen before. There is renewed hope in
    the community and among Tribal council that online education
    opportunities can become reality. Telemedicine can work to help
    improve the community's health.
        These services ordinary Americans have been using for the
    past 20 years are still not a reality for my community. These
    disparities may be among the most extreme, but the disparities
    of the digital divide are felt across Indian Country. I support
    monies specifically allocated to rural American Indian Nations
    within the funds being negotiated. I can only speak to what my
    expertise is, which is my community, the most isolated and
    rural Tribe in the lower 48 states, which is the story of
    American Indian Country. If my story and expertise can also
    expand into other parts of rural America to help your decision-
    making to support build-out for all rural America, then I am
    honored. Now you have the ability to help communities like us,
    and I know that you will.
        I will be honored to address any questions the Committee
    might have of me. Thank you for your time.
        [The prepared statement of Ms. Watahomigie-Corliss
    follows:]

     Prepared Statement of Hon. Ophelia Watahomigie-Corliss, Councilwoman,
                           Havasupai Tribe, Supai, AZ
        Chairman Scott and Ranking Member Scott:

        Good morning. It is very exciting to be asked to come speak about
    the topic of Broadband Opportunity in Rural America through Affordable,
    Reliable, and High-Speed Broadband. My name is Ophelia Watahomigie-
    Corliss, I am a member of the Havasupai Tribe, and I am currently
    serving my second term as a Tribal councilwoman. I am here in my
    official capacity as an elected leader of the sovereign Havasupai
    Nation. I also serve as the telecommunications lead among my Tribal
    Council colleagues. Within this testimony I will tell you about my
    Tribes' inability to participate in online education opportunities
    until 2018 and how our children must leave their families and canyon
    home in order to obtain a high school diploma at age fourteen. My
    community had been promised working telemedicine for the past fifteen
    years and yet agencies have failed every time to execute their
    promises. Finally, in partnership with MuralNet, we built our own
    Havasupai pilot network that was successful in bringing high-speed
    Internet to homes for students and teachers, which has pushed the Tribe
    to find ways to provide broadband to the rest of our community.
        The Havasupai Reservation is the most isolated American Indian
    Tribe in the lower 48 states. The village of Supai is located on the
    floor of the Grand Canyon where it supports a population of 398
    residents, and when the children return home from boarding school the
    number increases to 423. Our home is surrounded by mile high red rock
    cliffs and mesa tops that surround Supai Village. This scene is very
    similar to what you see at the Grand Canyon National Park, which was
    our ancestral home. Our village and canyon are important links to our
    traditional way of life. The only way in or out of our canyon home is
    an 8 mile hike by foot, by horse, or our public transportation via
    helicopter which runs two to four times a week, depending on what time
    of year it is. All packages sent through the United States Postal
    Service are still delivered by mule trail mail to area code 86435. Even
    after you make it up and out of the canyon, the nearest two towns are
    67 miles away by car. My home, I am sure, qualifies under the
    definition of rural.
        Within the first 100 days of my first elected term, I responded to
    a letter from Northern Arizona University, and soon established a
    working relationship with the nonprofit organization MuralNet. This was
    the first project I ever presented to Tribal Council and it was not
    easy. MuralNet had promised to help the community bridge the Digital
    Divide. My fellow colleagues were somewhat apprehensive and proceeded
    to inform me of the many agencies that had already promised to bring
    telemedicine into the community, and failed. I seemed enthusiastic
    enough that they were eventually willing to give the project a chance.
        Initially, around 2008/2009, the village received Internet access
    from Niles Radio Communications by microwave point-to-point radio links
    producing 3 Mbps connection speeds at our access point in the village.
    In 2010 the access point was upgraded to receive up to 5 Mbps, and
    lastly upgraded in 2013 to receive a total of twenty Mbps. Using a
    Subscriber Module (SM) system the twenty Mbps were available and were
    split down the middle to provide 10 Mbps for Tribal administration, and
    10 Mbps for a public network. The Tribe runs twenty-four departments
    year-round, which means at least thirty-two computers were signed onto
    a 10 Mbps system at all times, constantly competing for bandwidth. Our
    capabilities were far from high-speed usage. Using an email browser and
    submitting our grant reports online were the most successful use of our
    SM system but our Tribal departments were still unable to sign onto and
    interact with webinars, which were becoming the expected norm.
        The 10 Mbps that are allocated for public use was available for
    portable devices such as phones and tablets. It catered to the
    community and the 35,000 tourists that come down to visit our world-
    famous waterfalls annually. The public network was only available
    within a 30 yard radius from the computer room that housed our network
    equipment and access point.
        The current health clinic in Havasupai is run by the Indian Health
    Service, which is a Federal agency who tried to establish their own
    Internet connection, but has only been successful thus far in obtaining
    1.5 Mbps for the use of its electronic medical records system. I have
    reports from many contracted doctors who, after waiting forty-five
    minutes to get into a patient profile, will lose the connection and the
    file. They refuse to use the electronic system and many choose to stick
    with paper charts. There was not enough Internet speed to support an
    electronic medical records system, let alone have the ability to
    establish telemedicine in the canyon. Many organizations have donated
    telemedicine equipment, but the equipment is useless due to low
    Internet speeds.
        Fast forward to 2015 when a local community college tried to
    partner with the Tribe to establish its first GED classes so that
    students could complete their work online and earn their diploma. The
    Tribe did not have the ability to get Internet to the homes of the GED
    students, so they would have to use the Internet in the village center.
    It was a very ambitious project, and many of the students already had
    jobs and wanted to work on their schooling at home, before or after
    work. The program had no graduates that year because it was nearly
    impossible to get their school work done in the allotted time when they
    had no access to the Internet at home.
        MuralNet had promised to help the Tribe bridge the homework gap the
    GED students were experiencing. It was 2017 when the project was given
    permission with a Tribal resolution to move forward to bring in high-
    speed Internet via a private LTE network for the entire village.
    MuralNet and the Tribe filed a request with the Federal Communications
    Commission (FCC) for a special temporary authorization (STA) permit to
    use Educational Broadband Service (EBS) spectrum over the village of
    Supai under its educational burden of proof guidelines. We were ready
    to deploy the network by November of 2017, but it took the FCC until
    February 2018 to approve our request. Within 5 days of the license
    approval we received the plug-in customer premises equipment (CPEs) for
    homes and established our first end-to-end high-speed Internet
    connection in the village with thirty Mbps of backhaul. There was
    Internet signal throughout Supai and homes in the center of town with
    direct line-of-site to the antenna tower had broadband speeds.
        During this time, the Tribe was working with its Early Head Start
    and Head Start programs to begin implementing new regulations that had
    been set by the Office of Head Start (OHS) in 2016. OHS was requiring
    all employees to have early childhood learning certificates,
    associate's, or bachelor's degrees depending on their job position, and
    our program had to prove their employees were enrolled in classes and
    on their way to receiving these certificates. This was proving
    troublesome for the Tribe. Although the OHS grants we had funded the
    classes, we did not have enough to pay for the employee's living
    expenses. The closest college to take the required classes would mean a
    hike, saddle ride, or helicopter ride out of the canyon and a 168 mile
    drive on top of that. If we sent them out of the canyon to attend
    school, we would also lose the employee at the Head Start. There are
    online classes, but the old network didn't have the capability to
    stream the videos, and the OHS deadline was getting close.
        Within 10 days of receiving the STA from the FCC, I had developed a
    check out program for the MuralNet CPEs for online educational use.
    Anyone in the community could present to me a printed approval letter
    of any type of online educational classes they would be taking, and I
    would check them out a CPE to connect them to Internet at home.
    Immediately twelve CPEs were checkout out to Early Head Start and Head
    Start teachers who began enrolling in GED classes, and community
    college classes. By the summer semesters, students were able to enroll
    into classes towards their bachelor's degrees. This put both of our
    Head Start programs in compliance with new OHS standards! The teachers
    at our local Bureau of Indian Education (BIE) school were next on the
    list to be provided CPEs for use in their apartments. The teachers used
    the MuralNet CPEs for lesson planning, research for instructional
    activities, continuing education classes, news and email access. These
    first groups of students and teachers were able to confirm how our
    pilot LTE network enabled them to complete their tasks online. They no
    longer needed to stay at the office until 8 p.m. to use the Internet at
    the school to get their work done. They could now work from home.
        The initial 6 month STA license was so successful that the FCC
    granted us an extension in May 2018. The second group to receive the
    CPEs were a group of seven students who were trying to complete the
    second round of GED courses provided by Coconino Community College
    located in Flagstaff, Arizona. The College had developed an interactive
    online class that students had to sign into twice a week and complete
    forty hours of work through online courses in order to earn their
    diploma. Although the CPEs were distributed in the middle of their GED
    course year, we made every effort to accommodate these students so
    could take these classes at home. The first time a class of our
    students was able to sign into the live class was August/September
    2018. Julie Baumgartner from Coconino Community College was teaching a
    math class in Flagstaff Arizona, 168 miles from the GED students. Once
    we successfully signed on, we could see Julie on our computer screens,
    we could hear her asking questions, and she even introduced her
    students in Flagstaff to us. Our Supai students watched her working out
    the problems on the board, and they could interact with the teacher.
    Some of the students were giving her answers to the solved problem on
    the board in real time. This was a historical moment for Supai because
    it was the first online, live, interactive class that had happened in
    the village.
        While we have had successes, we also have more needs. The Tribe's
    current BIE school only goes to the 8th grade, and for our children to
    receive a high school diploma they are expected to up root from their
    families at fourteen years old and attend a boarding school out of
    state. A significant percentage of these children are unable to adjust
    to living life with a family of strangers or in a dorm, and return to
    the village, never going back to their studies. A credit recovery
    program needs to be initiated for these children and a type of online
    high school programming needs to be investigated and initiated to keep
    educational progress sustained.
        There are also health and emergency service needs. For over fifteen
    years, the Tribe has been promised telemedicine services. This means
    over those years many agencies had supplied us with telemedicine
    equipment, all of which has been collecting dust because we lacked the
    high-speed Internet capabilities to run fluid programming. Telemedicine
    is so important because our community members have to stay out of the
    canyon and pay for hotel costs that can sometimes be over $1,000 a week
    when the helicopter only flies on Sunday and Friday in the winter. Our
    community is also suffering from a suicide cluster and sometimes we are
    left with no in person professional services for up to 3 weeks a month.
        The Havasupai Reservation is also home to world famous waterfalls,
    and 35,000 tourists visit the Reservation each year. We do not have
    good emergency communication capabilities to the furthest gorge that
    tourists like to visit, and their safety is our responsibility.
    Navigating the canyon can sometimes be a life or death situation if
    someone gets lost. During July 2017 the Tribe had to evacuate around
    200 people because of flash flooding, which kept the campground closed
    for months. These are some of the reasons the Havasupai Tribe must move
    forward with upgrading the network.
        The Havasupai submitted an application for a permanent license of
    the EBS spectrum A channels in May 2018. However, the FCC had frozen
    all EBS spectrum permanent license applications since 1995. But now the
    FCC is rewriting the rules. After all our initial successes, Tribal
    Council fully supported the MuralNet pilot project and I was sent to
    Washington, D.C. to get the Havasupai Tribe the needed spectrum for our
    future network expansion. With Mariel Triggs, the CEO of MuralNet, I
    met with Members of Congress, their representatives and all of the FCC
    Commissioners' offices, advocating for the need of a permanent license
    for the Havasupai Tribe and for other Tribal nations to be able to
    claim unused and unlicensed EBS spectrum over their lands.
        The success of our pilot project with MuralNet has motivated the
    Tribe to devote a part of its energy to upgrading the LTE Internet
    network. Currently only seven homes in the center of the village with
    direct line of site to the tower have had broadband speeds and homes on
    the outskirts have some connection issues. More and faster Internet
    connections means our network needs more bandwidth, equipment and
    backhaul. The initial investment for MuralNet to complete the pilot
    program was $15,000 in equipment costs and over $20,000 in lawyer fees,
    which is a very low cost to start a network. The planned network
    expansion would bring broadband coverage to the whole village, increase
    backhaul from fifty Mbps to 1 Gbps, provide emergency communications
    throughout the Canyon, connect an online charter high school, and allow
    for telemedicine in the new clinic, which will be beginning
    construction next year. To make our community network financially
    sustainable, high-speed Internet access can be sold to tourists in the
    campgrounds. The capital and network operator training costs are around
    $250,000-$300,000. These actions are being initiated because the Tribe
    has decided its people deserve the opportunities that are afforded by
    broadband. And we will have to do it for ourselves. The ruralness and
    population size of our community means there is no return on investment
    for outside Internet service providers or major telecoms to consider
    building the infrastructure.
        The benefits we have seen from this project are benefits we have
    not been able to realize in the canyon before. There is renewed hope in
    the community and among Tribal Council that online educational
    opportunities can become a reality on the canyon floor. Community
    members can better their lives and their education through future
    broadband expansion in Supai Village. The telemedicine that has been
    promised to the community can finally work and begin to help the
    community's spiritual, mental, and physical health at the new clinic.
    These services that ordinary Americans have been using for the past 20
    years are still not a reality for my entire community, but this is the
    first glimmer of hope we have seen for decades.
        The disparities felt by my community may be of the most extreme
    examples felt by rural Tribal nations, but the disparities of the
    Digital Divide are being felt all across Indian country. It is
    extremely important to allocate funding to rural America, and Tribal
    rural America, to build reliable broadband. If my community has had its
    first opportunities to participate in online education in 2018, then
    there are other communities out there who don't have the capabilities.
    Extremely isolated areas are in desperate need of telemedicine services
    and we still don't have those capabilities. That is an opportunity with
    the monies you allocate to provide us that ability. The Havasupai would
    use the funds to establish the community's first charter school and
    credit recovery programs, which are desperately needed to increase the
    morale of families to earn a better living and give them the
    opportunity to live their best life.
        I support monies allocated specifically to rural American Indian
    Nations within the funds being negotiated to support Building
    opportunity in rural America through affordable, reliable and high-
    speed broadband. I can only speak to what is my expertise and that is
    my community, the most isolated and rural Tribe in the lower 48 states,
    which is the story of American Indian Country. If my story and
    expertise can also expand into other parts of rural America and help
    your decision making to support building opportunity for all rural
    America, well then, I am also honored. I ask you to never to forget
    about us again, living at the bottom of the canyon, having had no
    access to online education or telemedicine services. We have felt left
    out and forgotten for decades. Now you have the ability to help
    communities like us, and I know that you will.
        I will be honored to address any questions the Committee might have
    of me. Thank you for your time.
                                   Attachment
    June 25, 2018

        Hon. Ophelia Watahomigie-Corliss,
        Havasupai Tribal Council,
        Supai, AZ

        Dear Council Member Watahomigie-Corliss,

        This letter serves as an assurance for the use of WiFi routers
    provided by the Havasupai Tribe. First, Havasupai Elementary School
    administration and staff thank the Tribe for the use of the WiFi
    routers located in some of the staff apartments. Second, school staff
    members, including teachers, are able to connect to the WiFi Internet
    for professional and personal access. Staff members use the Internet
    connectivity for the following:

       Lesson planning (i.e., Persons, NWEA, NASIS, etc.)

       Research for instructional activities

       On-line classes for professional development

       Personal entertainment (i.e., Netflix, Hulu, news, email,
            etc.)

        We appreciate the Havasupai Tribe's support in helping make
    Internet access available to our staff. In addition, the access helps
    make living in teacher housing more enjoyable. If you have any
    questions or concerns, please do not hesitate to contact me.
                Regards,
                [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

    Dr. Maxine Roanhorse-Dineyazhe,
    Acting Principal,
    Havasupai Elementary School.

        The Chairman. Thank you very much.
        Mr. Hurst, welcome. Please begin.

     STATEMENT OF C. BLAKE HURST, PRESIDENT, MISSOURI FARM BUREAU
      FEDERATION; BOARD MEMBER, AMERICAN FARM BUREAU FEDERATION,
                               TARKIO, MO

        Mr. Hurst. Good morning, Chairman Scott, Ranking Member
    Scott, and Members of the House Agriculture Subcommittee on
    Commodity Exchanges, Energy, and Credit. My name is Blake Hurst
    and I am from Atchison County, Missouri. I serve as President
    of the Missouri Farm Bureau and sit on the Board of Directors
    of American Farm Bureau Federation, whom I am representing here
    today.
        Broadband is no longer a luxury; it is a necessity. Rural
    broadband is essential to modern agriculture, the farmers and
    ranchers who grow our food, and for the quality of life in
    rural America.
        I am driving my combine and the phone rings. It is my 84
    year old father who is driving another combine. The
    conversation goes like this. Dad says, ``I just got a call from
    John Deere.'' I said, ``Uh-huh.'' Dad says, ``They said I was
    running out of DEF!'', which is a fuel additive we use. I said,
    ``Uh-huh.'' Days says, ``They are watching us!''
        Farming has changed. We used to think that we just grew
    corn and soybeans. Now we generate data, trillions of bits, all
    containing information that can make us more efficient,
    economical, and can reduce our environmental impact. On our
    farm, that data allows us to supply more fertilizer on our most
    productive land, cut fertilizer rates where yield potential is
    less, vary seed populations in real-time across the field, and
    yes, Dad, allows our equipment supplier to monitor our
    machinery, alerting us to potential problems.
        After we collect this data, we must transfer it from our
    machines to the company who writes our prescriptions for
    fertilizer and seed, share it with our partners, who supply our
    seed, and eventually utilize it when making crop insurance and
    other business decisions. Transferring this data, which is
    essential to the future success of every farmer, requires
    access to fast and reliable and affordable broadband.
        My friends in the livestock industry use broadband-based
    programs to monitor the development of each animal, analyze
    markets, make data-driven management decisions, and from
    monitoring feed usage and rations to scheduling delivery of
    animals, livestock farmers use broadband daily to improve the
    efficiency of their operations, and ensure the health of their
    herds.
        While broadband connectivity is critical on croplands and
    ranchlands, rural communities also need broadband for
    healthcare, government services, and educational and business
    opportunities. We still have members who have to travel to the
    nearest fast food restaurant in order to use a hotspot so their
    children can finish their homework. That really is not
    acceptable.
        Broadband is important to rural Americans because we
    deserve the ability to be a part of the larger society as well.
    Current and future generations of rural Americans will be left
    behind without adequate broadband service.
        While most Americans take broadband for granted, 26 percent
    of rural Americans lack access to broadband, compared to only
    about two percent of urban Americans. And we have to use an
    asterisk with even these figures, because the current data and
    maps used to collect broadband coverage are inadequate.
        The ability of the FCC and all other relevant agencies to
    utilize accurate coverage is the highest priority. With limited
    funding and an overabundance of need, more granular and
    accurate maps are critical to successfully target and
    distribute Federal broadband programs. That is why Farm Bureau
    supports the, bipartisan, H.R. 3162, the Broadband Data
    Improvement Act, that would improve the accuracy of broadband
    coverage maps and better direct Federal funds for broadband
    built-out. We say a special thanks to Representatives
    O'Halleran, Kirkpatrick, and Marshall for their support and
    sponsorship of this fine legislation.
        Many of our state Farm Bureaus have engaged with their
    state legislators to improve rural broadband development. We
    helped organize the Missouri Broadband Initiative Working
    Group, which brought together providers, local, state, and
    Federal officials, and end-users of broadband. Many of the
    challenged we identified in Missouri are addressed by the
    changes made in the 2018 Farm Bill, including the high
    deployment costs, delivering technology that will be adequate
    for the future, accountability, mapping, and data collection,
    and meeting technology needs of agriculture.
        Thank you for your leadership in making the necessary
    strides and providing the technology of the future, while
    safeguarding taxpayer dollars. Farm Bureau appreciates the
    Subcommittee's interest in rural broadband, and I am grateful
    for the opportunity to share our perspective with your today.
    We look forward to continuing to work with the Subcommittee in
    advancing the shared goals which I have highlighted here today,
    and I look forward to answering any questions you might have.
        [The prepared statement of Mr. Hurst follows:]

     Prepared Statement of C. Blake Hurst, President, Missouri Farm Bureau
     Federation; Board Member, American Farm Bureau Federation, Tarkio, MO
        Good morning, Chairman Scott (D-Ga.), Ranking Member Scott (R-Ga.),
    and Members of the House Agriculture Subcommittee on Commodity
    Exchanges, Energy, and Credit. My name is Blake Hurst, and I am a corn,
    soybean, and greenhouse farmer from Atchison County, Missouri. I serve
    as President of Missouri Farm Bureau and sit on the Board of Directors
    for the American Farm Bureau Federation, whom I am representing here
    today. Farm Bureau appreciates the opportunity to provide input on the
    necessity of broadband technology on America's farms, ranches, and in
    our agribusinesses.
    A. Introduction
        The American Farm Bureau Federation (Farm Bureau) is the nation's
    largest general farm organization, with nearly six million-member
    families, representing agricultural producers of nearly every type of
    crop and livestock across all 50 states and Puerto Rico.
        Broadband is no longer a luxury, it's a necessity. Rural broadband
    (fixed and mobile) is essential to modern agriculture, the farmers and
    ranchers who grow our food and the quality of life for rural Americans.
        I'm driving my combine, and the phone rings. It's my 84 year old
    father, who is in our other combine. The conversation goes like this:

              Dad. ``I just got a call from John Deere.''
              Me. ``Uh huh.''
              Dad. ``They said I was running out of DEF!'' (A diesel fuel
            additive)
              Me. ``Uh huh.''
              Dad. ``They're watching us!''

        Farming has changed. We used to think that we just grew corn and
    soybeans. Now we also generate data. Trillions of bits, all containing
    information that can make us more efficient, economical and reduce our
    environmental impact. On our farm, that data allows us to apply more
    fertilizer on our most productive land, cut rates where yield potential
    is less, vary seed populations in real time as we travel across the
    field, and yes, allows our equipment supplier to monitor our machinery,
    alerting us to potential problems. After we collect this data, we must
    transfer it from our machines to the company who writes our
    ``prescriptions,'' share it with our partners who supply our seed, and
    eventually utilize it when making crop insurance and other business
    decisions. Transferring this data, which is essential to the future
    success of every farmer, requires access to fast reliable and
    affordable broadband.
        My friends in the livestock industry use broadband-based programs
    to monitor the development of each animal they raise, analyze markets,
    and make data-driven management decisions for their animals. From
    monitoring feed usage and rations to scheduling delivery of animals,
    livestock farmers use broadband daily to improve the efficiency of
    their operations and ensure the health of their herds. Many
    veterinarians communicate lab results through e-mail with livestock
    farmers to get them information on animal health as quickly as
    possible. All the data collected can be compiled into production
    reports which help farmers make more informed decisions about their
    farm and ranch.
        While most Americans take broadband for granted, 26.4 percent of
    rural Americans lack access to broadband.\1\ This is alarming,
    particularly when compared to the only 1.7 percent of urban Americans
    who lack such access.\2\ However, an asterisk must be used alongside
    these figures because the current data and maps used to collect
    broadband coverage is flawed and fails to accurately determine
    broadband access. Farmers and ranchers, who already have seen a drastic
    50 percent decline in net farm income in the last 4 years, must have
    access to fixed and mobile broadband to be more efficient, economical
    and responsive to environmental needs.
    ---------------------------------------------------------------------------
        \1\ FCC Broadband Progress Report, https://docs.fcc.gov/public/
    attachments/FCC-19-44A1.pdf, 2019.
        \2\ Ibid.
    ---------------------------------------------------------------------------
    B. Improvements to Rural Prosperity
    Precision Agriculture and Farming Business
        Farmers and ranchers depend on broadband (fixed and mobile) just as
    they rely on highways, railways and waterways to ship food, fuel and
    fiber across the country and around the world. Many of the latest yield
    maximizing farming techniques require broadband connections for data
    collection and analysis performed both on the farm and in remote data
    centers. However, 29 percent of U.S. farms have no access to the
    Internet according to the USDA report, ``Farm Computer Usage and
    Ownership, 2017.''
        America's farmers and ranchers embrace technology that allows their
    farming businesses to be more efficient, economical and environmentally
    sensitive. Today's farmers and ranchers are using precision
    agricultural techniques to make decisions that impact the amount of
    fertilizer a farmer needs to purchase and apply to the field, the
    amount of water needed to sustain the crop, and the amount and type of
    herbicides or pesticides the farmer may need to apply. These are only a
    few examples of the reasons farmers use broadband connectivity to
    achieve optimal yield, lower environmental impact and maximize profits.
        According to USDA's ``A Case for Rural Broadband,'' if access to
    broadband and adoption of digital agricultural technologies matched
    producer demand, U.S. agriculture would realize benefits amounting to
    nearly 18 percent of total U.S. market production, or $64.5 billion
    annually, based on 2017 levels. Farm Bureau's economic team analyzed
    the USDA report and wrote a Market Intel story, ``Unleashing Broadband
    on Rural America Leads to Nearly $65 Billion in Economic Benefits
    Annually.'' The entire Market Intel story is attached as Appendix A to
    this testimony. Some highlights from this analysis include:

       Row Crops--The highest rate of adoption for precision
            technology used to improve yields and reduce costs is in the
            already highly mechanized row crop sector. USDA estimates
            connected technologies in row crops could result in a $13.1
            billion gross benefit annually from next generation precision
            agriculture.

       Livestock and Dairy--According to the USDA's estimates, the
            livestock and dairy sectors are poised to benefit the most from
            next generation precision agriculture, with annual potential
            gross benefits totaling $20.6 billion. The majority of
            estimated benefits come from the production side and are
            focused on increased efficiency of animal care.

       Specialty Crops--Like row crop growers, specialty crop
            farmers could also see major gains with the adoption of new
            production and planning technology. Total annual benefits for
            next generation precision ag for specialty crops is estimated
            at $13.3 billion.

        Broadband is important to our businesses in more prosaic ways.
    Farmers and ranchers rely on broadband access to manage and operate
    successful businesses, the same as small businesses do in urban and
    suburban America. Access to broadband is essential for farmers and
    ranchers to follow commodity markets, communicate with their customers,
    gain access to new markets around the world and, increasingly, for
    regulatory compliance. Additionally, our accounting program requires us
    to download the latest tax data to do payroll and prepare our taxes. We
    use broadband to place orders for our greenhouse business and can check
    availability and pricing in real time. We would not be in business
    without access to broadband, and we cannot compete with businesses in
    more urban areas if we don't have connectivity.
    Quality of Life
        Rural communities need access to health care, government services,
    and educational and business opportunities. For many rural communities,
    access can only be gained by using broadband services and sophisticated
    technologies that require high-speed connections. There are Farm Bureau
    members who need to take their kids to the parking lot of the nearest
    fast food restaurant to do research papers and complete their homework
    because their house does not have access to broadband. This is
    unacceptable. As more and more primary care physicians and specialists
    leave rural communities, telemedicine has become a necessity to provide
    critical healthcare to our parents and kids. I'm concerned for the
    well-being of my 84 year old father, who still is a full-time farmer.
        I've listed business, health, and educational reasons for
    broadband's importance, but it's also important to rural Americans
    because we deserve the ability to be part of the larger society as
    well. Many families live across town, in another state or possibly
    another country and broadband allow families to connect, even when they
    are miles apart. Broadband allows grandparents to connect with their
    grandchildren through FaceTime and Skype. Streaming videos, using
    social media and participating in popular culture is important for
    social interactions. Rural Americans should have access to the same
    media as our urban neighbors.
        Current and future generations of rural Americans will be left
    behind their fellow citizens if they are without affordable high-speed
    broadband service that enables them to tap into health care and
    education services, government agencies, and create new business
    opportunities.
    C. 2018 Farm Bill Modifications
        In the last few years, Farm Bureau members have elevated the
    priority of broadband access and affordability because of its impact on
    their daily lives. Farm Bureau has included rural broadband deployment
    as one of its strategic action issues for 2019 because many of our farm
    families are frustrated with the lack of services available in rural
    America.
        Many of our state Farm Bureaus have engaged with their state
    legislatures to expand rural broadband deployment and have been
    conducting research on the impact of broadband deployment for rural
    communities. Let me walk you through some of the research that the
    Missouri Farm Bureau conducted concerning the deficits in current
    broadband programs provided at the state and Federal level. We helped
    organize the Missouri Broadband Initiative Working Group, which brought
    together broadband providers, local, state, and Federal officials, and
    end-users of broadband. Together, this group identified multiple
    opportunities and challenges to broadband deployment in our state and
    around the country. We now have a state broadband grant program and
    will soon roll out a comprehensive state broadband plan.
        The recent changes in the 2018 Farm Bill made necessary strides in
    providing the technology of the future while safeguarding taxpayer
    dollars. Many of the challenges that we identified in Missouri are
    addressed by these changes, including:

       High Deployment Costs: Time and time again we have heard
            about the high cost of deploying broadband to rural areas. The
            2018 Farm Bill increased the authorization for broadband
            deployment from $25 million to $350 million to help facilitate
            more broadband development nationwide. In addition, the farm
            bill established a grant program to help providers who are
            reaching the most rural citizens. It is crucial that these
            programs are fully funded at the authorized level to help
            ensure that rural communities can benefit from broadband
            services.

       Delivering Technology of the Future: Prior to the passage of
            the 2018 Farm Bill, some rural broadband programs did not
            deliver service that is adequate and scalable into the future.
            The 2018 Farm Bill focused on ``future-proof'' technology and
            established benchmarks for broadband services. By giving USDA
            the authority to set minimum acceptable standards based on the
            life of the loan or grant awarded, we are ensuring that our tax
            dollars are not being spent on technology that will be outdated
            by the time projects are complete.

       Accountability: Ensuring judicious use of taxpayer dollars
            was a priority in the 2018 Farm Bill. Thanks to the work of the
            House and Senate Agriculture Committees, more safeguards are in
            place to make sure that the services promised are the services
            delivered by loan and grant recipients. Prior to this
            legislation, very few safeguards existed in this regard. It is
            vital that when Federal programs come into an area to address
            the lack of access that they do it right the first time.

       Mapping and Data Collection: Knowing where adequate
            broadband services do and do not exist is crucial to crafting
            sound public policies related to broadband deployment. The 2018
            Farm Bill made significant progress in streamlining applicant
            processes and took steps to drill down to more granular data
            sets in determining where services are being provided. Missouri
            is fortunate to have been selected for a mapping pilot program,
            but more work remains on ensuring that the data collected
            nationwide is accurate and adequately reflects the current
            needs of our rural communities.

       Meeting the Technology Needs of Agriculture: In response to
            the growing needs of agriculture, the 2018 Farm Bill
            established the Precision Agriculture Connectivity Task Force.
            This legislation directs the FCC and U.S. Department of
            Agriculture to work together to identify gaps in mobile
            broadband coverage to farmland and ranchland. Then, policies
            will be recommended to fill 90 percent of those identified gaps
            by 2025. The legislation is an important step in changing the
            way the FCC and other agencies think about rural broadband as
            we strive to build the information infrastructure that modern
            production agriculture increasingly needs to be successful.
            Farm Bureau looks forward to participating in the nomination
            process.
    D. Importance of Broadband Mapping to Agriculture
        As efforts to improve access to broadband in rural areas continue,
    the ability of the FCC and all other relevant agencies to utilize
    accurate coverage maps is the highest priority. With limited funding to
    address an estimated $45-$65 billion issue and an overabundance of
    need, more granular and accurate maps are critical to successfully
    target and distribute Federal broadband programs. Currently, the FCC's
    National Broadband Map relies on Census block data to determine which
    areas are served, underserved, and unserved across the country. Census
    blocks are too large in rural and remote areas to accurately target
    broadband investments. If even one household in a given Census block is
    reported by a provider as being served, then the entire block is
    considered served and is therefore likely excluded from eligibility to
    receive Federal funds for rural broadband buildout. There are more than
    3,200 Census blocks across the country that are larger than the
    District of Columbia, and five that are larger than the state of
    Connecticut. In fact, Census blocks larger than 2\2\ miles comprise
    more than 64 percent of the U.S. land area, which means that every
    rural area is impacted by this problem in some way.
        Farm Bureau recommends that more granular data be used to determine
    areas of coverage. Gathering and, equally as important, verifying the
    data to accurately target and distribute the funding is critical to the
    success of broadband deployment for rural America. Adjustments in the
    data collection matrix to develop the mapping will assist in
    identifying areas in rural America where the digital divide is the
    greatest.
        Farm Bureau supports H.R. 3162, the Broadband Data Improvement Act,
    that would improve the accuracy of broadband coverage maps and better
    direct Federal funds for broadband buildout. This bipartisan bill would
    require broadband providers to report data to create an improved
    National Broadband Map that is significantly more accurate and
    granular, an outcome that Farm Bureau policy supports. To improve
    accuracy and granularity, H.R. 3162 includes a three-pronged data
    validation process that focuses on: public feedback, third-party
    commercial datasets and on-the-ground field validation.
    E. Broadband Coverage for Croplands and Ranchlands
        We strongly advocate for the inclusion of cropland and ranchland as
    a metric of broadband access. Precision agricultural equipment requires
    reliable, high capacity fixed and mobile broadband connections for data
    collection and analysis performed both on the farm and in remote data
    centers. As more precision equipment becomes available, farmers cannot
    take full advantage of that equipment if they do not have access to
    reliable, high capacity broadband in the field or on the farm.
    F. Conclusion
        Farm Bureau appreciates the Subcommittee's interest in rural
    broadband and I am grateful for the opportunity to share our
    perspective with you today. Rural broadband (fixed and mobile) is
    essential to modern agriculture, the farmers and ranchers who grow our
    food and the quality of life for rural Americans. Broadband is no
    longer a luxury, it's a necessity.
        We look forward to continuing to work with the Subcommittee in
    advancing the shared goals, which I have highlighted here today.
                                   Appendix A
    Unleashing Broadband on Rural American Leads to Nearly $65 Billion in
            Economic Benefits Annually
    https://www.fb.org/market-intel/unleashing-broadband-on-rural-america-
    leads-to-nearly-65-billion-in-econom
    Market Intel
    June 17, 2019
    By: Megan Nelson, Economic Analyst
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Credit: Mauricio Lima/CC BY 2.0.
            [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Editor's note: the video is retained in Committee file; it
            can be accessed at: https://youtu.be/6FDl-XjuDro.

        According to USDA's ``A Case for Rural Broadband, (https://
    www.usda.gov/sites/default/files/documents/case-for-rural-
    broadband.pdf)'' if access to broadband and adoption of digital
    agricultural technologies matched producer demand, U.S. agriculture
    would realize benefits amounting to nearly 18% of total U.S. market
    production, or $64.5 billion annually, based on 2017 levels. The
    report, published by the American Broadband Initiative, analyzes the
    possible economic benefits of bringing e-connectivity to the heartland
    and, more importantly, what needs to be done to make it happen.
        From the way producers store and ship commodities to the way
    consumers purchase their food, the introduction and widespread usage of
    the household refrigerator has irrevocably changed the food supply
    chain system. A similar shift is upon us with the advent of digital
    technology and next generation precision agriculture, resulting in
    ever-increasing productivity with fewer inputs, better market access
    and healthier rural communities. Just as electricity allowed for
    refrigeration, to realize the benefits of this new digital technology,
    high-speed broadband service must be available everywhere.
    Figure 1. Annual Potential Gross Economic Benefit of Precision
            Agriculture Technologies Derived from Broadband
           [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Source: USDA.
    Benefits
    Row Crops
        The highest rate of adoption for precision technology used to
    improve yields and reduce costs is in the already highly mechanized row
    crop sector. USDA estimates connected technologies in row crops could
    result in a $13.1 billion gross benefit annually from next generation
    precision ag. Technology for improved planning, such as microclimate
    modeling, yield monitoring and precision seeding, is estimated to have
    a combined potential annual gross benefit of $4.2 billion, with $1.1
    billion attributable to access to broadband services. On the production
    side of new technologies, the potential is even greater at $6.7 billion
    in possible benefits derived from precision agriculture, with $2.5
    billion attributable to broadband. With an average dependence of 34% on
    broadband services to utilize these new technologies, the key to
    unlocking these significant gains is full deployment and adoption of
    broadband infrastructure. Figure 1 outlines the potential benefits for
    row crop production and planning technology compared to the potential
    attributable to broadband with the percent of technology dependent on
    broadband.
    Figure 2. Potential Benefits for Row Crops By Digital Technology Type
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Source: USDA, Farm Bureau calculations.
    Specialty Crops
        Like row crop growers, specialty crop farmers could also see major
    gains with the adoption of new production and planning technology.
    Total annual benefits for next generation precision ag for specialty
    crops is estimated at $13.3 billion. With a possible increase of $8.5
    billion, market coordination efforts will likely get the biggest boost
    from the adoption of digital technologies. Of the new opportunities in
    market coordination, direct-to-consumer sales are estimated to post a
    potential annual gross benefit of $6.4 billion, with $3.2 billion in
    potential attributable to broadband. Specialty crop producers can
    shorten the supply chain by utilizing digital platforms. USDA estimates
    a revenue increase of 50% per unit of apples, 649% per unit of salad
    mix and 183% per unit of blueberries. Figure 2 illustrates the
    breakdown of potential financial benefits from next generation
    precision ag and the amount attributable to access to broadband
    services.
    Figure 3. Potential Benefits in Specialty Crops from Digital Technology
            By Business Function
            [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Source: USDA, Farm Bureau calculations.
    Livestock and Dairy
        According to the USDA's estimates, the livestock and dairy sectors
    are poised to benefit the most from next generation precision ag, with
    annual potential gross benefits totaling $20.6 billion. The majority of
    estimated benefits come from the production side and are focused on
    increased efficiency of animal care. Utilizing Bluetooth technology,
    animal wearables transmit general health data directly to the producer,
    resulting in a 15% reduction in medication per animal, as well as a
    shortening of the cattle finishing process by 4 to 6 weeks.
    Technological advances in general health monitoring alone are estimated
    to generate $8.8 billion in annual gross benefits. Unsurprisingly, as
    poised as producers in the livestock and dairy sectors are to reap
    enormous benefits from next generation precision ag, they are also the
    most dependent on reliable high-speed broadband to enable new
    technological advancements. Figure 3 outlines the potential benefits
    for livestock and dairy compared to the potential attributable to
    broadband along with the percent of technology dependent on broadband.
    Figure 4. Potential Benefits for Livestock and Dairy By Digital
            Technology Type
            [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

              Source: USDA, Farm Bureau calculations.
    Strategies for Action
        As with electricity, the dawn of digital technology has brought an
    unimaginable amount of change to every aspect of our lives. Precision
    agriculture has led to 7.5% fewer people at risk of going hungry in
    developing countries and an up to 80% reduction in the application of
    crop protection tools. However, while new technology is able to inform
    and improve business decision making, without widespread adoption of
    next generation precision agriculture tools and access to broadband
    infrastructure, these benefits cannot be realized.
        USDA has outlined key priorities for strategic action planning
    involving improved broadband deployment, incentivizing innovative
    technologies and creating environments for innovation, strategic
    funding and communication. To bring broadband services to even the most
    remote areas, public and private entities must work closely with
    communities to determine specific needs and challenges. Reducing
    barriers in Federal processes to access government assets is one of the
    cornerstones of the American Broadband Initiative and continues to be a
    focus at the Federal level. The task of actualizing broadband
    infrastructure relies on funding for deployment as well as for new
    innovations that can lead to long-term successes for the entire sector.
    Summary
        USDA's report puts the hypothesized potential benefits that
    broadband technology and infrastructure could bring to rural areas at
    $64.5 billion annually. Increasing the availability of broadband to all
    of rural America, coupled with increased precision agriculture adoption
    are estimated to increase the gross economic benefits to row crop
    agriculture by 4%, adding up to $5.9 billion, increasing 19% for
    specialty crops, or up to $8.6 billion, and 7%, or up to $23 billion,
    for livestock.
        One limitation of the report is it does not incorporate the
    implementation costs, which will inevitably be incurred by rural
    residents, service providers and/or state and Federal Governments. As
    such, this report should be seen as a tool to illustrate the potential
    of broadband technology, rather than the only source for future
    investment-related decision-making.
        USDA leaves us with this call to action--spread the word. For the
    full economic benefits of high-speed broadband to be realized
    throughout rural areas, adoption rates of precision agriculture tools
    and next generation technology must be much higher. All potential
    benefits are estimations based on rigorous research; however, producers
    must perform their own cost-benefit analysis to see where these
    emerging technologies fit in their operations.

              Contact: Megan Nelson, Economic Analyst, (202) 406-3629,
            megann@fb.org, twitter.com/@MeganRNelson1

        The Chairman. Thank you very much, and thank each of you
    for your testimonies. They were very informative and it gave us
    much, much information that some of us were not really aware
    of. And so, we thank you for that.
        Now we go to questions for the Members. Members will be
    recognized for questioning in order of seniority for Members
    who were here at the start of the hearing. After that, Members
    will be recognized in order of arrival.
        And I will start things off. I recognize myself for 5
    minutes.
        Dr. Hess, may I please start with you, because in your
    testimony, you talked about the Stroke Belt, and Georgia is
    right there in the heart of that.
        Let me share with you some of the latest statistics. In
    Georgia, 3.5 percent of adults in Georgia had a stroke in 2018.
    In rural areas, the statistic for Georgia was 6.1, nearly twice
    that average. And it was 8.2 percent in 2017. This is one of
    the reasons I give a health fair every single year in my
    district for each of the 17 years we got here, and we address
    that dearly. We have the doctors and the physicians and all the
    great hospitals, as you may be aware. We have great recognition
    for this health fair, and that is what we address so much.
        Can you explain the increases and decreases of these
    statistics, and also, can you tell us the answer to: are we
    doing something differently year to year, or are stroke numbers
    normally this varied?
        Dr. Hess. Yes, Chairman Scott, those are very good points.
        So, not only is Georgia in the Stroke Belt, but most of the
    coastal plain of the Southeast, so South Carolina, North
    Carolina, Mississippi, Alabama. And it is usually in the
    coastal plain, but it is. There are racial disparities, too.
    African American men have a very high rate compared to whites.
    African American men are the highest, and African American
    women, and then it drops down to white women and men.
        The Chairman. Yes. What would be a rate racially on that?
    That is a very good point. What is the magnitude or the
    differentiation?
        Dr. Hess. Well, it is a ratio of probably between 1.5 and 2
    times as high, but you have to look at age. You have to adjust
    it for age, and the tragedy is, like the patient I talked
    about, 45 years old. In Georgia, in the Stroke Belt, we have
    strokes occurring a decade earlier than other parts of the
    country. Not only are there more strokes, but they are
    occurring in the prime of life. It is not unusual to see a 45
    or a 50 year old person. It is not just elderly people who are
    having strokes.
        And the other thing is the strokes were only the tip of the
    iceberg. I don't want to get too off broadband here, but there
    are a lot of silent strokes that occur that people don't even
    know about. For every stroke you have, there are five silent
    strokes, and that is a big contributor to dementia. A lot of
    this could be--I would rather actually focus on prevention than
    just treating the stroke would be better. It is treatment of
    hypertension is by far and away the biggest bang for your buck.
    We don't have as many programs as we used to have to treat
    hypertension, and a lot of rural patients don't have good
    access to healthcare, and so their blood pressure isn't as well
    treated.
        African Americans have a higher prevalence of hypertension.
    They have more difficult to treat hypertension, and for any
    given level of blood pressure, they have more end organ damage
    like stroke. There are these definite racial differences and
    they tend to be accentuated in rural areas where there is less
    access to healthcare.
        The Chairman. Right. Well, thank you very much for that.
        Ms. Mollgaard, you gave a very interesting saying. You
    said--if I can remember correctly, you said ``If you want to go
    fast, go alone, if you want to go far, go together.'' What did
    you mean by that? Give us an example of what you meant.
        Ms. Mollgaard. Yes, it is an African proverb that I have
    heard and it really resonates with the work that we do on our
    local community level. To do the work that all of us here are
    doing, you need to forge these partnerships with a variety of
    sectors. You have to work with your government. You have to
    work with your schools. You have to work with your local
    businesses to really drive sustainable change in your
    community.
        That quote I like because it might take more time. This
    work is heavy lifting, but when you bring the right people
    together and everyone is at the table, you can make a lasting
    impact for your communities, your regions, your states, and the
    nation.
        The Chairman. Well, thank you very much. I hope you won't
    mind if I use that. I am going to be on television promoting my
    health fair, and I will use that. But I will give you credit.
    That is a great saying.
        Ms. Mollgaard. It was not from me. I just resaid----
        The Chairman. Oh, it is from Africa. Good.
        I now recognize the gentleman from Georgia, Ranking Member
    Scott.
        Mr. Austin Scott of Georgia. Thank you, Mr. Chairman. I was
    waiting on the good doctor down there to give us a lecture
    about the fact that we go so far as to fry our vegetables,
    fried okra, fried tomatoes, we haven't figured out how to fry
    lettuce yet, but we pretty much fry everything before we eat it
    down there. Certainly, the way we eat, and it is good eating.
        Dr. Hess. Yes.
        Mr. Austin Scott of Georgia. It has an impact on the
    strokes we have.
        I want to focus first, Mr. Hurst, on you. I remember the
    old days of my granddad's 4430, and you pull a broadcast
    spreader, and when you turn the irrigation on, you put just as
    much water on the wet area as you did on the dry area.
        Can you talk a little further--and you mentioned this
    briefly. Can you talk further about how you and your
    colleagues, and the ag industry as a whole, is able to utilize
    broadband on the farm to help reduce the inputs, fertilizer,
    pesticides, water, the way that they help production
    agriculture be more profitable and have less impact on the
    environment, while at the same time having greater yields?
        Mr. Hurst. Well, we keep pretty accurate yield maps as we
    go across the field, and basically we can check the yield for
    down to a few square feet. And it is counterintuitive, but what
    you learn when you do that is to put a little more fertilizer
    on the parts that are green on the map that are of higher
    yields, a little less fertilizer where it is less productive.
    Before, we would use the same amount of fertilizer across the
    field, and it was wasted on places where the soil was thinner,
    was poor. We also do the same thing with seed, higher
    population where we have better capacity for yield. The less
    runoff obviously saves us money, but maybe more important for
    society, it saves the application of chemicals that can cause
    problems when they end up in the wrong place.
        Mr. Austin Scott of Georgia. I would add to the fact that
    the machinery today is much more complicated than it was in the
    past, and if you have a problem, my tractor's instruction
    manual is literally on my iPhone. But if I don't have access to
    the Internet, I can't get the information I need.
        Mr. Hurst. Yes, we absolutely use--just Google a problem,
    and if they can't fix it and we have to have a tech come out
    from our dealership, the first thing he does is hook up to the
    Internet to start tracing the codes.
        Mr. Austin Scott of Georgia. I beg to differ. The first
    thing he does is he starts that timer when he leaves the shop
    and they get a pretty penny, as my granddad would say.
        Mr. Hurst. Absolutely.
        Mr. Austin Scott of Georgia. Doctor, you have a
    relationship with Tift Regional Hospital where my father is a
    physician. I know I have talked with him many times in the
    past, him as an orthopedic surgeon and trauma surgeon. Just the
    ability in rural America for a physician to pull up an X-ray at
    their home instead of having to drive to the hospital to look
    at a patient to know if that is something that is an emergency,
    an emergency that requires an operation today, or if it is
    something that the patient is actually better off with a ``wait
    and see'' approach.
        If you could expand a little further on how it is helping
    deliver healthcare into the rural parts of the country, I would
    appreciate that.
        Dr. Hess. Yes. Well, almost any hospital to conduct any
    kind of business has to have broadband now, because you are
    sending images. Like you said, if your father wants to look at
    an image at home or if they are sending images to be read by
    these different teleradiology firms, which may be in Australia
    reading things.
        Mr. Austin Scott of Georgia. That is right.
        Dr. Hess. And so you have to have that to function. The
    trouble is at peak times that bandwidth, there is a lot of
    competition for that bandwidth in a hospital, and that is the
    problem.
        The problem is getting into patient homes, is the other
    problem, and getting into clinics. A lot of times they don't
    have broadband access.
        Mr. Austin Scott of Georgia. I was thinking the physician's
    home.
        Dr. Hess. Yes. Well, the physician's office even can have
    trouble, you are right. I mean, you can have down times. Even
    we sometimes have trouble in Augusta. One of the worst things
    that ever happens is if my cable goes out from a lightning
    storm. Because I do telestroke, we all have backup systems;
    but, we have to have wireless backup systems. You are right.
    Even for physicians trying to conduct business, it is very
    difficult in rural areas.
        In Tifton, where you are, you already recounted the issues.
    And that is probably one of the better places we have seen in
    rural Georgia. I mean, some of the places we see, these 25 bed
    hospitals, they really struggle.
        Mr. Austin Scott of Georgia. Right.
        Dr. Hess. They struggle. I don't know how they do it.
        Mr. Austin Scott of Georgia. My time is about to expire.
        I want to say this. As someone who--from Tift County, we
    are very fortunate to have a quality medical community there.
    We also have I-75 and 319 and 82 that come through there, and
    as you know, we have a shortage of neurologists in the area.
    And when we have a neurological incident, if we are not able to
    have the telemedicine--even if you are able to have the
    telemedicine, one of the biggest questions is which way does
    the ambulance go? Does it go to Thomasville? Does it go to
    Macon, or does it head your way? Because in these areas where
    you have so few neurologists, even if the closest hospital--if
    that neurologist isn't there or if that neurologist is in a
    long procedure, the quickest help is sometimes further away.
        Dr. Hess. Yes.
        Mr. Austin Scott of Georgia. And the access to immediately
    know where that patient needs to go in those situations it
    truly is the difference in life and death.
        But thank you for being here.
        Dr. Hess. Yes.
        Mr. Austin Scott of Georgia. Maybe we can have a second
    round of questions.
        The Chairman. Yes. Thank you very much, Mr. Scott.
        And now we will hear from the distinguished lady from
    Minnesota, Ms. Craig.
        Ms. Craig. Thank you so much, Mr. Chairman, and thank you
    to the Ranking Member today for holding this hearing.
        We all know that broadband is the gateway to rural schools,
    businesses, and healthcare providers. I am extremely pleased to
    have Red Wing, Minnesota's own Neela Mollgaard here to share
    the success story of Red Wing, one of the most incredible
    stories of how broadband can transform a community's economic
    future.
        Neela, in your testimony, you mentioned that Red Wing
    Ignite has played a significant role in creating new
    educational opportunities for students in STEM, coding, and
    hands-on internships. How does broadband access expand the
    learning opportunities available to students outside of the
    classroom, and additionally, how does your organization
    collaborate with local school districts to improve those career
    pathways for students?
        Ms. Mollgaard. I am happy to answer, once my microphone is
    on here. Yes. When we launched our nonprofit, we felt we should
    be focusing on our current innovators, the startup community.
    We learned quickly, though, we also need to help the future
    innovators. On our daily work with our manufacturers, with the
    startups we support, and the new next gen technology that we
    see in the nation, we know that there are new skills that are
    needed today, and those are in artificial intelligence and
    cyber security, in coding, in automation, and so, our schools
    and schools all around might not have the capacity or the
    ability to teach those new skills that are needed.
        We work with our partners in our school districts and our
    local college to try to provide those skills necessary for the
    students, whether that be inside or outside of the classroom.
        A couple years ago, we started a STEAM team. We added A in
    there for the Arts. And what we did is we tried to provide more
    learning opportunities for these students with those skills
    that are so needed right now. What we learned, though, is we
    didn't want to do one and done programming. We wanted to do
    sustainable, impactful change. And so, we worked even closer
    with the schools to help provide some leadership to implement a
    new careers pathway at our K-12 system, which will be new
    curriculum and experiential learning for our schools.
        I am pleased to say that out of the four pathways, two will
    focus on technology and science, and the other would be
    business and entrepreneurship.
        Ms. Craig. Thank you for that. You really addressed my
    second question in your answer, because we were talking about
    that as well, because we are looking at how do we make sure
    that your program is aligning Red Wing with the jobs skills
    that are needed in greater Minnesota.
        Can you talk a little bit about just--I know this
    Committee, and I am also on the Transportation and
    Infrastructure Committee--we often talk about how can we make
    sure that people can earn a good opportunity and living where
    they want to live? Please talk a little bit more about the
    entrepreneurship that has been unleashed. It is just stunning
    to me that you have been able to incorporate all of this here
    and in what is just a beautiful Mississippi River town that is
    growing by leaps and bounds.
        Ms. Mollgaard. Yes. We have had some early successes with
    increasing the job market and keeping our community
    competitive. One program I could focus on is our Learn and Earn
    Program. It is one in five pilots in the State of Minnesota,
    working with high school students in high-demand, high-growth
    jobs. We have placed students in manufacturers around us, and
    they not only get a college certification, but work site
    learning. They can choose the path. Is it college or is it
    directly into career? And so, success rates right now, we have
    five students going to a technical college. We have four going
    to a university for engineering, and three got a job
    immediately out of high school for local employers.
        With our startups, too, we are just providing the tools
    needed to be able to advance their business one step at a time
    with tools that they would not automatically have.
        Ms. Craig. Thank you so much. I just want to add that this
    hearing is incredibly important. We are talking about
    broadband, but I hope we all see that through your testimony
    here today, Neela, it takes intentional leadership. It takes
    collaboration to make sure that we reap the full benefits and
    opportunities of the Federal dollars that we are investing in
    these programs.
        Thank you for being here, and with that, I yield back.
        The Chairman. Thank you, Ms. Craig.
        Now, Mr. Baird, you are recognized for 5 minutes.
        Mr. Baird. Thank you, Mr. Chairman, and Minority Member
    Scott as well. I appreciate the opportunity to have questions
    which deal with--my first one deals with telehealth.
        Purdue University's Center for Regional Development has
    conducted numerous studies on a lack of rural broadband and
    social and economic benefits to Americans, and what can be
    gained from increasing that access. Many of you as witnesses
    mentioned those benefits here today.
        In the Wabash Valley Heartland Innovation Network, it is a
    ten county area in my district that includes much of the area
    of about 97,500 people, and they don't have access to
    residential broadband. We have been interested in expanding the
    appropriations that would be involved in improving or funding
    distance learning and telemedicine, and to give better access
    to the equipment that would that.
        Dr. Hess, I would ask you if you would care to elaborate on
    the types of healthcare services that can be--in addition to
    what you work with that might be provided to a patient in his
    or her home, and I am also looking at the kind of equipment
    that works best for that patient in order to receive that
    telehealth and telemedicine.
        Dr. Hess. Yes. One of the biggest needs is telepsychiatry
    and telemental health. It is a huge need. Actually, if you look
    at requests that we get, it is often for telepsychiatry. There
    is a big movement now to develop different platforms, because
    that is a huge need.
        Some of that would be done in clinics. Some of it could
    potentially be done in patient homes. Most of the things in
    patient homes would be more preventative care. In medicine, we
    are not very good at preventative care. We tend to be in a fee
    for service world where the more we do as physicians, we get
    paid. That is just how the reimbursement is set up. But we
    would like to go to a world where we are rewarded and
    reimbursed for preventing disease. But we are not there yet.
        A lot of this can be done, as I mentioned--it doesn't have
    to be--there is such a shortage of physicians now in many areas
    that a lot of this can be done with nurses, nurse
    practitioners. They tend to be very, very good at this,
    developing relationships. You look at patients that have
    complex diseases, chronic diseases like diabetes and
    hypertension, and you focus on them. And a lot of that managing
    can be done by nurses in the home or pharmacists to review
    their medication.
        The other big group is, at five percent, we call them the
    super users. Five percent of patients consume about 50 percent
    of the healthcare resources. They go to emergency rooms. They
    get admitted a lot. And that would be a group to focus on, and
    there has been some movement now to focus on those patients. It
    can't all be done through telehealth. You do need boots-on-the-
    ground. You need to touch people. You can't do everything by
    telehealth, but telehealth is a great adjunct, particularly in
    rural areas.
        The other thing is we can provide--specialists tend not to
    be in rural areas, and telehealth is a great way to bring a
    specialist consultation, if not to a patient's home, to a
    community health clinic where they are going. I think it is a
    combination.
        Most of the stuff in a patient home is monitoring for
    diseases you have, so you are monitoring the blood pressure. We
    are not very good at controlling blood pressure. And a lot of
    times, it is because we put people on so many medications, they
    can't keep track of them. I can't take three pills a day. I
    forget. How can we expect our patients to take ten pills a day?
    That is best done by nurses, nurse practitioners, and
    pharmacists. Doctors, we are not too good at that, honestly.
        Mr. Baird. [audio malfunction in hearing room.]
        Dr. Hess. Well, there are a lot of vendors. Our company
    that we sold was mostly focused on more in the hospital base,
    but there are more and more units you can use at the home. They
    are much simpler. They are often--you want to do something with
    an iPad or a computer. There are more and more things you can
    do with an iPad now, but you need the broadband connectivity.
    And on an iPad or a tablet, I should say, you can put a lot of
    patient education. Because, we are not very good also at
    educating our patients. We tend to rush through. We tell them
    we are going to get an echocardiogram. They don't know what
    that is. A lot of that information could be put on tablets that
    they could work with.
        There are a number of systems. I don't want to go through
    all the commercials. There are a number of companies that do
    that; but, if you have the connectivity, you can always find a
    vendor to help you with the technology. The connectivity and
    the human factors are more important than the technology. I
    mean, the technology is almost a commodity. There are many good
    vendors for it.
        Mr. Baird. Thank you very much, and I see I am out of time.
    I wish I had time to ask every one of the witnesses. I have
    questions.
        But thank you, Mr. Chairman. I yield back.
        The Chairman. Well, thank you very much.
        Now we recognize the distinguished lady from Iowa, Mrs.
    Axne.
        Mrs. Axne. Thank you, Mr. Chairman and Ranking Member, for
    holding this important hearing.
        Rural broadband, of course, is essential to modern
    agriculture, small businesses, and rural communities, as so
    many of you are talking about today. And as a Member of this
    Committee and a member of the Rural Broadband Task Force,
    getting our rural communities connected to the Internet so they
    can grow and thrive is definitely one of my highest priorities.
        Iowa ranks among the top ten best states for education,
    opportunity, healthcare access, but it comes in 33rd for
    Internet connection. The FCC defines rural broadband as 25
    megabits per second. As a reference, watching a movie on
    Netflix takes at least 5 megabits per second, and our rural
    communities and farmers, as several of you have pointed out,
    are not sitting around watching TV. Many of the latest farming
    technologies require broadband connections for data access and
    analysis of their fields. Farmers and businesses rely on
    broadband access to manage their inventory, communicate with
    customers, and grow online. Adequate broadband access is
    critical to the success of our rural communities, small
    business owners, and farmers.
        According to the FCC, 26.4 percent of rural Americans lack
    access to adequate Internet speeds, and that is definitely true
    in my district. We don't know how many Iowans are lacking
    broadband access because current FCC maps indicate a much
    higher connectivity rate than actual data from our local
    communications companies. There are large parts of my
    district--and I can tell you this from firsthand experience--
    where cell phone service isn't even available, much less
    Internet. And in the areas that do have Internet coverage,
    there can be huge differences.
        For instance, in Red Oak, it is ranked 54th among all Iowa
    cities for Internet connection, but literally just 23 miles
    away in a town very similar in size, Shenandoah, it is ranked
    430th. And even my largest city, Des Moines, has 37 percent
    slower Internet connectivity than the national average.
        I think much of this comes from the disparity of the last
    mile, which is when Internet providers won't extend into the
    areas that they see as unprofitable, often stopping right at
    county lines or just outside the business district, leaving
    rural communities to either foot the bill or not be able to
    compete in a 21st century economy.
        I want to highlight some folks in Montgomery County, Iowa,
    and the important work they are doing, led by Shawnna Silvius,
    the Director of Montgomery County Economic Development.
    Montgomery County is leveraging USDA's new Market Tax Credit
    Program to complete that final mile of connectivity, and when
    they are successful, they will literally be the first county in
    Iowa to have certified fiber optic to every home and business.
    The first in Iowa, and it is 2019.
        When I spoke with Shawnna and Red Oak Mayor Bill Billings,
    Montgomery County supervisors Brian Amos, Mike Olson, and local
    business owners like Kevin Cabbage and Mickey Anderson about
    the economic development that high-speed Internet brings, they
    all shared that connecting our rural communities is critical to
    ensuring our rural communities survive.
        From finding all the right avenues to funding, to
    navigating all the different agencies, the USDA, FCC,
    Department of Commerce, et cetera, our communities have very
    little guidance or assistance. I am really happy to have you
    all here today, because given your experience, you have been
    successful in navigating these broadband issues and helping
    connect your communities.
        I would ask any one of you to comment and give me the
    advice that you have to help communities like mine who are
    either struggling to get started, having trouble finding enough
    funding, or who need to close that last mile gap. Thank you.
        Mr. Hengel. Thank you, Congresswoman. Great questions and
    great comments, by the way. I think your district is similar to
    mine, I would imagine, in what we deal with.
        First off, I want to recognize the fact that there is bad
    data out there, and I think that is important that we gather
    some data.
        We were lucky in my region because we had a cooperative
    that has decided to lay the fiber, because it is part of their
    mission. They believe deeply that economic development and
    community development is part of their mission as a rural
    cooperative. And so, that we are very lucky to do so.
        With MidCo also having a personal interest and as a
    company--the success allowed them to make what would be
    decisions that are beyond what I would say would be business
    case analysis.
        And so, I think that you have to use all the resources you
    can. You have to bring together both the business community as
    well as the education community, the healthcare community, and
    make the case. In Minnesota, we created the Office of
    Broadband, which has provided some leverage funds as well as
    Federal funds, to start reaching that extra mile, which is
    incredibly difficult to get to.
        Mrs. Axne. Thank you. Any other comments?
        Mr. Hurst. Yes, please. Thank you. I live about 20 miles
    south of Shenandoah, so I can certainly agree with the lack of
    broadband in that community.
        Good help in Missouri from rural electric cooperatives and
    other cooperatives. Actually, our broadband comes from a small
    cooperative in southwest Iowa to our farm, and they reach
    across the state lines there. These are really outstanding
    efforts from the cooperatives, and we appreciate that very
    much.
        Mrs. Axne. Thank you.
        The Chairman. Thank you very much.
        The gentleman from South Dakota, Mr. Johnson, 5 minutes.
        Mr. Johnson. Thank you very much, Mr. Chairman.
        For 4 years, I was the Vice President of an engineering and
    consulting firm that worked in rural broadband, and we designed
    and put in place about 8,000 miles of fiber optic network a
    year, did a number of wireless builds as well. And I am not
    sure there was anything more rewarding than seeing the real
    joy, the satisfaction of these communities that were getting
    connected to real gigabit-type networks that they had not had
    access to previously.
        And I was particularly struck when there were traditionally
    underserved communities or subcommunities. And we have talked a
    fair amount today about demographic differences in broadband
    availability.
        I want to shift just a little bit to demographic
    differences in broadband adaptation, or to what extent people
    are actually using the speeds that they can get access to. And
    of course, we often talk about this with regard to age, and so,
    I was just curious for any of the panelists, if you want to
    share from your medical or Tribal or agricultural communities
    stories you may have about getting older Americans connected to
    these resources.
        Dr. Hess. Well, I will just start with one anecdote. We
    were actually going to apply for a P-CORI (Patient-Centered
    Outcomes Research Institute) grant to look at post-stroke care,
    and most stroke patients are elderly. And so, before we did
    that and applied, we were going to use telehealth and actually
    connecting with iPads and smart phones to try to do follow up
    with nurses. We started. First, one of the nurses said, ``Why
    don't you do a survey and see how many elderly Americans with
    stroke have a cell phone or know how to use a cell phone,'' and
    the numbers were disappointingly poor. Most of them didn't have
    access to a cell phone. They may have had a grandchild or a
    child with one, but they weren't necessarily in the house. And
    more than \1/2\ of them didn't know how to use a cell phone or
    how to use a tablet. And they were intimidated by that
    technology. This was only 3 years ago.
        In terms of the health field, when you get to elderly
    people who have a stroke who may already have cognitive
    problems, that can be a problem. You are going to need someone
    in the family maybe to help them. Often the younger you are,
    the more technology adept you are.
        It is an issue with some of our aged patients. That is just
    my anecdote.
        Ms. Mollgaard. I would say also that it is about the
    adaptation, as you speak. It is when individuals can really
    change the way that they work, learn, and live, using this
    technology. They won't substitute it. I mean, why our youth are
    no longer going to go to communities that don't have broadband.
    That will be a requirement for the future, as our youth are
    looking for new homes.
        Once we have the technology and everyone has technology, it
    should be like electricity. Everyone should expect it. It
    shouldn't be some have and have not. Then they can use this new
    technology, provide better healthcare, provide better
    educational outcomes. They will have that adoption rate. It
    will see the value to their day-to-day lives and how they care
    for their elderly parents or improve their own health. And then
    at that point, adoption will really be finalized.
        Mr. Johnson. Maybe for you, Councilwoman, I mean, I would
    imagine dealing with Tribal elders sometimes it is hard for
    them to--when you talked about the increase in the quality of
    life of people using some of these new speeds. But I am sure
    Tribal elders lagged in that access.
        Ms. Watahomigie-Corliss. Mr. Johnson, you are correct. In
    the idea of public health, we are working on some crisis
    response protocols within the community, and we have set up
    kind of a public education guideline and system that we are
    about to deploy in regards to our state Medicaid. Even the
    community themselves don't know what questions to ask when they
    are flown out of the canyon to a regional medical center, and
    we are just now establishing a question card.
        In the idea of a community, Native Americans usually do a
    public outreach and will have a community meeting where we will
    invite the public, and that is where we would start.
        Mr. Johnson. And then for Mr. Hurst, all of my buddies in
    their 30s, 40s, and 50s who are ag producers are using
    technology a lot. My producer buddies who are in their 70s and
    80s, less so. I am sure my experience isn't unique in that way?
        Mr. Hurst. I mentioned my father in the testimony. I kid
    him. He is the only guy, besides drug dealers, that depends on
    a burner phone from Wal-Mart; but, he pays attention to those
    maps, so we are making progress. But there is definitely a
    generational difference.
        The Chairman. All right, thank you very much.
        Mr. Johnson. Thank you, Mr. Chairman.
        The Chairman. You are welcome. We will now recognize Mrs.
    Kirkpatrick, the lady from Arizona, 5 minutes.
        Mrs. Kirkpatrick. Thank you, Mr. Chairman. Thank you for
    having this really important hearing.
        I have been working on expanding rural broadband since I
    was first elected to the legislature in Arizona in 2004. I grew
    up on the White Mountain Apache Nation in Arizona, very remote
    Tribe. When my cousin was principal of the elementary school
    there, she started a computer lab because she realized that
    practically none of the households had computers in their
    homes. And yet, if these kids were not computer literate going
    on to higher education--and a lot of them went off the
    reservation to boarding schools--they would be at a lifelong
    disadvantage. But even that was restricted. They would spend
    maybe an hour or 2 a week in the computer lab, but at least
    they had some exposure.
        I am very concerned about this for our rural areas that
    lack connectivity and that opportunity for our young people.
        I just spent a week with my 2 year old and 4 year old
    grandsons who had their iPads with them the whole time. It is
    second nature to them to use their iPads. But that is not the
    case for a lot of rural students.
        I have hiked down to Supai. It is a beautiful, beautiful
    area, but I just wondered, Ms. Watahomigie-Corliss, how many
    households in Supai have computers in their homes?
        Ms. Watahomigie-Corliss. With our old SM system, we did
    have a public network with 10 megabits, and we did try to
    deploy home modem use. And out of that old system, I would say
    that was around 2010, probably about 20 homes were able to
    receive the modems. But does that mean they have a laptop? It
    mostly means that they have a portable device, which would be a
    cell phone or an iPad.
        Also, in regards to our GED programs that we have been
    trying to initiate, since 2015, that is also the same case. The
    students will ask the Tribe for a laptop because they don't
    have one. Last year, I was only able to get two laptops
    donated. In the same way that I was able to check out the CPEs
    for home Internet use, I also checked out the laptops and
    currently, we only have two.
        I would have to say, Mrs. Kirkpatrick, I would guess of the
    128 homes in the village of Supai, I would guess about maybe 28
    of those homes may have a computer.
        Mrs. Kirkpatrick. Thank you.
        I am going to switch gears a little bit. I have a Veteran's
    Advisory Council, and we just met when I was home last week.
    And we come from--they come from all over the district. I have
    a very rural county, Cochise County, and the veterans depend on
    telemedicine and the Internet to communicate with the VA
    hospitals in Arizona. And I would just like the panel's
    comments on what we can do to improve access for veterans in
    rural America in terms of telemedicine?
        Dr. Hess. Yes, I will take the first stab.
        The VA has actually been at the forefront of telemedicine.
    I mean, they have actually taken the initiative in a lot of
    areas. But, a lot of it depends what division you are in and
    where VA is doing it. I know there are some--it is not too
    widespread where I am in Georgia, but it sounds like your VA is
    pretty far ahead. And you are absolutely right. Veterans, there
    are just so many VA hospitals and they have tried to develop a
    lot more clinics; but again, there are wait times. There are
    access issues, just like there is everywhere else.
        I remember the VA was talking about this in the early 2000s
    and late 1990s. They were ahead of the game. I don't know that
    I have a magic pill for that, but it is a very good question.
    And they have been at the forefront, compared to other
    healthcare systems.
        Mrs. Kirkpatrick. Yes, they really have been working at it.
    There are still some software problems that I am hearing about,
    but they have really taken the lead in that.
        Any other comments from anyone else on the panel? I have
    about 30 seconds left. Okay, yes.
        Ms. Watahomigie-Corliss. Yes, I do have listed here
    available types of spectrum that maybe the VA would be--or
    consider either applying for a license or there are also
    unlicensed networks here. There is the Citizens' Broadband
    Radio Spectrum, which is called CBRS. That is a 3.5 gigahertz.
    It is lightly licensed and should be available late summer.
    There is the Educational Broadband Service Spectrum, but the
    FCC did just make their determination on that yesterday. There
    will be Tribal priority windows and then that will go up for
    auction. There is also unlicensed spectrum of 900 megahertz,
    2.4 gigahertz, and 5.8 gigahertz, and there is also what is
    called TV white space, and it is currently unlicensed but it
    has a wide enough range of frequencies to be available in most
    areas.
        Mrs. Kirkpatrick. I would love to work with the Tribe on
    expanding that in any way I can.
        Thank you, Mr. Chairman. I yield back.
        The Chairman. Thank you very much, and now we will hear
    from the distinguished lady from Missouri, Mrs. Hartzler, for 5
    minutes.
        Mrs. Hartzler. Thank you, Mr. Chairman, and thank you each
    for being here. What an impressive panel. I just think your
    communities and your states are very blessed to have you in
    leadership.
        I want to start with Mr. Hurst. You have talked about, in
    your testimony, about the importance of broadband mapping to
    agriculture. Can you describe some of the problems that we are
    currently facing about--a little bit more about the legislation
    that you mentioned that would be helpful, but also about the
    FCC's National Broadband Map Initiative that is underway, and
    how you think that might be helpful?
        Mr. Hurst. The way it works now, as I understand it, if one
    person, one home in a Census block has access, then that means
    that that Census block is not eligible for any Federal
    programs. But it may be that it is just only one home, because
    in rural areas, because of the low population density, a Census
    block can be a lot of square miles. We need more granular data
    that gives us a better idea of how good that penetration is,
    how many people actually in the Census block are being served.
    That is why it is so very, very important that we work on these
    maps. It is one of our initiatives we are working on with our
    broadband group in Missouri. H.R. 3162 has that as its goal.
    There are also things written in the farm bill that would
    improve our mapping.
        In order to fix the problem, we have to be able to measure
    it, and so far, we can't.
        Mrs. Hartzler. Right, and I am glad that we are focused on
    that because I think that is just something that hasn't been
    focused on as much, but it is critical that we get the maps
    right so that we can get the funding where it is needed and
    make sure that people are helped. Thank you for that.
        Ms. Mollgaard, I really was inspired by hearing more about
    what is going in Red Wing, Minnesota, and your enthusiasm and
    just the great things there. But I want to get more specific,
    because I want to do this more in my district.
        You said that it is funded by the U.S. Economic Development
    Administration that provides technical assistance and support
    to rural communities. Is the support financially, or just
    technical assistance? What specific Federal programs--was it
    Reconnect funding? Was it the FCC's Connect America fund, or
    what did your community tap into, or is it just privately
    funded to help you expand and bring this broadband to your
    community?
        Ms. Mollgaard. In my written testimony, I list many of our
    partners----
        Mrs. Hartzler. Push your mic--there you go. Thanks.
        Ms. Mollgaard. In my written testimony, I list all of our
    wonderful partners and funders. It has been public-private
    partnership. Our City of Red Wing supports us. We have local
    foundations. We have had other grants, state and then with U.S.
    Ignite, that was funded by--they were initially funded by the
    White House, the National Science Foundation grant dollars.
    Currently as you were referring to with the EDA, we were
    selected by an organization called the Center on Rural
    Innovation to be part of their rural innovation initiative, and
    because we were one of nine communities in the nation, we were
    able to receive in-kind technical assistance to apply for the
    I-6 Challenge grant. We don't know the outcome of that. Now
    that I am here, maybe I need to go and see what the status of
    that grant application is.
        But it will be a wonderful network of communities, nine
    communities throughout the nation that will now work together
    to try to improve our innovation-based economies. It is the EDA
    I-6 Challenge grant is what I was referring to with the help
    from the Center for Rural Innovation.
        Mrs. Hartzler. We have come a long ways in providing some
    funding, but the problem, and you referenced it in your
    comments, was sustainability. There is money to help put the
    broadband there initially, but then you have to be able to
    sustain that model. And so, I was curious about that.
        But I wanted to talk about speeds just a little bit, and go
    back to Mr. Hurst.
        As you know, Missouri has set out a new broadband plan, but
    the plan's goal is to achieve universal access to high-speed
    Internet with speeds of at least 100 megabits per second
    download and 20 megabits upload for all Missouri citizens by
    2028, and I know there are similar goals elsewhere. Can you
    talk a little bit about how and why the states are adopting
    these broadband speeds that significantly outpace the Federal
    programs right now? And I was glad to offer the amendment in
    the farm bill that says now that USDA programs have to have at
    least 25 Mbps download and 3 Mbps upload speed, but that is
    still a far difference than Missouri's goals. Can you talk on
    that just a second?
        Mr. Hurst. Yes. We appreciate your help on the amendment,
    because before it was 10 Mbps to 1 Mbps, which is totally
    inadequate. Congresswoman Axne mentioned how much broadband it
    takes to watch Netflix, but the point is, in a rural home, you
    may have someone watching Netflix at the same time two or three
    children are trying to get on the Internet to do their
    homework, at the same time that perhaps we are uploading the
    data that we generated that day on our combines. We need the
    faster service because we are finding more and more ways to use
    broadband.
        I think Missouri's goal is ambitious, but it is necessary.
        Mrs. Hartzler. Thank you. Thank you, Mr. Chairman.
        The Chairman. Thank you very much, and now we will hear
    from the very distinguished gentlelady from Virginia, Ms.
    Spanberger.
        Ms. Spanberger. Thank you very much, Mr. Chairman, and
    thank you so much for being here today and for sharing your
    stories about how important broadband is to rural communities.
        Coming from a district like mine in central Virginia where
    many of my constituents don't have access to broadband, your
    stories of the challenges your communities have had to overcome
    to get broadband and how it often took longer than you would
    have liked really do resonate with me, and they reflect the
    stories I have heard from my constituents.
        One of my constituents, Roy, from Orange County, wrote to
    tell me that when he moved into his house 16 years ago, various
    Internet providers told him that he would have broadband very
    soon. You probably know where this story goes. It hasn't
    happened yet. He has a farm business, and the lack of high-
    speed Internet significantly impacts his outreach and his
    sales. And he has also seen the effect of the lack of broadband
    has had on the local high school students as they try to do
    their homework.
        Another constituent, Crystal, from Henrico County in our
    district, works in healthcare, and many of her rural patients
    don't have easy access to the Internet, and she isn't able to
    give them the same follow up healthcare information online that
    she would like to and that she is able to with other patients.
        As communities in our districts are looking to expand our
    access to broadband, I appreciate the opportunity to learn from
    your experiences. And I was particularly struck by some of the
    comments that you made, Councilwoman Watahomigie-Corliss and
    Dr. Hess, related to the ability to use broadband Internet as
    it relates to telemedicine, and recognizing the challenges that
    you all have seen in your different communities, the challenge
    of having insignificant speed for applications such as
    telemedicine, and sir, you recounted the story of your Taco
    Bell experience when trying to deal directly to a patient.
        Knowing what you know now and what you have seen, I am
    wondering where you think other constituencies might be able to
    be a part of this conversation, be it medical professionals, be
    it veterans, as my colleague mentioned. Frequently, those of us
    who represent rural communities and those who live in rural
    communities are talking about this issue, but I also represent
    suburban communities where this issue isn't seen as prevalent.
    And so, I am wondering how, beyond this Committee room, we can
    continue to have this conversation so that people across the
    country understand the impact this has on our country.
        And I will start with you both if you have any comments.
        Ms. Watahomigie-Corliss. Hi there. In regards to
    telemedicine services, I think public outreach and partnership
    are important. I don't know how many times I have come to D.C.
    and nobody knows who the Havasupai even are. And in that
    regard, how are they supposed to know that I am from the most
    rural Native American Tribe in the lower 48 states?
        Now, the ruralness of my community, as I mentioned, will
    not create return of investment for people to build the
    infrastructure, and that is the way it has been all the way up
    until this point. We have been able to partner with a nonprofit
    organization, MuralNet, whose mission was to bring broadband
    speeds and connect the homework gap in Native America, and we
    just happened to be their first partnership, and we were able
    to get an approved STA license through the FCC, only one of six
    since 1995.
        Times have changed. The equipment, the cost of it is not as
    much as it used to be, and it costs us $35,000 in total for our
    first deployment.
        Ms. Spanberger. And when we are looking at how we can help
    communities like yours, like the ones that I serve, do you have
    any suggestions--to other witnesses as well--about how we can
    bring additional voices to this conversation so it is not just
    the people who are always impacted who are kind of ringing the
    bell of how important this is from a healthcare perspective,
    from an educational perspective, or from an economic
    perspective? How we can really get additional advocates to
    recognize the value of ensuring that all of our communities are
    connected, and so it is not wholly dependent on people like the
    Councilwoman or people like Ms. Mollgaard to bring it to their
    communities and to do that outreach?
        Ms. Watahomigie-Corliss. I do have a short statement that
    combining government initiatives to help bridge the rural
    digital divide, so that we can work together in partnership to
    help build those networks.
        Ms. Spanberger. Would anyone else--Dr. Hess?
        Dr. Hess. Yes, it is a very good question, and a very hard
    question. I am trying to think how to answer you.
        Charlottesville, where you are close to--I don't know if it
    is in that district--University of Virginia has a great
    telemedicine program, and we work with them. We work with them
    very, very closely.
        I will tell a story. We once had a hospital that was
    reluctant to start telestroke. Some of the physicians didn't
    believe in it, and so I went and gave a talk in a Methodist
    church one Sunday night, and they asked me--I was talking about
    stroke. And they said, ``Well, what about this drug TPA, Dr.
    Hess? If we go to the local hospital, can we get it?'' And I
    said no, and I told them how they could, and they literally
    marched on the hospital. You get hospitals, you get churches,
    you get communities to realize what they are missing.
        Now, the Internet connectivity is better to hospitals, but
    there is still--you have to get the public behind you.
        In Georgia, we worked out of churches which were a strong
    voice, and working with the university--that is the world I
    know. Working with the universities, we have a lot of support
    groups, that is how we kind of have done it, working with other
    community health centers, federally-qualified health centers.
    Of course, I am biased to the telehealth point. You bring all
    those constituencies together, and I think that helps.
        But it is a very good question, and I am not sure I
    answered it very well.
        Ms. Spanberger. No, I appreciate that. I have a list of
    constituencies you mentioned, so I appreciate that input and I
    believe I am out of time, so I will yield back. Thank you.
    Thank you.
        The Chairman. Thank you, and now we will hear from Mr. Van
    Drew, the gentleman from New Jersey.
        Mr. Van Drew. Thank you, Mr. Chairman. I want to thank you
    all for being here and sharing your experiences, your
    knowledge, and your insight for everyone that is here.
        The testimony we have heard today is important, and it is
    important, believe it or not, in New Jersey. And I know
    everybody thinks what is this guy doing on the Agriculture
    Committee? What is he doing involved with agricultural issues?
    He is from New Jersey, the most densely populated state in the
    United States of America. But actually, I have the most rural
    part of the state, and my district makes up, geographically, 40
    percent of the state, so I have almost \1/2\ of the state. And
    we have some of these same issues.
        I remember when I became, years ago, a new state senator,
    learning about those issues and being so surprised, surprised
    that people were really concerned and worried that the
    emergency services that they wanted to get or needed were not
    foolproof by any means, and sometimes it didn't work. Concerned
    that their kids were really having a difficult time doing their
    homework. Concerned that their businesses weren't doing as well
    as they nearly could, especially in the way business works
    today, because they weren't able to access the Internet
    properly. Concerned for their safety. Concerned for their
    economic security. Concerned for their farming, because again,
    farming has, as you all elaborated so well, farming has changed
    so much over the years and is going to change a lot more. And
    our world is going to change more. We are going to be short of
    doctors in the areas that you are speaking about, but we are
    going to be short of physicians almost everywhere. Maybe not in
    midtown Manhattan, but let me tell you, in major swaths of the
    country, we are going to have a physician shortage and a
    healthcare shortage that is very serious. Imagine how it is
    going to be in areas like this. I am from south Jersey, and my
    area of south Jersey, people who need care, even for
    developmentally disabled kids or need a host of other things
    aren't able to access them. It isn't only in the Midwest or in
    certain areas. It can be anywhere.
        We have the lowest per capita income, the highest rate of
    obesity, the highest rate of teenage pregnancy. I can go
    through the list. And yet, just a few miles away will be some
    of the most beautiful homes on the shores and the beaches. It
    is a real dichotomy.
        The work that you are doing is important, because you can't
    give people success--you can't--but you can give them
    opportunity to achieve success, and that is what you are all
    about, and that is what this is about. You can't expect people
    to do as well as they should when we have this kind of digital
    divide. And we still have it, even in places like south Jersey,
    as unbelievable as that is.
        Along those lines of success, I just thought--anybody can
    answer it. Broadband obviously makes the economy better. Any
    particular ways that you believe it levels the playing field?
    And I think you know the answer between urban and rural and the
    job market.
        Mr. Hengel. Absolutely. Thank you, Congressman, for the
    comment.
        Being in economic development for 30 years, I have seen
    great changes, and certainly, broadband has been the central
    focus of why those changes have occurred over the last 5 years.
    The increasingly economic development is about a race for
    talent, and I can't stress enough the importance of being able
    to provide a community that people want to live, and to want to
    be a part of. And that is--certainly broadband is a central
    part of that. That is simply going to be a must-have. People
    are not going to live, particularly young people, in
    communities where they cannot stay connected. And so, that is
    so important.
        Also, I would add is there simply aren't any low-tech jobs
    anymore. There just aren't. There are no low-tech industries.
    In my neighborhood or my area of the state, logging, wood
    products manufacturing, sawmilling, all those are significant
    data users. I think it is critical that without the broadband,
    you simply are not going to be able to keep up with the global
    economy.
        Mr. Van Drew. And I think you are right, and the world has
    changed. Whether we like it, whether we don't like it, it is
    the reality, and those of us in government have a
    responsibility to make sure that everybody does have that
    opportunity.
        And just alluding to what the Congresswoman was saying
    before, a lot of people don't know that. It is amazing. Even in
    my district, from the western part of the district, which is
    generally less affluent and doesn't have some of the access to
    the eastern part of my district where people do and are quite
    wealthy, they have no idea. If I was to tell them that, they
    would say, ``No, not in New Jersey. That can't be.'' I think we
    have our work cut out for us, and it really is an important
    subject for the entire nation.
        Thank you.
        The Chairman. Well thank you, Mr. Van Drew, for your
    excellent remarks. I agree with you wholeheartedly.
        Before we end, I would like to recognize our Ranking Member
    for any additional comments, closing, or questions you may
    have.
        Mr. Austin Scott of Georgia. Thank you, Mr. Chairman.
        I want to comment on Mr. Hurst's answer to Mrs. Hartzler's
    question. The industry has the ability to provide shape file
    mapping today to the FCC, and if the FCC would begin to use
    that and they could use it virtually immediately. It would not
    take long at all to implement that. Then we would have those
    more accurate maps that you and Mrs. Hartzler were discussing.
        Ma'am, I appreciate your testimony about the different
    capabilities and technologies that are out there. As someone
    who lives 15 miles north of--I would call it a city. Most
    people would call it a town. I recognize the technology that is
    going to work at my house might not be the same technology that
    is deployed in the city. I don't care what technology it is, as
    long as it works, and it seems that that is your approach, and
    I appreciate that very much. If there is anything that this
    Committee can do to help you with any licensure that you may
    need help with, I think that the Committee would be more than
    willing to help provide that support to the people that you
    represent in your Tribe.
        Doctor, I appreciate you being here, and appreciate the
    others who testified as well. It seems to me that what we have,
    maybe it is the old question of the chicken and the egg. Do we
    build the biggest, fastest interstate we can, how do we get it
    there, I guess is my question, Mr. Chairman, and I am--I don't
    care what the technology is. I am not biased to any of them,
    but I do know this. We can do a better job, and we have to do a
    better job, because we are losing our population in rural
    America.
        I represent 24 counties right now. I expect after the next
    Census, I will probably represent 26 or 27, and Congressman
    Bishop, just to my west, currently represents 28, and he will
    probably represent 31 or 32. And you guys in the Metro area are
    picking them up.
        The Chairman. I represent seven right now, I used to
    represent 13.
        Mr. Austin Scott of Georgia. Yes, but there has been a huge
    population shift from the urban areas, the metropolitan areas,
    and this is one of--it is education, it is healthcare. But in
    the end, a lot of it revolves around technology and access to
    that, and we can play a big part in fixing that.
        Thank you so much for the hearing. To those who were here
    to testify, thank you for your testimony. It was extremely
    important, and this is something that we can and will be
    working together to help resolve.
        The Chairman. Thank you so much, Ranking Member. You
    touched on a number of very important parts. And to answer part
    of your question, going forward, we need to understand that the
    bottom line right now about this, it takes money. It takes
    money. It takes priority of funding. And so, with that in mind,
    I would like to make a suggestion. I would start with you, Mr.
    Hurst, with the American Farm Bureau. You all are well-placed.
    No national organization is more well-placed to get into this
    bargaining situation with rebuilding our infrastructure. Right
    now, we need our rural communities to have a seat at the table
    as we look at the budget, as we look at where this money needs
    to go.
        I would like for you to give Zippy, my good friend Zippy
    Duvall--we worked together on many things--and of course, he
    comes right out of Georgia, so go back to my days in the
    Georgia State Senate. But here is what I am suggesting. There
    is some definitive, well-respected source that needs to submit
    to this Congress the kind of funding that our rural communities
    that we need to devote to accomplish everything that we have
    said here. And I hope that you all know that from the passion
    you heard from our Committee Members, that we in this
    Subcommittee on Commodity Exchanges, Energy, and Credit, we are
    this financial arm of the agriculture industry, and our whole
    approach--there is nobody better to be the champions for
    getting proper broadband and Internet access to our rural
    communities. But you and your organization is probably the
    premier organization that is well-placed to say to us, ``This
    is how much money it is going to take for us to be a part.''
        Right now, the figure that keeps bouncing around--sometimes
    it is hard to get this one in the room, that one in the room at
    the same time. But we are going to get there. We have no choice
    but to move ahead. Our infrastructure is crumbling, we have to
    send this clarion callout that crumbling is not just taking
    place with bricks, with mortar, with just roads, highways,
    trains, all of that. This crumbling has been taking place in
    our rural communities, and we have to lift up our rural
    communities and give them a premier prime seat at the table as
    we divide and determine the amount of money that we need.
        And as I said right now, it is fluctuating between $2 and
    $2\1/2\ trillion. My estimate is when you look at what needs to
    be done in the rural communities for broadband, it is life-
    saving. I mean, it is more than just crumbling roads.
    Infrastructure is human beings. They are us. They are people.
    Not just roads, not just airports. We got to get that through.
    It is education. It is job training. It is healthcare. It is
    lifting up and making people not just want to live in rural
    areas, but will desire to live there. And we have to give that
    attention to it.
        I would like for you to understand that that is why we had
    this. Austin Scott and I met early last year when we knew at
    the beginning of the year that we would be in charge of this.
    This is a strong, bipartisan, Democratic and Republican
    Committee. That is what it takes to get the job done. We are
    uniquely placed to do it, but we need you all to tell us as
    soon as possible how much money it is going to take. How it
    should be applied to make sure that our rural communities are
    the sparkling oases of life, of excitement, of productivity
    that they have been as the source of the foundation of our
    country. Our country wasn't founded on big cities. They were
    founded with people in small towns, and towns that grew into
    cities. But it is the rural communities that need to have our
    energy and our direction. And so, I want to make sure that you
    all take down this assignment, our Subcommittee here, and
    Ranking Member Scott and myself and our Members will be your
    champions to get this done. But the next step is we have to get
    the money appropriated to do it, and we need you all to let us
    know how much it is going to take so we can start selling it up
    here. All right?
        Again, thank you all, and there is some homework I need to
    read here. Let me put my glasses on. Under the Rules of the
    Committee, the record of today's hearing will remain open for
    10 calendar days to receive additional material and
    supplementary written responses from the witnesses to any
    questions posed by a Member.
        This hearing of the Subcommittee on Commodity Exchanges,
    Energy, and Credit is adjourned.
        [Whereupon, at 11:56 a.m., the Subcommittee was adjourned.]
        [Material submitted for inclusion in the record follows:]
    Letter Submitted by Hon. Ann Kirkpatrick, a Representative in Congress
       from Arizona; on Behalf of James D. Ogsbury, Executive Director,
                         Western Governors' Association
    July 9, 2019

    Hon. David Scott,                    Hon. Austin Scott,
    Chairman,                            Ranking Minority Member,
    Subcommittee on Commodity            Subcommittee on Commodity
     Exchanges, Energy, and Credit,       Exchanges, Energy, and Credit,
    Committee on Agriculture,            Committee on Agriculture,
    U.S. House of Representatives,       U.S. House of Representatives,
    Washington, D.C.;                    Washington, D.C.

        Dear Chairman David Scott and Ranking Member Austin Scott:

        In advance of the Subcommittee's July 11 hearing on ``Building
    Opportunity in Rural America through Affordable, Reliable and High-
    Speed Broadband,'' attached please find three Western Governors'
    Association (WGA) policy resolutions addressing broadband deployment:

       WGA Policy Resolution 2019-04 (http://www.westgov.org/
            images/editor/WGA_PR_2019-
            04_Health_Care_in_Western_States.pdf), Health Care in Western
            States;

       WGA Policy Resolution 2018-13 (http://westgov.org/images/
            editor/WGA_PR_2018-13_Workforce_Development.pdf), Workforce
            Development in the Western United States; and

       WGA Policy Resolution 2017-09 (https://westgov.org/images/
            editor/2017-09_Western_Agriculture.pdf), Western Agriculture.

        I request that these documents be included in the permanent record
    of the hearing, as they articulate Western Governors' policy positions
    on this important issue.
        Please contact me if you have any questions or require further
    information. In the meantime, with warm regards and best wishes, I am
                Respectfully,
                [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

    James D. Ogsbury,
    Executive Director.
                                  attachment 1
    Policy Resolution 2019-04
    Health Care in Western States
    A. Background
      1.  Ensuring access to high-quality, affordable health care services
                is an important element of maintaining and enhancing the
                quality of life in western states for our growing
                populations. It is the basis for healthy communities and
                healthy economies.

      2.  Western states face unique challenges in health care, including
                growing rates of substance use disorder, provider shortages
                in underserved and rural areas, and limited access to
                broadband. Low population densities and the vast distances
                between population centers also make it difficult for
                providers to establish economically-sustainable health care
                systems in rural areas.

      3.  Distance and density also inhibit construction of the technology
                infrastructure that would provide or improve broadband
                connectivity in underserved and rural areas. Expanding
                broadband access provides numerous quality-of-life benefits
                for rural Americans, including economic development, social
                connectivity, education, public safety, and access to
                telehealth and telemedicine.

      4.  The health care sector faces severe personnel shortages in
                western states, despite efforts of Western Governors, such
                as the foundation of Western Governors University and other
                medical training programs in western states, to ensure
                adequate numbers of qualified medical personnel. This
                challenge is particularly acute in the West's underserved
                and rural areas. Ensuring access to health care services
                requires an adequate number and distribution of physicians,
                nurses and other trained health care professionals.
                Population growth, aging residents, and challenges
                involving Tribal health care and services for veterans
                require a renewed focus on developing our nation's health
                care workforce.

      5.  Western states struggle with access to behavioral health services
                and higher-than average suicide rates. The ten states with
                the highest suicide rates in the nation are all located in
                the West.

      6.  Substance use disorder (SUD), including alcohol and drug misuse,
                is a major public health and safety crisis affecting nearly
                21 million Americans. It is particularly prevalent in
                western states where individuals are more likely to have
                SUD during their lifetime. SUD crosses all social and
                economic lines and tragically takes the lives of tens of
                thousands of Americans every year. While state and Federal
                progress has been made to fight this epidemic, additional
                efforts are necessary to help bridge prevention and
                treatment gaps in western states.

      7.  In many cases, health disparities and barriers to accessing
                health care are particularly acute for certain populations
                in the West. A better understanding of the role that social
                determinants play in health outcomes can inform the
                development of effective health policy to increase access
                for these populations.

      8.  Western states have a unique body of experience, knowledge and
                perspective with respect to health care. The Western
                Governors' Association (WGA) is ideally situated to collect
                and disseminate information, including best practices, case
                studies and policy options, that states can use to improve
                the foundation for health care services and advocate for
                shared policy priorities on behalf of their citizens.
    B. Governors' Policy Statement
      1.  Federal efforts to address health care workforce and access needs
                should reflect early, meaningful and substantive input from
                Governors, who are best positioned to assess the needs of
                their states and help develop solutions to meet these
                needs. State-Federal collaboration and coordination are
                integral to addressing these health care challenges.
                Wherever possible, and where appropriate, the Federal
                Government should respect state authority and maximize
                flexibility granted to states and Governors.

      2.  The Federal Government should work with states to facilitate the
                deployment of broadband to underserved and rural areas,
                recognizing that adequate broadband access has a direct
                correlation on rural populations' ability to access
                telehealth and telemedicine.

      3.  Despite efforts by Western Governors to address the shortage of
                qualified health care workers, significant challenges
                remain. Governors urge the Federal Government to examine
                and implement programs to ensure states have an adequate
                health care workforce--including in primary care and other
                in-demand specialties--that is prepared to serve diverse
                populations in urban, suburban, and rural communities.
                Governors also support efforts to increase the diversity of
                the health care workforce to improve health outcomes for
                all.

      4.  Western Governors support efforts to improve the quality and
                quantity of behavioral health services available to our
                residents, as these services are essential to reducing
                suicide rates and treating a range of behavioral health
                conditions, including substance use disorder.

      5.  The Federal Government should work toward treating addiction as a
                chronic illness and work with Western Governors to develop
                strategies for addressing substance use disorder that work
                in concert with state efforts and recognize regional
                variations in substance use disorder patterns.
    C. Governors' Management Directive
      1.  The Governors direct WGA staff to work with Congressional
                committees of jurisdiction, the Executive Branch, and other
                entities, where appropriate, to achieve the objectives of
                this resolution.

      2.  Furthermore, the Governors direct WGA staff to consult with the
                Staff Advisory Council regarding its efforts to realize the
                objectives of this resolution and to keep the Governors
                apprised of its progress in this regard.

              Western Governors enact new policy resolutions and amend
            existing resolutions on a bi-annual basis. Please consult
            westgov.org/resolutions for the most current copy of a
            resolution and a list of all current WGA policy resolutions.
                                  attachment 2
    Policy Resolution 2018-13
    Workforce Development in the Western United States
    A. Background
      1.  Workforce development efforts contribute to the economic well-
                being of western states by enabling people to find
                fulfilling, well-paying jobs, fostering economic mobility,
                and ensuring that businesses have access to the skilled
                employees they need to thrive.

      2.  Western states had an average unemployment rate of just under 4.0
                percent in March 2018.\1\ Many businesses report that they
                cannot find qualified candidates for open positions. At the
                same time, many jobseekers are unable to find good jobs for
                which they are qualified.
    ---------------------------------------------------------------------------
        \1\ Bureau of Labor Statistics, Local Area Unemployment Statistics,
    May 18, 2018.

      3.  Workforce development challenges are particularly acute in rural
                communities, which are commonly characterized by higher
                rates of unemployment, a lack of economic diversity,
                geographic isolation, and limited infrastructure, including
    ---------------------------------------------------------------------------
                access to broadband.

      4.  Economic equity continues to be a problem across states, with
                people of color and people with disabilities, regardless of
                career preparation and credential levels, seeing poorer
                rates of employment and earnings than majority populations.

      5.  There are 6.6 million unfilled jobs in the United States due in
                part to a shortage of workers with the skills and
                qualifications to fill those positions.\2\ The largest gap
                is in middle skills jobs, which require more than a high
                school diploma but less than a 4 year degree.
    ---------------------------------------------------------------------------
        \2\ Bureau of Labor Statistics, Job Openings and Labor Turnover
    Summary, May 8, 2018.

      6.  Postsecondary education and training is critical in today's
                economy. Almost 80 percent of jobs in the United States
                require a postsecondary credential, including certificates,
                associate degrees, 4 year degrees, and licenses.\3\
    ---------------------------------------------------------------------------
        \3\ National Skills Coalition, United States Middle-Skill Fact
    Sheet (https://www.nationalskillscoalition.org/state-policy/fact-
    sheets), February 2017

      7.  On average, those holding a bachelor's degree earn more than
                those who have not attained that degree, but those who do
                not reach that level of education can still find good
                employment. There are 30 million jobs that don't require a
                4 year degree and pay at least $35,000 per year with a
                median salary of $55,000.\4\
    ---------------------------------------------------------------------------
        \4\ Carnevale, A.P., Strohl, J., and Ridley, N., Good Jobs that Pay
    Without a BA: A State-by-State Analysis (https://goodjobsdata.org/wp-
    content/uploads/Good-Jobs-States.pdf). Georgetown University Center of
    Education and the Workforce, 2017.

      8.  Education systems have not kept pace with economic realities.
                Student success is traditionally perceived, and measured,
                as moving directly from high school to a 4 year degree
                program. Today, only 20 percent of students successfully
                complete that traditional pathway to their career.\5\ The
                rest are finding their own pathways to success, which may
                include entering the world of work or pursuing other types
                of credentials. Many, however, encounter obstacles.
    ---------------------------------------------------------------------------
        \5\ U.S. Department of Education, National Center for Education
    Statistics, The Condition of Education 2017 (https://nces.ed.gov/
    programs/coe/indicator_ctr.asp), May 2018.

      9.  On average, only about \1/3\ of high schoolers are engaged in
                school, meaning that \2/3\ are not actively involved in or
                enthusiastic about school.\6\ Three million young adults
                ages 16-24 are not participating in either work or
                education.\7\
    ---------------------------------------------------------------------------
        \6\ 2016 Gallup Student Poll Snapshot Report (https://
    news.gallup.com/reports/210995/6.aspx).
        \7\ Brookings, Employment and disconnection among teens and young
    adults: The role of place, race, and education (https://
    www.brookings.edu/research/employment-and-disconnection-among-teens-
    and-young-adults-the-role-of-place-race-and-education/), May 2016.

      10.  Additionally, many Americans start a college degree but do not
                complete it, leaving them with the burdensome costs of
                higher education but no wage benefit--35 million people
                over 25 have some college credits but no degree.\8\
    ---------------------------------------------------------------------------
        \8\ U.S. Census Bureau, Educational Attainment in the United
    States: 2017, December 14, 2017.

      11.  As students increasingly pursue indirect routes to higher
                education, over 70 percent of students enrolled in
                postsecondary education are now ``nontraditional students''
                who may be older, working full or part time, or caring for
    ---------------------------------------------------------------------------
                children.

      12.  Technology will continue to be a disruptive force in the labor
                market, driving potentially drastic changes in the labor
                demands of certain industries. It is expected that many
                jobs that will be in demand in 2030 do not yet exist.
                Workers will need to be able to acquire new skills over
                their careers to adapt to change. Up to \1/3\ of U.S.
                workers in 2030 may need to learn new skills or move into a
                new occupation due to the impacts of automation.\9\
    ---------------------------------------------------------------------------
        \9\ McKinsey Global Institute, Jobs Lost, Jobs Gained: Workforce
    Transitions in a Time of Automation (https://www.mckinsey.com//media/
    McKinsey/Global%20Themes/Future%20of%20
    Organizations/
    What%20the%20future%20of%20work%20will%20mean%20for%20jobs%20
    skills%20and%20wages/MGI-Jobs-Lost-Jobs-Gained-Report-December-6-
    2017.ashx), December 2017.

      13.  To address these issues, Western Governors have prioritized a
                variety of workforce development efforts, from better
                aligning education with labor market demands to expanding
                workforce services and training opportunities for the
                unemployed and underemployed to attracting more skilled
    ---------------------------------------------------------------------------
                workers.

      14.  Western states are also leading the way on expanding work-based
                learning opportunities for both students and adults. Work-
                based learning programs, including registered
                apprenticeships, allow people to acquire in-demand skills
                while earning a salary.

      15.  Employer leadership is critical to ensure that workforce
                development efforts are satisfying the needs of an ever-
                changing economy. Businesses in the West have taken an
                active role in working with educational institutions and
                workforce agencies but increasing industry participation
                will remain critical.
    B. Governors' Policy Statement
      1.  Western Governors recognize that there are many pathways students
                can take to a successful career, including short-term
                education and skills training or work-based learning
                programs such as registered apprenticeships. Students and
                jobseekers should have access to understand their options
                and the potential outcomes of these programs.

      2.  Facilitating lifelong learning is essential to prepare for the
                impacts of technology on the labor market. Western
                Governors encourage Congress to increase student access to
                short-term education and skills training programs in
                reauthorization of the Higher Education Act, including
                through expanding the Pell Grant program to include high-
                quality short-term training programs leading to industry-
                recognized credentials. These flexible work-force oriented
                funds should be coupled with plans to adopt and report
                outcomes metrics tied to employment and earnings to
                maximize the success of this policy in equipping workers
                for high-opportunity jobs and careers.

      3.  Western Governors also support the expansion of work-based
                learning programs, including registered apprenticeships.
                Western Governors encourage Congress and Federal agencies
                to support and incentivize state-, local-, and industry-led
                partnerships to create and scale work-based learning and
                apprenticeship programs. New Federal investments in
                apprenticeships should align with existing efforts to
                foster a coherent system with minimal duplication at the
                Federal, state, and local level.

      4.  Career and technical education (CTE) helps expose students to
                their career options and develop skills they will need in
                the workforce. Western Governors call on Congress to
                reauthorize and fully fund the Carl D. Perkins Career and
                Technical Education Act. Reauthorization of the act should
                take into consideration the following principles:

           Governors and states are in the best position to
                determine how to use Fed-
                  eral CTE funding to meet the unique needs of their
                economies.

           High-quality CTE programs should lead to in-demand, high
                wage careers;
                  include career and academic advising; include pathways to
                4 year degrees,
                  for example through articulation agreements or stackable
                credentials; and
                  develop employability skills through integrated education
                and training,
                  work-based learning or leadership opportunities.

      5.  Western Governors note that Federal funding for workforce
                development through the Workforce Innovation and
                Opportunity Act supports economic growth and job creation
                in the states. Western Governors request that the 15
                percent reserve for statewide activities be maintained.
                This funding allows Governors to be flexible in addressing
                state needs and supports innovation.

      6.  Western Governors encourage the Federal agencies, including the
                U.S. Department of Labor and U.S. Department of Education,
                to coordinate their efforts to better align Federal
                workforce development, career and technical education, and
                higher education programs.

      7.  Western Governors recognize the benefits of measuring and
                reporting outcomes by institution and program. Reporting
                completion rates, employment and earnings will provide
                useful information for students and their families and help
                promote the success of these programs to prepare students
                for in-demand jobs and careers in their regions. Western
                Governors encourage Congress to include the College
                Transparency Act in reauthorization of the Higher Education
                Act, to adopt and report on earnings, employment, and
                credential attainment metrics by education provider and
                individual program in a manner that protects student
                privacy and ensures data security.

      8.  Employers play an important role in state workforce development
                efforts. Western Governors support efforts to incentivize
                employers to play a more active role in talent development,
                through partnership with state workforce development
                agencies and educational institutions or investments in the
                skills and training of their employees.

      9.  Rural communities are at risk of falling further behind in skills
                necessary for the economy of the future due to a lack of
                broadband access. Western Governors encourage Federal
                agencies and Congress to continue to deploy resources to
                solve this urgent need.

      10.  Professional licensing requirements vary by state and can create
                a barrier to mobility for professionals in western states.
                Where possible, Western Governors should work together to
                minimize this barrier.
    C. Governors' Management Directive
      1.  The Governors direct WGA staff to work with Congressional
                committees of jurisdiction, the Executive Branch, and other
                entities, where appropriate, to achieve the objectives of
                this resolution.

      2.  Furthermore, the Governors direct WGA staff to consult with the
                Staff Advisory Council regarding its efforts to realize the
                objectives of this resolution and to keep the Governors
                apprised of its progress in this regard.

              Western Governors enact new policy resolutions and amend
            existing resolutions on a bi-annual basis. Please consult
            www.westgov.org/resolutions for the most current copy of a
            resolution and a list of all current WGA policy resolutions.
                                  attachment 3
    Policy Resolution 2017-09
    Western Agriculture
    A. Background
      1.  Agriculture and forestry in the western states and territories
                are significantly different than in other regions of the
                country. We have greater variations in soil, climate,
                terrain, commodities and production practices, and water
                availability.

      2.  Farms, forests, and rangelands are important contributors to the
                economies and quality of life of western states. Among
                other important values, western agricultural and forest
                lands are primary sources of open space, wildlife habitat,
                water supplies, and diverse rural economic opportunities in
                the recreation, food, fiber, energy and biobased product
                industries.

      3.  Trade promotion plays an important role in ensuring that western
                agricultural products and food have an opportunity to
                compete with products produced and subsidized
                internationally.

      4.  Western states have seen some of the most significant increases
                in per-capita veteran populations since 2000, including
                surges in returning veterans under the age of 25. It is
                estimated that nearly 25 percent of all veterans live in
                rural areas. These veterans have slightly lower rates of
                employment compared to veterans living in urban areas and
                to their non-veteran rural colleagues.

      5.  Responsible management of Federal lands is a significant concern
                for Western Governors. Western states include more than 75
                percent of our National Forest and rangeland ecosystems.
                These public lands serve as critical economic drivers, and
                they provide numerous conservation benefits, water supply,
                and recreational opportunities for Western communities and
                the nation.

      6.  The West's network of land-grant universities and colleges,
                including Cooperative Extension Service programs, continue
                to provide national leadership in research to develop more
                resilient seeds and crops, manage soil health, advance
                technology deployment in the biobased economy and conduct
                on-farm research experiments that help farmers and ranchers
                be more effective and efficient.

      7.  Western Governors recognize that nutrition assistance programs
                can meet the needs of children and the most vulnerable,
                while creating economic opportunity across the agriculture
                supply-chain from the store where food is purchased, all
                the way back to the farm. Western Governors acknowledge
                recent efforts to reduce rates of nutrition program fraud
                and abuse, deliver programs under budget, and improve
                program effectiveness.

      8.  Many agricultural producers in the West rely on irrigation water
                delivery systems that are shared among multiple producers
                and operated by an irrigation district, canal company, or
                mutual ditch company.
    B. Governors' Policy Statement
      1.  Western Governors support funding for the U.S. Department of
                Agriculture (USDA) Market Access and Foreign Market
                Development Programs to promote opportunities for western
                producers to increase export revenues and encourage trade
                agreements that maximize benefits for the West's farmers,
                ranchers and forest landowners.

      2.  Western Governors support adequate funding for the USDA Specialty
                Crop Block Grant Program (SCBGP) that provides critical
                research, education, and promotion tools to the fruit and
                vegetable producers.

      3.  Western States have experienced sharp declines in farm income and
                farm prices since 2013. Western Governors support a farm
                safety net that recognizes past deficit reduction
                contributions of the agricultural sector and maintains
                funding for other key commodity, conservation, crop
                insurance, research, energy, and export promotion programs.
                In particular, Western Governors note that the conservation
                title of the 2014 Farm Bill contributed to deficit
                reduction, saving taxpayers $6 billion by consolidating 23
                programs into 13, streamlining and targeting delivery to
                farmers, ranchers, and foresters. Western Governors support
                farm bill funding levels based on need rather than baseline
                budget targets.

      4.  Western Governors encourage the expansion of programs that can
                meet the unique educational, training, technical and
                financial needs of new, beginning and veteran farmers and
                ranchers and other USDA programming that can help returning
                veterans develop and expand business opportunities in rural
                communities.

      5.  Western Governors continue to support collaborative, targeted and
                voluntary conservation to address locally identified
                natural resource issues for farm, range, and forest
                resource concerns on private and public lands, such as soil
                health, air and water quality, drought and wildfire
                resilience, wildlife habitat conservation and invasive
                species. Western Governors support the role of conservation
                title programs in providing voluntary solutions to
                threatened and endangered species, water quality
                impairments, groundwater recharge, and other regulatory
                concerns potentially facing producers.

      6.  Western Governors support an increase in the role that state and
                local governments have in managing public lands for
                multiple uses, including agriculture.

      7.  Western Governors continue to urge Congress to provide a
                comprehensive solution for the current approach to
                budgeting for wildland fire for the Departments of [the]
                Interior and Agriculture. Any fire budget solution must
                address the chronic problem of the rising costs of wildfire
                and the complicating problem of mid-season budget transfers
                when appropriated funding becomes insufficient. A
                comprehensive fix is needed to address capacity constraints
                and allow for a predictable program of work for agencies to
                fulfill their management responsibilities.

      8.  Western Governors acknowledge significant progress toward
                achieving forest restoration goals by using authorities
                granted in the 2014 Farm Bill. Western Governors support
                permanent authorization of the Insect and Disease
                designation provisions of section 602 of the 2014 Farm Bill
                and the elimination of project constraints from section 603
                for condition class or fire regimes outside of the Wildland
                Urban Interface (WUI). Western Governors also support
                creating additional flexibility to Good Neighbor Authority
                to address conflicting language on road construction and
                reconstruction and the uses of program income. The lack of
                flexibility restricts opportunities for states to partner
                in shared stewardship work across boundaries.

      9.  Within the context of comprehensive wildland fire budget reform,
                existing law and forest plans, Western Governors support
                the use of new tools to streamline environmental analysis
                to increase the pace and scale of restoration activities.
                Specifically, Western Governors support creation of a new
                pilot program to prioritize landscape-scale environmental
                analysis for restoration projects envisioned over
                geographies greater than 100,000 acres. This pilot program
                should allow for predictable project-scale implementation
                and adaptive management. Western Governors believe Federal
                agencies should develop guidance to build consistency in
                environmental analysis and bring agency practice in
                conducting environmental assessments (EAs) more in line
                with the administrative policy intent of streamlined,
                summary documents. Western Governors affirm that Congress
                should resolve outstanding issues with potential
                requirements to reinitiate endangered species consultations
                following the adoption, amendment or revision of an
                appropriate management plan.

      10.  Western Governors support Congress establishing a restoration
                categorical exclusion (CE) based on a record of analysis
                from the past 5 years of projects where agency analysis and
                a decision recognized a finding of no significant
                environmental impact. Western Governors support allowing
                Federal agencies to analyze only the action and no-action
                alternatives when a project is collaboratively developed,
                unless a third alternative is proposed during scoping and
                meets the purpose and need of the project. Western
                Governors also support rewarding successful implementation
                of collaborative projects through funding, retained-receipt
                authority, or other capacity to pursue subsequent projects.

      11.  Western Governors support efforts to expand research funding to
                address drought, a changing climate and extreme weather
                risks facing western producers.

      12.  Western Governors encourage the effective use of extension and
                other partnerships to deliver practical tools, technologies
                and information to farmers, ranchers and forest landowners.

      13.  Nutrition assistance programs should continue to allow
                flexibility for states to respond to unique economic
                conditions, serve all eligible participants without
                drastically reducing benefits, and encourage continued
                pursuit of transparency and accountability in program
                administration.

      14.  Western Governors support changes to conservation title programs
                that remove existing contracting barriers for western
                producers, and make the farm bill's conservation title
                programs more accessible and relevant to western producers
                and their associations.

      15.  Western Governors support coordinated state and Federal action
                to expand markets for wood products that can achieve forest
                and rangeland restoration objectives and foster rural
                employment and income opportunities. Western Governors
                support coordinated financing and grant support from USDA
                Rural Development programs and the USDA Forest Service to
                advance wood product business development, infrastructure,
                and demonstration products in the areas of mass timber
                construction and biomass energy.

      16.  Western Governors support the USDA, Animal and Plant Health
                Inspection Service (APHIS) and Agricultur[al] Research
                Service (ARS). APHIS works in partnership with state
                departments of agriculture to monitor, prevent and control
                infestations of invasive pests and diseases and curtail or
                minimize wildlife conflicts, which can cause widespread
                environmental and economic damage and safety hazards. APHIS
                works in cooperation with other Federal agencies, states,
                territories, counties and private entities to implement
                management programs. ARS conducts research to develop and
                transfer solutions to agricultural problems of high
                national priority, and shares information to ensure high
                quality, safe food and other agricultural products. ARS
                research helps sustain a competitive economy; enhance the
                natural resource base and the environment; provide economic
                opportunities for rural communities and society as a whole,
                and; provide the necessary infrastructure to create and
                maintain a diverse workplace.

      17.  Western Governors support the continued efforts of the Rural
                Utilities Service to provide financial assistance for
                drinking water, wastewater facilities and broadband
                connectivity in rural and remote areas, particularly in
                communities that have minimal or no such infrastructure.
                Expanding broadband access to rural America will allow
                citizens to compete in a global market and have access to
                IT health care, education and public safety resources.

      18.  Western Governors support the recommendations identified over
                the course of the WGA National Forest and Rangeland
                Management Initiative, and incorporate those
                recommendations related to the reauthorization of the
                Agricultural Act into this resolution by reference.
    C. Governors' Management Directive
      1.  The Governors direct WGA staff to work with Congressional
                committees of jurisdiction, the Executive Branch, and other
                entities, where appropriate, to achieve the objectives of
                this resolution.

      2.  Furthermore, the Governors direct WGA staff to consult with the
                Staff Advisory Council regarding its efforts to realize the
                objectives of this resolution and to keep the Governors
                apprised of its progress in this regard.

              Western Governors enact new policy resolutions and amend
            existing resolutions on a bi-annual basis. Please consult
            www.westgov.org/resolutions for the most current copy of a
            resolution and a list of all current WGA policy resolutions.
                                     ______

                              Submitted Questions
    Questions Submitted by Hon. Stacey E. Plaskett, a Delegate in Congress
            from Virgin Islands
    Response from Neela Mollgaard, Executive Director, Red Wing Ignite
        Question. Ensuring reliable broadband access is clearly a crucial
    component of encouraging economic growth. Broadband is a critical
    component of our economic development and I see that you have built
    partnerships and initiatives with schools, government, businesses and
    nonprofits.
        How can we build public-private partnerships to support broadband
    infrastructure in the Virgin Islands?
        Answer. Public-private partnerships were essential to the creation
    of Red Wing Ignite. Since its inception, Red Wing Ignite forged
    partnerships with government, academia, corporate partners, and
    individuals to grow our innovative ecosystem to advance entrepreneurs,
    businesses and students.
        The launch of Red Wing Ignite was a collaboration between the City
    of Red Wing, the Red Wing Port Authority, U.S. Ignite, Hiawatha
    Broadband Communications, community leaders and funders. It took
    perseverance from local champions to make the idea a reality. Broadband
    infrastructure is essential, but so is an organization like Ignite--
    bringing opportunity, access and exposure to the skills required in the
    21st Century economy.
        In 2012, Red Wing was one of 25 cities to join U.S. Ignite's their
    national network. U.S. Ignite was initially funded by the White House
    Office of Science and Technology Policy and the National Science
    Foundation. They provided leadership and guidance on best practices to
    foster a culture to create new innovative technologies.
        In 2015, we were designated as a Blandin Broadband Community by the
    Blandin Foundation. The Blandin Foundation introduced us to the
    Intelligent Community Forum model (see image). Both of these
    organizations emphasized the importance of partnerships across sectors,
    and we saw this to be true on the frontlines of our work locally.
    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        It has been years of learning, setbacks, pivots and many wins to
    get where we are today. This format is challenging to provide an in-
    depth response to this involved question. I would encourage your local
    champions and constituents to reach out directly to learn more.
    Response from C. Blake Hurst, President, Missouri Farm Bureau
            Federation; Board Member, American Farm Bureau Federation
        Question 1. In the Virgin Islands, so many people still lack basic
    and reliable access to the Internet and our businesses cannot compete
    globally and we are unable to attract larger businesses to the
    Territory without increase broadband.
        What assistance were you able to offer for Missouri residents that
    assisted your farmers in rural development?
        Answer. A working group was created that consisted of the Director
    of the Missouri Department of Agriculture, the Director of Extension at
    the University of Missouri, the Deputy Director of the Missouri
    Department of Economic Development (DED) and Missouri Farm Bureau. The
    group met on a regular basis and planned a rural broadband conference
    open to representatives of providers, rural organizations, the public
    sector and academia. The conference created the momentum to seek a
    broadband coordinator position within DED and legislation to start a
    broadband grant program. A coordinator was hired, legislation was
    approved to create the broadband grant program and a $5 million
    appropriation was received this fiscal year. A second statewide
    broadband conference was held this summer and we expect regulations for
    the grant program to be released soon.
        Missouri's progress can be traced back to a few very dedicated
    individuals who believe broadband is critical in both urban and rural
    areas. Support from local and statewide elected officials has also been
    instrumental in our success to date. Missouri residents have benefitted
    from increased coordination between the public- and private-sectors,
    greater awareness of the need for improved access to affordable
    broadband and an intense focus on funding opportunities at the state
    and Federal level.

        Question 2. Your testimony provided a lot of insight into the
    specific impacts of broadband access and precision ag technology for
    farmers. Fixed wireless and mobile technologies have clearly played an
    important role in filling the broadband needs of farmers and rural
    communities.
        Given the lower infrastructure requirements and cost of
    implementing those technologies, has further improvement and broader
    adoption of these technologies specifically affected the ability of
    smaller farms to adopt precision ag technology?
        Answer. The decision to adopt precision agricultural technology is
    based on its return on investment. Fa[r]mers and ranchers wear many
    different hats, including owning a business and keeping the business
    profitable. If the technology will allow the farmer to be more
    efficient and have a positive return on investment, then there is a
    strong likelihood that the farmer will invest in that technology,
    regardless of farm size. The only certainty is the lack of broadband
    prevents many farmers from even considering precision agriculture
    technology because there is no reason to invest in a technology that
    won't work in your fields.

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