Letter to the Hon. Ajit Pai, Chairman of the Federal Communications Commission, and the Hon. Kris Monteith, Bureau Chief of the Wireline Competition Bureau - Tipton, Colorado Delegation Members Urge FCC to Grant Children's Hospital Colorado Funding for Rapid Expansion of Telehealth

Letter

Dear Chairman Pai and Chief Monteith:

We write to request your timely consideration of Children's Hospital Colorado's (Children's Colorado) application for the Federal Communications Commission (FCC) COVID-19 Telehealth Program, as it underscores the immediate needs of an essential health care provider in the fight against the Coronavirus Disease 2019 (COVID-19).

In response to the COVID-19 pandemic, Congress passed, and the President signed into law, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which included $200 million for a FCC COVID-19 Telehealth Program to support health care providers' efforts to address the coronavirus by providing telecommunications services, information services, and devices necessary for telehealth services.

In Colorado, there are over 10,100 confirmed cases and, tragically, 449 deaths. The number of overall COVID-19 hospitalizations in Colorado remains near record highs. Social distancing in order to quell community spread will remain vitally important across our state, and telehealth can facilitate safe access to care while limiting the spread of the virus.

While we are still learning exactly how COVID-19 affects children, it is clear that the disease threatens access to health care for the vulnerable population that Children's Colorado treats. Children's Colorado is the primary provider of care for children, adolescents, and young adults with complex pediatric illnesses in Colorado, Wyoming, Montana, North and South Dakota, western Kansas, western Nebraska, and parts of New Mexico.

As a result of the requirement to suspend elective visits and procedures, Children's Colorado is currently delaying care for approximately 1,600 procedures and 30,000 patient visits every month. The deferral of visits and procedures protects patients, health care workers, and preserves personal protective equipment (PPE). However, many of Children's Colorado patients remain chronically ill and vulnerable, requiring ongoing access to the elevated level of care available only at Children's Hospital.

Fortunately, many patients do not need to physically come into the hospital to receive that care.

Children's Colorado has already undertaken a massive mobilization of a novel treatment paradigm, growing their telehealth volume from an average of 20 visits per day in 2019 to an average of 1,200 per day now. Still, much more is needed. Children's Colorado has the potential to considerably build on this momentum, extend it further to all patients who need it, and sustain that access going forward.

Children's Colorado's goal with the requested FCC funding, if granted, is to:

-Support ongoing state-of-the-art care for children, adolescents, and young adults, especially those with complex pediatric illnesses, in a safe and effective manner that reduces their risk of exposure to COVID-19;
-Reduce exposure to family members, medical care teams, and communities in Colorado and across the region by conducting visits virtually when possible, limiting the need for travel and in-person contact; and
-Reduce the amount of PPE used during in-person visits, of which there is an ongoing shortage.

More specifically, Children's Colorado's is planning to redesign care delivery through a massive expansion of telehealth in four stages:

Mobilization: rapid expansion of secure telemedicine capacity to treat as many patients as possible in the coming months, while adapting hospital space and supporting patients/families to safely receive home-based care, all while training independent primary care providers (PCPs) on integration of telemedicine into their workplaces.

Mitigation: implementation of home-based treatment and ongoing monitoring of chronic illnesses in vulnerable populations, and expansion of telemedicine use across Emergency Department and inpatient care to limit the spread of infection and promote workforce safety.

Recovery: maintain ambulatory visit volume via telehealth, as operating rooms and procedure centers increase hours, to accommodate pent-up demand of delayed in-person visits, and incorporate provider-to-provider solutions to ensure best-practice care with collaboration between the academic medical center and community-based PCPs.

Optimization: sustain the expanded use of creative solutions, including home-based monitoring, for vulnerable populations, while growing capacity to provide scheduled and on demand telehealth visits incorporating specialist providers, primary care partners in medical homes, and patients and families.

In several weeks' time, borne out of necessity and innovation, COVID-19 has driven changes to the health care ecosystem--including the rapid scaling of telemedicine--at a rate unimaginable just a few months ago. The proposed FCC funding would help limit community spread of the virus and significantly mitigate the impact of COVID-19 on Children's Colorado's patients who are at greatest risk of poor health by implementing telehealth and other creative technological solutions to ensure continued patient access from their homes and in partnership with their community PCP.

Therefore, we encourage you to give the application submitted by the Children's Hospital Colorado every appropriate consideration consistent with all applicable laws and regulations. Thank you for your consideration, and please notify our offices of any funds awarded.