There are wide gaps in available services between those living in rural areas and those in urban areas of the Commonwealth. For those in rural areas there are many barriers to receiving a variety of services, including access to healthcare. It is common for those in the most rural parts of the Commonwealth to have no broadband access and no healthcare providers within reach. In addition, these individuals face barriers such as transportation, caretaker availability for appointments, social anxiety, and availability of specialists within a reasonable distance.

The expansion of telehealth throughout the country during the pandemic brought to light the possibilities of telehealth to break down barriers to healthcare access for individuals in rural areas and individuals with disabilities. To properly access telehealth services, broadband access is a must. Virginia has been making great strides toward providing broadband access to all. Currently, approximately 160,000 locations across the Commonwealth are without broadband access. As Virginia continues to work towards universal broadband access, it is also important to look at other options for individuals needing access to telehealth services. Community connections are the key to providing options.

Across the country, communities are working to develop options for individuals to access the healthcare that they need. Communities that have had success in creating options can serve as models for Virginia in creating its options for access to healthcare. Community anchor institutions can help to provide these services for their constituents. Community anchor institutions include schools, libraries, medical and healthcare providers, public safety entities, community colleges, community support organizations, and others. These community anchor institutions are uniquely positioned to provide information and assistance regarding access to broadband, telehealth, and other related services.

The recommendations proposed below address possible solutions to the barriers to telehealth. Implementing these recommendations would help the Commonwealth continue to move forward with telehealth and assist individuals with disabilities in accessing appropriate healthcare services.

Recommendations related to Broadband Access

1. The Department of Housing and Community Development (DHCD) should work with local communities to implement community-based options, such as use of community anchor institutions, to fill gaps in access in the near term and to provide options for access for all. DHCD should target those areas with higher percentages of individuals with disabilities and low levels of broadband access.

Recommendations related to Broadband Affordability

2. To boost enrollment in the FCC Affordable Connectivity Program, the Department of Housing and Community Development (DHCD) should partner with local Community Services Boards and disability services and advocacy organizations to effectively disseminate DHCD-prepared information to specific areas targeted by the Outreach Grant and provide assistance through the application process.

3. The Governor and General Assembly should engage Virginia’s Congressional Delegation to advocate for sustained funding of the Affordable Connectivity Program.

Recommendations related to Telehealth Accessibility

4. The Virginia Board of Health should create and implement a plan to educate telehealth service providers on current laws and standards for accommodating individuals with disabilities consistent with the Board’s authority under § 32.1-122.03:1 of the Code of Virginia. This plan should encompass various aspects, such as allowing extra time for appointments, ensuring the availability of suitable platforms that accommodate interpreters or other necessary support, and enabling remote login from a third location.

5. The Virginia General Assembly should direct the Virginia Department of Health Professions to establish and implement a continuing education requirement for healthcare professionals on best practices for providing telehealth services, including specific information on telehealth and individuals with disabilities.

6. The Virginia Broadband Advisory Council should study the innovative partnerships being developed in other states and use them to develop recommendations to the Governor’s Office for consideration for the SFY 2026 budget on how Virginia can expand broadband access through community partnerships.

Recommendations related to Digital Health Literacy

7. When updating the state telehealth plan, the Virginia Telehealth Network and the Virginia Department of Health should incorporate strategies and a plan for collaborating with community partners to offer digital literacy services to individuals who require them.

8. The Office of Broadband should include a plan for collaboration with community-based organizations and community-anchor institutions in the 2024 Digital Opportunity Plan. In addition, the Office of Broadband should collaborate with those organizations and stakeholders on implementation.

Recommendations related to Resource Requirements

9. The General Assembly should establish a workgroup to identify suitable sources of new funding or additional funding for programs that supply essential technology equipment and training in its use to support access to telehealth.

10. When updating the state telehealth plan, the Virginia Telehealth Network and the Virginia Department of Health should include strategies to increase access to resources, including using the Virginia Assistive Technology System and the Assistive Technology Loan Fund Authority.