Texas’s $3.3 billion federal grant for broadband infrastructure could improve statewide access to telehealth


Boram Kim


Last month, Texas was awarded $3.3 billion, the largest of the federal government’s $42.5 billion Broadband Equity, Access, and Deployment (BEAD) grants to states, for broadband infrastructure investments. 


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The Texas Broadband Development Office (TBDO) plans to utilize the funds to award financial grants, low-interest loans, and other financial incentives to allow internet service providers to expand access to broadband services in underserved areas.

Gov. Greg Abbott signed House Bill 9 into law earlier this year, which could invest an additional $1.5 billion into TBDO should voters approve the funding this November. 

The National Telecommunications and Information Administration (NTIA) administers BEAD with the aim of furthering the deployment and use of broadband and other technologies in America, laying the groundwork for, among other things, healthcare. 

“As the administrator of TBDO, I believe that expanding reliable access to high-speed internet presents a significant opportunity for Texas to energize local economies, provide greater access to telemedicine, increase educational opportunities, and safeguard Texas’s role as the economic engine of our nation.”

— Glenn Hegar, Texas state comptroller, press statement from March 2023

TBDO will initiate the BEAD grant application process in 2024. While details of the funding have yet to be determined, Texas officials are already engaged in plans to improve access to telehealth services at the state and local levels. 

In its last meeting, the eHealth Advisory Committee heard updates from the City of Dallas on efforts to expand free public wifi access. 

The committee also heard from the Health and Human Services Commission (HHSC) regarding the digital adoption of the state’s health information exchange.

The City of Dallas, through another NTIA grant, plans to build “middle mile” infrastructure in underserved areas where access to the internet remains a challenge without free public resources. 

“Now the middle mile infrastructure does not provide direct services to individuals in their homes, but what it does do is it provides a transport mechanism that allows for the main internet services to connect into last mile services or to those individual points.

What a middle mile infrastructure really does for the city of Dallas is it provides cost-effective connectivity for all of our facilities, but [also] for providers that can utilize the backhaul from our middle mile infrastructure to deliver much lower-cost services to the residents.

This is a mechanism that will allow for us to really bring down the costs of delivering both city services, but also delivering broadband access services directly to our residents as well.”

— Bill Zielinski, chief information officer for the City of Dallas, June eHAC meeting

More than half of residents in southern parts of the city reported not having access to broadband services, according to US Census figures. Officials aim to bridge those kinds of digital divides by making access to digital services more affordable.

The state has prioritized improving healthcare access for rural communities, where broadband access is also a challenge. The Statewide Health Coordinating Council focuses on factors that affect health equity in Texas and recommended reforms to address rural access, Medicaid enrollment, youth mental health support, and telehealth services. 

As part of its 2019 strategic health information technology plan, HHSC aims to increase HIE utilization among Texas Medicaid providers. Texas currently maintains a statewide HIE infrastructure to support connectivity with the state’s Medicaid system and assists healthcare organizations and local HIEs in connecting to HIETexas, the statewide exchange network. 

George Gooch, CEO of Texas Health Services Authority, which administers the state-level exchange services, told State of Reform that investment in broadband infrastructure across Texas can revolutionize the way medical services are delivered and accessed. 

“Broadband internet reduces barriers to efficient and secure sharing of electronic health records among healthcare providers. Instant access to patient information ensures that medical professionals can make informed decisions, reduce errors, and enhance coordination of care. This, in turn, leads to better patient management and continuity of care. Broadband connectivity also enhances the capability of Health Information Exchanges in rural and underserved parts of the state.

Health Information Exchange enables healthcare providers to more efficiently share patient data across different healthcare systems and organizations securely. This streamlined information flow helps medical professionals gain a comprehensive view of patients’ medical history, medications, allergies, and test results, leading to better diagnosis and treatment plans.”

— Gooch