Rhode Island
Despite Cox lawsuit, state officials aren’t slowing on high-speed internet program • Rhode Island Current
Rhode Island’s economic development agency is forging ahead with a $108 million high-speed internet program, despite a lawsuit from Cox Communications contesting the data used to develop the plan.
Rhode Island Commerce Corp. on Monday agreed to spend another $434,000 on its contract with international telecommunications firm Altman Solon LLP, according to Matt Touchette, a Commerce spokesperson. A copy of the agreement was not immediately available.
The company was hired in August 2023 for a $1.3 million, two-year contract to help Rhode Island meet requirements tied to various federal broadband expansion programs. That included $108 million awarded to the Ocean State through the National Telecommunications and Information Administration’s Broadband Equity, Access, and Deployment (BEAD) Program. The federal funding aims to bring high-speed internet to underserved communities in states nationwide.
Yet the data around which R.I. Commerce built its initial proposal — identifying neighborhoods where internet speeds were slower than federally accepted minimums — is under scrutiny by one of the state’s largest internet service providers.
R.I. Commerce, Cox Communications can’t connect on broadband access map
The Sept. 23 lawsuit filed by Cox Communications asks a Providence County Superior Court judge to stop R.I. Commerce from proceeding with its broadband access plan, which has already received preliminary approval from federal regulators. A final proposal, due July 2025, must also be approved in order to receive federal funding.
Cox alleges that the state’s plan relies on inaccurate and outdated broadband maps, which incorrectly classified 30,000 homes statewide, including affluent areas in Newport and Westerly, as “underserved communities” in need of broadband access. Cox contends that it already provides high-speed internet to these areas, accusing the state of mismanaging federal funding at the expense of residents who truly need broadband access.
Touchette said in an interview on Monday that the increase in funding for Altman Solon is unrelated to the pending lawsuit. Instead, Touchette pointed to new and updated federal requirements for the BEAD program as reason for “cost overages” beyond what the existing contract envisioned.
For example, federal regulators recently released new guidance for states on incorporating low-Earth orbit (LEO) satellites into their plans. The satellites are typically used to bring internet to remote or otherwise inaccessible locations, and are not expected to significantly change Rhode Island’s existing plan, according to Touchette. In order to qualify for full federal funding, the state has to incorporate the new rules regarding LEO satellites anyway.
To Karl Wadensten, a Commerce board member, the extra funding to Altman Solon is a no-brainer.
“Either you’re going to spend the money on the contract, which gets offset when you get the $108 million, or you don’t spend it and you don’t qualify for federal funding,” Wadensten said in an interview on Wednesday.
Underlying the expense is the lack of in-house expertise among state officials to comply with the avalanche of federal requirements. Wadensten suspects Rhode Island is not alone in this.
“No one in Rhode Island knows how to do this, but I don’t think anyone in any of the states knows,” Wadensten said.
Charlie Meisch, a spokesperson for the National Telecommunications and Information Administration, said the BEAD program was intended to be flexible based on the “changing realities that states are facing.”
“We continue to issue guidance and technical assistance to support the states in this important program, and one of our ongoing top priorities is equipping the states with the tools they need to run a successful grant program,” Meisch said in a statement Wednesday.
Calling in the experts
Anticipating the wave of federal funding available for broadband programs, Rhode Island lawmakers passed legislation in 2022 to create a state broadband coordinator position and a complementary, 12-member advisory panel. Mark Preston, vice president of construction in the eastern region for Cox, is one of the members on the broadband advisory council.
Former state Rep. Deborah Ruggiero, who sponsored the 2022 bill and sits on the state broadband advisory council, said it was unrealistic for the state broadband coordinator to handle all elements of Rhode Island’s broadband plan alone.
“The federal regulations apply the same to every state in the country,” Ruggiero, a Jamestown Democrat, said in an interview Wednesday. “Virginia has 20 staff devoted to broadband. Maine has eight. We have two people within Commerce.”
Hence, why Commerce sought outside expertise to develop the state’s broadband infrastructure plan, including developing and implementing the components of its BEAD program.
Altman Solon, selected through a competitive bidding process, describes itself as a leading international telecommunications, media and technology strategy consultant firm, with its own proprietary network planning tool to help internet service providers and state governments expand broadband coverage and comply with federal funding requirements.
Swope Fleming, a partner in Altman Solon’s Boston office, declined to comment on the firm’s work for R.I. Commerce when reached by phone Wednesday.
No one in Rhode Island knows how to do this, but I don’t think anyone in any of the states knows.
– Karl Wadensten, R.I. Commerce board member
The original, August 2023 work order does not specifically mention mapping in the scope of company work, but requires the firm to help identify and plan for how to serve neighborhoods in need of expanded broadband access.
Cox in its lawsuit alleged the state erred in its mapping, relying on consumer-reported, free speed tests through a company called Ookla, that were “layered” over existing federal broadband information for Rhode Island. However, no one, including Cox, has actually seen the data used to create the state broadband maps, which do not align with the company’s own data or other publicly available resources, according to the lawsuit.
Not for lack of trying. Cox submitted a public records request for the information, but was told it would take 3,440 hours for R.I. Commerce to compile and review, with a corresponding $52,000 cost for labor.
Without this information, Cox maintains it did not get a fair chance to protest the state broadband maps during the 38-day public challenge period, which ended July 6. The internet provider also said it did not have time to run the 105,000 speed tests needed to formally challenge the map based on the state requirements.
The extra funding for Altman Solon’s contract also covers the cost to respond to information requests from internet service providers, Touchette said. He did not directly name Cox or the lawsuit in his explanation.
“We attempt to be maximally responsive to any information request we receive, and we want to be sure our responses are technically sound,” Touchette said. “This is true at all times but was especially prudent given recent events.”
Touchette previously refuted the claims made by Cox in the lawsuit, in turn accusing the company of trying to undermine the state’s broadband infrastructure rollout plan because it could help competing internet service providers.
Ruggerio labeled the lawsuit a “PR stunt.”
“The NTIA has indicated the process was fair, equitable and transparent,” Ruggiero said. “Cox was at the meetings; they know exactly what the process was. Now, they are having a temper tantrum because they can’t get all of the $108 million that’s coming to Rhode Island.”
“There’s no harm to Cox,” Ruggerio continued. “They are free to bid like every other vendor.”
Regardless of Cox’s intentions, it’s possible state broadband maps could look different than what Cox’s internal data suggests, said Don Nokes, president and cofounder of IT services firm NetCenergy. That’s especially true for “last-mile” physical infrastructure that connects the larger network to an individual home or business.
“The last mile map is constantly being updated,” said Nokes, whose Warwick-based company helped develop last-mile infrastructure plans for several area colleges and universities. “It’s a moving target. If two different people are collecting the data, they are not going to be in sync.”
Bill Fischer, a spokesperson for Cox, reiterated the company’s concerns over “inaccurate and manipulated” maps and data in a statement Wednesday.
“We have significant concerns about how Commerce is spending these precious one-time federal dollars to build redundant broadband internet infrastructure in some of Rhode Island’s wealthiest communities,” Fischer said. “We’ve made several requests for the rationale and data they used to make their determinations since their mapping contradicts our network’s capabilities and our own speed test results as well as the FCC’s National Broadband Map – but we have been rebuffed each time.”
Cox is the fifth-largest internet service provider and largest private broadband company nationwide, serving 7 million homes and businesses across 18 states. In Rhode Island, it competes primarily with Verizon, as local internet service providers have largely disappeared, although Block Island began its own municipal broadband service in 2023.
The lawsuit in Providence County Superior Court remains pending, according to online court records.
Updated to include comments from former state representative Deborah Ruggiero and spokespeople for Cox Communications and the National Telecommunications and Information Administration.
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Rhode Island
Experiencing low back pain? Clinical trial at Brown Health could help.
The injection could be “revolutionary” for treating degenerative disc disease, said the trial’s principal investigator
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A clinical trial at Brown University Health to treat chronic low back pain with a one-time, non-surgical injection treatment is seeking to enroll patients in Rhode Island.
The trial is testing whether a single injection of rexlemestrocel-L, an experimental stem cell therapy derived from healthy adult donors, combined with hyaluronic acid, a gel-like substance found in the body’s joints, and delivered directly into the damaged disc, can provide prolonged relief for low back pain.
Low back pain, or degenerative disc disease, can affect quality of life, disrupt daily activities, commission people out of work and have an impact on a person’s mood, said Alexios Carayannopoulos, chief of physical medicine and rehabilitation at Rhode Island Hospital, Newport Hospital and Brown Health Medical Group and the principal investigator in the trial.
The treatment Carayannopoulos is investigating involves an injection without the need for an incision or hardware. While other treatments, such as anti-inflammatory pills, physical therapy or steroid injections, assuage the pain, they don’t treat the underlying issues with the damaged disc. The trial’s injection aims to do more than numb pain: it seeks to change the environment inside the disc, reducing inflammation and potentially slowing or stabilizing disc degeneration, according to Carayannopoulos.
Earlier clinical trials of the injection with over 400 patients “found substantial pain improvements” lasting up to two to three years, according to Carayannopoulos. They also showed signs that the injection slowed disc height loss.
Carayannopoulos reckons the treatment could be “revolutionary” for managing chronic low back pain.
“We have struggled through many years trying to figure out the holy grail for treating back pain,” Carayannopoulos said.
There are surgical options and non-surgical options for treating low back pain. In most cases, the non-surgical options are sought first, but some patients still get unnecessary surgeries, according to Carayannopoulos.
The new treatment could also cut back on the use of opioids, which for some patients can be addictive to the point of overdose. More than half of opioid prescriptions are for low back pain, according to Carayannopoulos.
“If we can identify a treatment that has long-term promise, then we can sort of have a paradigm shift in the way we organize and treat a cohort of patients with degenerative disc pain, which is one of the common contributors to low back pain,” Carayannopoulos said.
Carayannopoulos did not have data on how many people suffer from low back pain in Rhode Island, but based on the number of spine centers in the state and anecdotal evidence, he reckons there is a significant number of people with the condition.
“Part of that comes from some of the legacy of blue-collar work that’s being done, industry stuff, line work that’s still being done, some jewelry business. But the type of stuff that we see is often degenerate, meaning it’s happened over time,” he said.
The trial is funded by Mesoblast, an Australia-based medicine company specializing in inflammatory diseases. It is designed for adults 18 years and older who have experienced chronic low back pain for at least six months, have been diagnosed with degenerative disc disease and have not found relief from other treatment options.
The trial is recruiting participants at Rhode Island Hospital and Newport Hospital. They will not be charged for participating and will be reimbursed for time and travel, according to Brown Health. To inquire about the trial, call 401-793-9177 or fill out a pre-screening information form online.
The trial is in its third phase, where researchers and clinicians are comparing results with a larger group of patients. It will be followed by a fourth phase, which will seek FDA approval to monitor long-term effectiveness and safety.
Rhode Island
R.I. legislative commission recommends medical school at URI, suggests $20m in ‘seed funding’ – The Boston Globe
“It’s clear that enabling Rhode Island students to more affordably enter the primary care field, and supporting them once they make that choice, is both feasible and necessary,” Lauria said.
URI President Marc Parlange, also the commission’s co-chairman, said the medical school would be a “natural and strategic extension” of URI’s work. “It would help address Rhode Island’s primary care shortage while strengthening our state’s economy,” he said in a statement.
Lauria said the commission is calling for the state to provide $20 million in “initial seed funding” for the medical school in the state budget for fiscal year 2027, and $22.5 million in annual state funding beginning in 2029, when the first class of students would arrive. The commission also recommended the General Assembly create “a dedicated, recurring budget line to support ongoing medical school planning, accreditation, and initial operational activities.”
In an October report, the Tripp Umbach consulting firm told the commission the school’s start-up costs would total $175 million, and the commission called for exploring federal grants, a direct state budget appropriation, and a statewide bond referendum.
The consultants projected the medical school would be financially stable by its third year of operation, with costs offset by tuition revenue, clinical partnerships, and research growth. And the consultants projected the school would end up generating $196 million in annual economic activity, support about 1,335 jobs, and contribute $4.5 million in annual state and local tax revenue.
During a Rhode Map Live event in June, some officials called the medical school proposal a distraction from addressing the immediate need to provide more financial support and to improve the shortage of primary care doctors.
“In terms of the problem we face today, that won’t fix it,” Attorney General Peter F. Neronha said at the time. “As the head of Anchor [Medical Associates] said to me when I talked to him, that’s like telling the patient that the inexperienced doctor will be with you in a decade.”
But Lauria said the Senate is pursing short-term, medium-term, and long-term solutions to the shortage of primary care doctors, and the medical school is a long-term solution.
In the short term, Lauria said legislators pushed to speed up a Medicaid rate review aimed at boosting reimbursements for primary care doctors. And she noted the Senate passed legislation prohibiting insurers from requiring prior authorization for medically necessary health care services.
Lauria, who is a primary care nurse practitioner, said Rhode Island is lagging behind other states in Medicaid reimbursement rates. For example, she said, she practices medicine in East Greenwich, but if she did so 23 miles away Massachusetts, she could make 20 percent to 30 percent more.
Senate President Valarie J. Lawson, an East Providence Democrat, noted if the Legislature doesn’t act now on a public medical school, it might be having the same conversation in a decade, she said.
Lawson said her own primary care doctor is retiring at the end of March. “We know that we need to recruit physicians here and we need to retain them,” she said.
The commission report acknowledged that a URI medical school would not solve the state’s primary care problem. “Educating more clinicians is necessary but not sufficient for increasing supply,” the report states.
Doctors tend to stay where they train, so Rhode Island must have a plan to produce more primary care doctors through a residency strategy that incentivizes training more primary care doctors and trains them in places such as community health centers, the report states. Appropriate payment for primary care, reduced administrative burdens for clinicians, and lower uninsured rates could also be considered.
The commission called for creating a Primary Care Commission “to ensure continued focus on achieving a primary care–oriented system of care.” The commission also called for the development of a scholarship program linked to a minimum five-year obligation to local primary care practice.
The commission voted 15-0 in favor of the report. Senator Thomas J. Paolino, a Lincoln Republican on the commission, said, “The importance of this issue cannot be understated. My colleagues and I continually hear from constituents frustrated by skyrocketing healthcare costs, severe workplace shortages, and especially limited access to primary care.”
The commission began its work in 2024 when then-Senate President Dominick J. Ruggerio named 21 people to the panel. In February 2025, the Joint Committee on Legislative Services approved $150,000 for a feasibility study. Tripp Umbach made a presentation on its draft of the report in May.
Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him @FitzProv.
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