Re: An orderly approach for lifting the "freeze" on higher powered land mobile operations in the 460-470 MHz Band
Liberty Place, Suite 700
325 Seventh Street, NW
Washington, DC 20004-2802
(202) 638-1100 Phone
Tuesday, September 23rd 2003
Mr. John Muleta
Wireless Telecommunications Bureau
Federal Communications Commission
334 12th St., SW
Washington, DC 20554
Dear Mr. Muleta:
On behalf of the American Hospital Association’s (AHA) Task Force on Medical Telemetry, I am writing to ask for a prompt and orderly approach to the lifting of the current freeze on the licensing of the 460-470 MHz band for high-power land mobiles. With the Commission’s anticipated date for consideration of such action fast approaching, it is critical that an orderly process be established to avoid the real and significant potential for harmful interference to critical care wireless medical telemetry systems that remain in this band.
In June 2000 the Commission created the WMTS Radio Service in the 608 – 614 MHz and 1.4 GHz bands, and announced its intention to “lift the freeze on high power land mobile applications in the 460-470 MHz band within three years from the effective date of final rules in this proceeding [i.e., October 16, 2003].” At that time, the Commission declined to accept the AHA’s proposal for a five-year transition period before the freeze would be lifted, noting, among other things, that “[e] quipment is already available to operate in the 608-614 MHz band we are allocating in this proceeding, and equipment to operate in the other bands allocated in this proceeding should become available over the next two years.” The specific allocation for the WMTS, and the rules governing the use of that allocation by the WMTS and its “neighbors,” remained in flux for more than two years; indeed, the rules governing the re-aligned 1.4 GHz allocation, the so-called “other bands,” by the WMTS, telemetry and other land mobile users, were not finalized in WT Docket No. 02-8 until August, 2002. Although WMTS equipment operating in the 1.4 GHz band is available in the market from competitive sources, such equipment was not, as the Commission expected, generally available within the two-year window cited by the Commission. Because hospitals require long lead times for budgeting purposes (government-funded hospitals need even more time), the delay in the widespread availability of equipment in the new bands has had a significant impact on many hospitals’ consideration of new system purchases.
In addition, the nation’s economic problems have adversely affected capital spending in all sectors, especially in health care. As government funding for health care has been strained, the funds to upgrade medical telemetry systems that might reasonably have been predicted in June 2000 have not been available to hospitals who of necessity must allocate scarce capital to meet a variety of medical needs and new government mandates.
We are sure you agree that no one will benefit if widespread interference to medical telemetry services results from the premature use of this band by higher-powered land mobile systems. We are also sure that neither the Commission nor the land mobile community is eager for a replay of the public relations problems created by the undisciplined introduction of HDTV signals in the 174-216 MHz band in 1998 that ultimately led to the creation of the AHA Task Force and the cooperative development of the WMTS allocation.
Fearing that the anticipated transition out of the 460-470 MHz band had not been completed, the AHA polled its members to determine the number of hospitals that have not yet been able to move, or to make arrangements to move, out of the 460-470 MHz spectrum. More than 165 hospitals, from large urban medical centers and regional facilities to smaller hospitals in less populated areas, advised us that they have not been able to move to frequencies now allocated to the WMTS. Many reasons were cited: the lack of adequate available spectrum in the 608-614 MHz band; the inability to adequately analyze the newer equipment in the 1.4 GHz band during the appropriate budgeting cycle; the lack of engineering resources to transition all required systems on a timely basis; and, in many cases, simply the lack of economic resources at a time of significant strains on health care services budgets. Indeed, given the current budgetary crunch, many hospitals cannot be sure that they will be able to move frequencies for up to a year, and perhaps longer. The survey indicates that there is no particular geographic limitation to the hospitals affected; the problem exists nationwide. And while we had hoped that the affected hospitals might be concentrated at one part of the frequency band, in fact there seems to be no particular area within this band that is under-populated with these systems. Simply stated, a lifting of the freeze in any geographic location and in any part of the band without close coordination with these affected hospitals has the potential to create interference to existing medical telemetry systems.
We recognize that the land mobile community is eager to obtain the full utilization of this band, and to allow the increased power levels that would be authorized upon the lifting of the freeze. On the other hand, a number of Commission actions since the freeze was first imposed, including the allocation of additional spectrum in the 1.4 GHz band, the auctioning of substantial amounts of spectrum in the 700 MHz band, and the opening of the entire 450-460 MHz band to higher-power operations, at least has had some positive effect in lessening the strain on existing land mobile allocations.
Balancing these competing interests, we believe an orderly transition can be implemented that will accommodate the interests of both the health care and land mobile constituencies, at least in part. As the Commission has not yet announced any process for lifting the freeze on accepting higher-power applications in the 460-470 MHz band, we urge the Commission’s expeditious consideration and adoption of the following approach:
As soon as it determines it is appropriate, the FCC should announce its intent to lift the freeze on accepting applications for high-power operations in the 460-470 MHz band starting six months after the announcement is made.
During the first five months after this announcement, the AHA, in conjunction with the FCC and the Food and Drug Administration, would notify all hospitals of the need to register their geographic location and the channels they are using in the 460-470 MHz band with the American Society for Health Care Engineering (ASHE), the database administrator for the WMTS.
Beginning in the sixth month following the FCC announcement, land mobile coordinators would be authorized (with payment of appropriate fees designed only to cover ASHE’s costs for such searches) to access and search the ASHE database as part of the function by which they would coordinate the higher-powered land mobile use of the 460-470 MHz band ; using a 40 mile protection distance between the land mobile base station and any hospitals registering systems in the WMTS, the coordinators would assign channels for higher- powered land mobile operations only on channels in the band that would not create co-channel or adjacent channel interference to a hospital that registered its operations in the 460-470 MHz band.
Hospitals registering their 460 MHz systems with ASHE will be obligated to notify ASHE promptly after they have terminated their use of any channels in the 460 MHz band, and the AHA will continue to encourage all medical facilities to move to the WMTS channels as soon as practical. Beginning with the 18th month after the FCC’s announcement, to the extent that no better alternatives were available, the land mobile coordinators would be authorized to utilize a 20 mile protection distance, and any hospital experiencing interference would be required to work directly with those land mobile licensees who are licensed in their geographic area to mitigate such interference, but without any recourse to require any changes to the land mobile licensee who is operating within its licensed parameters.
Following the 30th month after the FCC announcement, land mobile coordinators would be authorized, using good engineering analysis, to license any available frequency without reference to the existence of wireless medical telemetry systems remaining on channels in the 460 MHz band.
The AHA proposal allows for a fully informed coordination between the land mobile community and existing wireless medical telemetry systems; provides reasonable assurance that, in the short term, significant amounts of interference to registered hospitals will be avoided; and allows the entire band to be utilized by high-power land mobiles to some degree throughout the nation, with a very small likelihood that in any geographic area land mobile licensees with a real need for higher-powered operations in this band will not be able to be accommodated. Most significantly, this approach allows for an orderly transition of medical telemetry systems out of the 460-470 MHz band in a fashion that is more consistent with the Commission’s expectations regarding the availability of equipment in the 1.4 GHz band when it first announced its intention to lift the freeze in 2000.
We are available to discuss our ideas with you and your staff at your earliest convenience. Thank you for your consideration.
Executive Vice President
 Amendment of Parts 2 and 95 of the Commission's Rules to Create a Wireless Medical Telemetry Service, ET Docket No. 99-255, PR Docket 92-235, Report and Order, 15 FCC Rcd 11206, at para. 57 (2000)(the “WMTS Order”), at para. 65
 See WMTS Order, at para. 64 (emphasis added)
 The number of reporting hospitals, of course, is likely just a subset of the number of hospitals that may be affected by a premature lifting of the freeze. While the AHA represents nearly 85% of all U.S. hospitals, there are hospitals that fall outside AHA membership that could be affected. Also, many hospitals are so severely affected by budget issues that they did not have the time, resources, or expertise to even respond to our informal survey.
 Indeed, many hospitals indicated that they will have very little, if any, funding for new medical telemetry systems in the foreseeable future, and asked the AHA to convince the FCC to maintain the status quo for a much longer period than we are proposing in this letter.
 This six-month period is actually shorter than the notice period provided in June 2000 when the FCC lifted the freeze on higher-powered land mobile use of the 450-460 MHz band, a band in which there was virtually no remaining wireless medical telemetry use. See DA 00-1360, released June 29, 2000. In that case, the Commission set a date after which coordination could begin approximately one month before the first date on which applications would be accepted for filing.
 The AHA has previously reached out to the Land Mobile Communications Council (“LMCC”) for support for an orderly lifting of the freeze. While not prepared to support the various proposals outlined to them, the LMCC expressed a strong commitment to the type of frequency coordination effort already being undertaken with reference to the 1.4 GHz band as the most efficient method of avoiding harmful interference in this band as well.