Most rural hospitals have fallen on hard times — but not in Atchison.


Atchison General Hospital has seen a growth in the number of patients it served in recent years, and the hospital has even been planning to grow, buying the assets of a shuttered facility in Horton.


But there is at least one barrier still remaining, according to assistant city manager Justin Pregont: broadband internet connectivity.


While the hospital, like the city itself, is served by AT&T and Vyve Broadband, they both use one set of cables.


That means if there is an outage, both the hospital and Atchison residents alike are in trouble if they’re looking to get online. And residents say they are unhappy with the customer service provided by AT&T, while fear about a lack of competition looms.


The city does have a base level of broadband service, Pregont acknowledged, which is not true of smaller communities in the area.


But there are some parts of town that are not served and the area has found that it is too big to seek out many funding opportunities to beef up connectivity.


"The problem is [Atchison] is not really big enough to attract big investments outside of major anchor institutions," Pregont said. "But we’re too small to receive any provider of last resort subsidy ... We kind of exist in this donut hole."


To resolve this, the city, alongside Atchison County and Rainbow Communications, applied for a Connectivity Emergency Response Grants — a program set up by the state using $50 million in federal CARES Act funds to address broadband issues throughout the state.


Some counties, including Atchison, also opted to use some of their county allotment of CARES Act funds to help communities who lacked service before the pandemic.


The irony is that money, which only would have come about because of COVID-19, is being funneled into solving a problem which the pandemic has laid bare.


"In my business, the silver lining of the COVID virus has been that everyone realizes that broadband is super important and wants to do things about deploying it," said Catherine Moyer, CEO of Pioneer Communications, a Ulysses-based provider.


Anywhere from 20% to 30% of the state’s rural population lacks access to basic broadband service, which the Federal Communications Commission defines as a 25 megabits per second download speed and a 3 mbps upload speed, according to Stanley Adams, director of the state’s Broadband Initiative.


And issues also exist in urban areas for residents who lack the ability to afford high-speed internet or are less digitally literate.


But the true scope of the state’s rural broadband problem is still an open question. Part of the problem is that good data is hard to come by.


"We need a set of facts we can all agree to," Adams said.


While the FCC reports which areas theoretically have coverage, that data is based off of what is called the Form 477, which experts agree is unreliable because it uses Census blocks to report coverage.


If one household has sufficient broadband in a given Census block, which in western Kansas can be sizable, the entire block is registered as having minimal connectivity when that could be far from the case.


"Here locally we could come up with a lot of examples of people who aren’t getting minimally acceptable service, even though that is what is reported in the databases," Pregont said.


In an attempt to rectify that, the state partnered last year with Connected Nation, a Kentucky-based nonprofit, to develop a more accurate map than what can be compiled based on federal data.


The result, the Kansas Broadband Map, is not perfect, some say, as it relies on data self-reported by internet service providers — not all of whom wanted to participate.


But it gives a better baseline for what the scope of the state’s problem actually is, according to Brent Legg, ConnectedNation’s vice president of government affairs.


Looking at the map, Legg says, underscores a truth about broadband in Kansas: It isn’t just far-flung farms that lack connectivity but also homes in relatively populated areas, like Dodge City, Liberal and even Atchison.


"You could have the biggest impact, the biggest bang for your buck, if you focus on those areas that have been identified as unserved but have a relatively high household density so you can knock out more locations," Legg said. "If you focus in … on those areas on the map, you’re going to be able to impact a lot of households in short order."


The goal is for more communities across the state to look like Pittsburg.


While the city had decent internet coverage six years ago from Cox, many residents weren’t satisfied. Jay Byers, Pittsburg’s assistant city manager, said that he even toyed around with starting a municipal broadband company, just to provide competition.


But then two smaller providers expanded offerings into the city. Soon, the Kansas Fiber Network, a statewide coalition of providers, ran cable through town. And then new competition forced Cox to improve their service, as well.


"We’ve had an explosion of internet options within the last six years," Byers said, noting that every household in Pittsburg has access to 1 gigabyte internet service at home.


But not everyone in the city has access to that opportunity. Byers said that many families could not afford even the more basic internet packages available, squeezing them out of the economic development that has followed the rising broadband speeds.


That’s why Pittsburg opted for a different state grant program: A separate, $10 million pot of money, also powered by the CARES Act, which is intended to help boost service to low-income communities.


The city’s plan is to scale up its Citizens Broadband Radio Service, a private cellular network that is increasingly being used to replace last-mile fiber networks.


The city and school district could then distribute equipment to the 1,500 families that qualify for free or reduced-price lunches, giving students access to the cellular network and thus instruction, both during the pandemic and well into the future.


Byers said they believe the project is so important that the city is willing to build it out themselves if they don’t get the grant.


"Internet has the chance to leave some parts of your population behind," he said. "And ... I really think we’re going to be able to reach out to them and provide them those resources so that they are able to participate in some of the economic growth that we’re experiencing here."


It is not unusual for government funds to be used to support projects like those in Atchison or Pittsburg. But having it happen all at once presents a major opportunity for rural Kansas, advocates say.


"This may be one of those once-in-a-lifetime opportunities," said Mary Jane Stankiewicz, executive director of the Communications Coalition of Kansas.


But there is at least one major barrier that could prevent this opportunity from being realized: time.


Like all other CARES Act expenditures, the federal relief funds must be spent by Dec. 30. But unlike other line items, like purchasing personal protective equipment, broadband projects require extensive planning and construction.


The Department of Commerce will render a decision on which projects will receive grant money by mid-September, meaning it will be off to the races for those approved to get them finished by the end of the year.


Adams said that this fact has been built into the process, with applicants judged in large part on their ability to quickly turn the project around.


But how many projects can achieve that remains to be seen, with permitting and engineering difficult on such a short timeframe. That’s on top of supply chain delays globally that have made accessing raw materials a much tougher challenge.


Moyer said Pioneer Communications had their plate full with projects already, including one in Garden City that might include CARES Act funds.


Adding these additional headaches didn’t make sense, she said.


"You put all these things together and unless you had something ready to go that would qualify, you were in a really heavy ask of all of your resources," Moyer said.


But if the state wants to spur economic growth and reverse the downturn brought on by COVID-19, broadband might be the kind of investment that will pay for itself.


Byers said that over half a billion dollars in investment has come into Pittsburg in the last seven years — dovetailing with the increased connectivity in the city.


While rural communities have selling points for businesses, they also need to offer the kind of connectivity that modern commerce demands, Byers said.


"If you can’t provide the broadband that people are wanting and needing and what has really become an essential part of business operations, then you have a really difficult hurdle to overcome," he said. "You have to add that hurdle to all the other ones. In Pittsburg that hurdle doesn’t exist ... It is easier for them to come in."