PROGRAM EVALUATION Prepared For The Budgetary Responsibility Oversight Committee Distance Learning and Telemedicine September 2003 Russell W. Hinton, State Auditor Performance Audit Operations Division 254 Washington St., S.W. Department of Audits and Accounts Atlanta, GA 30334-8400 Introduction While this report discusses distance learning and telemedicine, the focus of the evaluation is on the Georgia Statewide Academic and Medical System (GSAMS). GSAMS, as explained in detail on pages 5 & 6, is a video conferencing system, which has many applications but is used primarily for distance learning and telemedicine. The purposes of distance learning and telemedicine are provided below, but the key element of each is that all distance learning and telemedicine interaction occurs when the participants are separated by location. Distance learning: The purpose of distance learning is to provide greater access to quality education courses that allow individuals to attain their educational and enrichment goals at a distance. Telemedicine: The purpose of telemedicine is to improve patient care by providing greater access to medical consultations to individuals in remote locations. GSAMS and its distance learning and telemedicine applications are discussed throughout the report. In addition, other technologies used in distance learning and telemedicine are discussed as well as the overall distance learning environment in Georgia. Distance Learning Background As indicated in professional literature, rapid technological advances have made distance learning and telemedicine increasingly accessible. In the past decade, these advances have resulted in a significant growth in distance learning. For example, one publication states that 23 million students were enrolled nationally in distance learning courses in 2002, up from 710,000 in 1998, with 15% of all 2002 higher education students taking distance learning courses, up from 5% in 1998. There are three commonly identified elements of distance learning according to professional publications: The instructor and students are geographically remote from each other; Educational media including television, radio, CDs, or Internet technologies are used; and, Two-way communication between teacher and learner may occur using the mail, the telephone, desktop video, computer conferencing technologies, or the Internet. A wide variety of distance learning technologies are used by Georgia's state agencies, public and private schools, hospitals, and other organizations. These include Internet-based technologies, satellite communication systems, video conferencing networks, as well as telephones, fax machines, and printed or pre-recorded media (i.e., audio recordings and videotapes). No single technology is best for distance learning, and many distance learning activities involve some combination of the four media groups listed below in Exhibit 1. Exhibit 1 Distance Learning Instructional Media Medium Employed Voice Video Interactive Applications (2-way communication) Internet, Telephone, Audio Conferencing Passive Applications (1-way communication) Audio Cassette, Radio, CD, Voicemail Internet, Video Conferencing Video Cassette, CD Data Print E-mail, Internet None Fax Various media such as textbooks, CD, Fax Source: Professional publications. Within each media group, there are a variety of distance learning technologies available and depending upon the technology used, distance learning may take place in real-time or delayedtime. Real-Time (Synchronous) Communication: all parties participate at the same time. If a distance learning class uses a synchronous technology, a student must attend at a specified time. Forms of synchronous delivery include traditional classroom sessions, audio and video conferencing, or chat rooms where students communicate via the computer at the same time but from different places. Delayed-Time (Asynchronous) Communication: interaction between teacher and learner occurs at different times. For example, delayed-time communication occurs when an instructor posts lecture material on a website for students to access at a later time. Web-based courses, e-mail, list serves, voicemail systems, audiocassette courses, videotaped courses, and correspondence courses are all forms of asynchronous communication. Each type of technology has its strengths and weaknesses as seen in Exhibit 2 on page 3. Page 2 Distance Learning and Telemedicine Method of Delivery Broadcast Exhibit 2 Distance Learning and Telemedicine Technologies (1) Technical Application Description Strengths Weaknesses Satellite Transmissions Is not interactive a limited degree of live interactivity can be achieved using online chat software, or using a telephone bridge. Each site must have a satellite up- Satellite signals are down-linked from orbiting satellites and transferred into a viewing room. It is usually a one-way video High quality picture. Can deliver information to multiple sites at once. No distance limits in the continental US (requires link in order to have two-way interaction. Up-link transmitters and satellite transponder time are very expensive. and two-way audio more than one satellite to One-way video link uplink- If the system. reach other continents). video source is not co-located at the uplink site, then an additional network is required and that is an additional cost. Weather and Sun Spots can have major effects on the received signal. Microwave Transmissions Two-way audio/video technology that uses line of sight microwave dishes to transmit signals. Real time interaction. High broadcast quality picture. New technology permits non-line-of-sight. transmission. New rules will most likely permit two-way voice and data transmission. Weather has a major effect on signal. Terrestrial microwave interference is a problem. Multiple sites can receive the same broadcast, but not two-way. Distance limit of 20 miles (can be extended with retransmission). Internet / World-Wide-Web Near Real-time interaction Computer and Internet based transmissions (e.g., media files, internet conferences, Uses the global Internet. Information can be delivered either through two-way audio/video technology or in pre- packaged programs that can be downloaded as and instant feedback with online chats. Can incorporate multimedia. Flexible. Convenient. Can deliver information to Problems getting conferences through firewalls. Some networks cannot move information quickly enough, which negatively affect audio and video quality. Troubleshooting more difficult. and streaming video) files or as streaming multiple sites at once. Internet viruses, time of day, etc. video. Internet accessibility is affect network connection reliability relatively inexpensive, or and audio / video quality. free. Telecommunication Videoconferencing Lines (e.g., GSAMS) A combination of phone lines, cameras, and microphones for video and audio transmission to one or more sites. Participants at one location can see and hear others at other locations. Provides high degree of live interaction. High reliability of connection. Can deliver information to multiple sites at once. Higher video and audio quality than what is currently supported on the public Internet. Requires a detailed level of practice and training for instructors and facilitators in order to make the telephone connections within the short period of time between classes. Operation can be expensive. Dedicated Room- Not very portable. Pre-Recorded Media Audiotapes / CDs Videotapes / DVDs Cassette tapes or CDs are used to deliver lectures, panel discussions, or instructions. Useful in courses that require inflection, such as foreign languages or those for non-readers. Videotapes or DVDs are used to deliver lectures, panel discussions, or instructions in both an audio and video format that facilitate distance learning. Low cost. Easily accessible. Easily duplicated. Easy-to-use format. No visual cues. No interaction. Requires hardware. (1) All the technologies listed in this exhibit can be used in distance learning, but only select technologies, such as video teleconferencing and computerbased applications are used for telemedicine. Source: Interviews with distance learning professionals and review of trade publications. Distance Learning and Telemedicine Page 3 As shown in the preceding page, several of the technologies are video-based (e.g., satellite, video conferencing, and video tapes). These technologies can be described based on the interactivity they provide. Exhibit 3 illustrates these different video technologies based on the direction of the video and audio signals. Exhibit 3 Distance Learning Video Technologies One-way video and audio (Video Tapes) One-way video and two-way audio (Satellite Broadcast with Teleconferencing) Two-way video and two-way audio (VideoConferencing) Source: University of South Florida's Center for Instructional Technology. Distance Learning in Georgia Each of the three primary education agencies in Georgia the Georgia Department of Education (DOE), Department of Technical and Adult Education (DTAE), and the Board of Regents for the University System of Georgia (Regents) - have their own distance learning programs and initiatives to address the needs of their target populations: Page 4 Distance Learning and Telemedicine DOE: The Georgia e-Learning Program provides tuition-free web-based Advanced Placement (AP) and core curriculum courses to public high school students throughout Georgia. AP courses offered through the e-Learning Program include economics, psychology, and government while core subjects include mathematics, science, social studies and foreign languages. These courses can be taken at the student's school, home or at any location that can access the internet. Included in the e-Learning Program is a federal grant to increase the number of low-income students who take AP courses and exams. This grant also provides textbooks, stipends for school mentors, and laptops for the participating students to use for their online classes. State and federal funds allow the state to offer AP and core courses to all public high schools that apply. Course content is provided by a third-party vendor (Apex Learning), as well as by the Florida Virtual School, and Gwinnett and Cobb Counties. DOE provides training in online course delivery to teachers who teach these online courses. For the Spring 2002-2003 semester there were 256 students enrolled in Georgia e-Learning online courses. DOE also has the Georgia Learning Connections (GLC), a portal that hosts distance learning resources for teachers and students related to the Quality Core Curriculum. DTAE: The Georgia Virtual Technical College (GVTC) is an electronic clearinghouse for all web-based instruction offered through DTAE's 34 technical colleges. The GVTC does not teach the web-based courses. DTAE technical colleges teach all courses and GVTC provides an internet based portal that lists all web-based courses offered by DTAE institutions. There are numerous programs of study, the most popular being allied health and computer information systems. During FY 2002, GVTC offered over 2,400 courses that were fully online with over 30,000 enrollments. Additionally, DTAE institutions offered over 4,200 "web-enhanced" courses (traditional courses supplemented with distance learning activity) with over 47,000 enrollments. Regents: The 34 Regents institutions provide a wide variety of distance learning instruction through various means of delivery including GSAMS, web-based, and prerecorded media. In FY 2002, the 34 colleges and universities offered 2,731 distance learning course sections with enrollment of about 40,000. Each institution develops and teaches its own course offerings. The role of the Board of Regents in distance learning instruction is coordinated through its Advanced Learning Technologies (ALT) Division, which provides strategic and research support for the use of technologyfacilitated course delivery within the 34 colleges and universities in the university system. The Georgia Statewide Academic and Medical System (GSAMS) To facilitate distance learning and telemedicine in Georgia, the Georgia Technology Authority (GTA) operates the Georgia Statewide Academic and Medical System (GSAMS). GSAMS is a two-way video and two-way audio, real-time communication system that can be used for both distance learning and telemedicine. GSAMS is comprised of video monitors, cameras, microphones, and other communication hardware and operates by using a "codec" to compress and decompress video and audio signals into digital form to be transmitted between GSAMS sites over high-speed telecommunications lines. Distance Learning and Telemedicine Page 5 The Distance Learning and Telemedicine Act of 1992 (the Act) established the goal of developing a statewide, audio and video distance learning system that employed interactive technology in order to provide appropriate means for the continued development and enhancement of educational opportunities and medical care through the State of Georgia...If deployed state wide and linked with other networks on a national or international basis, they would permit students interactive access to a greater variety of instruction, thus enhancing educational quality throughout Georgia, and they would improve the delivery of medical care to all areas of Georgia. The development and implementation of the GSAMS network was carried out by the Distance Learning and Telemedicine Governing Board (the Governing Board) and the Department of Administrative Services (DOAS). The Governing Board was created by the Act to approve the design of the network and to authorize expenditures for qualified GSAMS purposes. DOAS administered the GSAMS network on a daily basis through November 2000, at which time GTA assumed the daily operations. GSAMS is a video-teleconferencing system, and each GSAMS location has video monitors, cameras, microphones, and other communication hardware. Information is transmitted between GSAMS sites over high-speed telecommunications lines. GTA's responsibilities currently include maintaining a database of GSAMS sites for billing purposes, scheduling out-of-state conferences through its GSAMS Gateway that allows GSAMS to communicate with different technologies in other states and countries, and contracting for the maintenance and troubleshooting service provider for GSAMS equipment. BellSouth handles the scheduling of in-state conferences and the maintenance of the high-speed T-1 lines. Primary Uses of GSAMS Each GSAMS site can send and receive live video and audio data to create a high-quality, twoway interactive communication event referred to as a "conference." These conferences may be established between GSAMS sites or between a GSAMS site and video conferencing technology in Georgia other than GSAMS, in another state, or in another country through the GSAMS Gateway. The primary uses for these conferences are either for distance learning or telemedicine purposes. Page 6 Distance Learning and Telemedicine Distance Learning A variety of educational institutions and other organizations employ GSAMS for distance learning as shown in the box below. Institutions Public K-12 schools and Regional Education Service Agencies (RESA); Public Colleges and Universities (in the University System of Georgia); Department Technical and Adult Education technical schools (DTAE); State government agencies; Other publicly or privately funded institutions such as private schools, Zoo Atlanta, and museums. How Institutions Use Distance Learning Course Instruction Staff development and training Administration Enrichment programming Continuing Education During fiscal year 2002, the GSAMS network logged 41,426 conferences for distance learning purposes, not including GSAMS Gateway conferences. These conferences amounted to a total usage time of 117,795 hours, resulting in an average conference time of approximately 2.8 hours. As seen in Exhibit 4 below, the majority (97%) of GSAMS distance learning usage for fiscal years 2000 through 2002 is accounted for by Regents institutions, GDC facilities, DTAE institutions, and DOE schools. In fact, of the 264 GSAMS sites in Georgia as of February 2003, 248 (94%) were distance learning sites. Exhibit 4 GSAMS Distance Learning Usage FY 2000 Hours FY 2001 Hours FY 2002 Hours # GSAMS Total FY Distance Learning 2000 - 2002 % of Total sites as of Feb. Hours 2003 University System/Board of Regents 1 64,580.5 58,528.0 58,972.9 182,081.4 48.6% 118 Georgia Department of Corrections (GDC)2 24,038.2 27,110.5 26,385.4 77,534.0 20.7% 22 Department of Technical and Adult Education 3 20,005.3 21,865.1 17,254.6 59,125.1 15.8% 16 Georgia Department of Education 4 17,617.6 15,255.0 11,482.0 44,354.6 11.8% 69 Other 5 4,196.9 3,498.5 3,700.0 11,395.4 3.0% 23 Total 130,438.5 126,257.0 117,795.0 374,490.4 100.0% 248 1. Includes usage for public colleges and universities as well as sites at Board of Regents Offices. 2. Includes usage for GDC prison facilities as well as GDC offices. 3. Includes usage for institutions under DTAE as well as sites at DTAE offices. 4. Includes usage for any public K-12 school, Regional Education Service Agencies (RESA), and sites at DOE offices. 5. Includes usage for GTA, DOJJ, medical facilities, private organizations, and other state agencies. Source: BellSouth usage records. Distance Learning and Telemedicine Page 7 Telemedicine GSAMS can also be used by physicians to provide medical services to patients in rural areas, patients who are not able to travel, and specialized populations such as prison inmates. A typical telemedicine consultation involves a physician at one GSAMS site performing examinations and making diagnoses of patients at a different GSAMS location. During FY 2002 there were 535 conferences for telemedicine, which amounted to a total usage time of 1,945 hours. As of February 2003, 16 (6%) of the 264 sites were GSAMS telemedicine sites. The Georgia Department of Corrections operated 11 telemedicine sites, local hospitals and medical centers operated four sites, and the Medical College of Georgia operated one site. Locations of GSAMS Sites As seen in Exhibit 5 on the following page, the 264 GSAMS sites as of February 2003 were located in 86 Georgia counties (54% of Georgia's 159 counties) and in South Carolina (two sites in Aiken, SC). In addition Exhibit 6, on page 10, shows the location of the GSAMS sites by the type of user, which includes Regents institutions, DTAE schools, DOE sites and locally controlled school districts, as well as other state administered facilities, state prisons, private schools, medical facilities and museums. Appendix A lists each GSAMS site in use (by county and type) as of February 2003. Page 8 Distance Learning and Telemedicine Exhibit 5 GSAMS Site Locations (Distance Learning and Telemedicine) GSAMS Sites Per County 0 GSAMS Sites 1 to 2 GSAMS Sites 3 to 6 GSAMS Sites 7 to 10 GSAMS Sites 11 to 15 GSAMS Sites 16+ GSAMS Sites (262 Sites) Source: GSAMS Billings Records for February 2003. Distance Learning and Telemedicine Page 9 Exhibit 6 Types of GSAMS Users Board of Regents GSAMS Sites DTAE GSAMS Sites (116 sites) Department of Education, RESA, and Local School System GSAMS Sites (16 sites) GSAMS Coverage for Corrections and Other Sites (69 sites) Source: GSAMS Billing Records for February 2003. Page 10 (61 sites) Distance Learning and Telemedicine GSAMS Financial Information A 1992 $73 million dollar settlement between the Georgia Public Service Commission and Southern Bell for rate over-charges was used to initially fund GSAMS. With the settlement, the General Assembly created the GSAMS Universal Service Fund (the Fund) and designated that it be used to develop a statewide distance learning and telemedicine network. As stated previously, the 1992 Act created the Governing Board to approve expenditures from the Fund and also established DOAS as the Fund's administrator (GTA assumed administrative responsibility for the Fund in 2000). The Fund could be used to purchase, lease, or otherwise acquire the common components, network facilities, and other commonly shared items of the statewide distance learning and telemedicine network infrastructure and for the payment of all salaries, wages, or any other costs incidental to the planning and provision of the statewide, shared use network as approved by the Governing Board. Exhibit 7 on the following page details the Fund's expenditures from fiscal year 1992 through March of fiscal year 2003. It should be noted that roughly 96% of all GSAMS expenditures occurred during fiscal years 1994 through 1999. In fact, during fiscal years 2001 through 2003, only $630,000 was spent out of the GSAMS Universal Service Fund. In addition to the $71 million in expenditures for the GSAMS network between 1992 and 2003, GTA estimated that state agencies and local governments expended $72.7 million over the same period for monthly line charges, employee costs, and other telecommunication expenses. Although the actual amount that has been expended for GSAMS is not readily available since most agencies combined expenditures for the system into their telecommunication, computer charges, or personnel expenditure categories, the estimated total expenditures on GSAMS from all sources was approximately $144.1 million. It should be noted that in fiscal year 2003, the General Assembly passed legislation allowing the Distance Learning and Telemedicine Governing Board to spend the balance of the Fund (over $20 million) on technology initiatives other than the GSAMS network. According to GTA personnel, this $20 million will be spent upgrading the state's PeopleSoft accounting software. Distance Learning and Telemedicine Page 11 Exhibit 7 GSAMS Universal Service Fund Balance FY 1993 to 2003(1) Funds Available GSAMS Universal Service Fund Interest Earned State Funds Funds Available Amount $73,204,867.00 $17,811,941.00 $391,521.32 $91,408,329.32 % of Revenue and Expense 80.09% 19.49% 0.43% 100.00% Expenditures FY 1992 Expenditures (2) GSAMS Equipment (3) Distance Learning Grants (4) Subsidies to Telephone Companies (5) Telecommunication Services (6) Transfer to GPTV (7) Administrative Expenses Subtotal of Expenditures Unencumbered Contracts Total Expenditures $395,466.00 $32,202,339.57 $21,774,926.71 $540,047.03 $7,504,930.14 $6,000,000.00 $3,988,361.92 $72,406,071.37 -$1,000,527.90 $71,405,543.47 0.55% 45.10% 30.49% 0.76% 10.51% 8.40% 5.59% -1.40% 100.00% Fund Balance $20,002,785.85 (1) Fund balance is based upon unaudited revenue and expenditure reports from GTA and DOAS. (2) Accounting reports detailing the categories that comprise the 1992 expenditures were not available, only the total expended. (3) GSAMS equipment includes expenditures for video conferencing equipment (e.g., cameras, Codecs, microphones, and televisions). (4) Distance learning grants funded all other expenditures not specifically for GSAMS equipment and service. (5) A portion (not to exceed $23 million) of the Fund could be used for a period of three years after March 20, 1992 for the purpose of offsetting transitional expenses and costs associated with establishing the 16mile toll-free calling radius for Georgia citizens. (6) Telecommunication services are expenditures for telephone service. (7) Funds transferred from the GSAMS Universal Service Fund to GPTV for a satellite transponder. Source: DOAS and GTA Financial Records as well as interviews with program staff. GSAMS User Costs The standard cost for an individual distance learning site to access the GSAMS network is Standard Monthly GSAMS Distance Learning Charge = $1,325.50 $1,325.50 per month (approximately $15,900 annually). This monthly charge includes BellSouth's charge $611.80 BellSouth Network Service charges (half a T-1 line use) $213.21 Sprint/AT&T InterLATA Access charge (long distance) $325.05 Forgent Video Equipment Maintenance charge $88.16 Local Phone Company charge for 3 phone lines $87.28 GTA Overhead for Operating Costs for the T-1 lines, the cost of a maintenance vendor contract, and the overhead added by GTA for GSAMS network administration. The rate charged to a particular GSAMS site may be higher or lower than this standard amount if the site chose a non-standard setup, such as opting out of the state's maintenance agreement. Each site is allotted 62.5 hours usage per month but may exceed this allotment without additional cost provided the GSAMS network, as a whole, has not exceeded the overall network limit set by BellSouth. Page 12 Distance Learning and Telemedicine Standard Monthly GSAMS Telemedicine Charge = $2,692.75 Telemedicine sites cost more to equip and operate on a monthly basis because physicians may $947 BellSouth Network Service charges (for full T-1 line use) $957 Sprint/AT&T InterLATA Access charge (long distance) $582 Forgent Video Equipment Maintenance charge $88.16 Local Phone Company charge for 3 phone lines $118.59 GTA Overhead for Operating Costs require higher quality resolution and bandwidth for their medical examinations. This higher quality is supplied by telemedicine sites using the bandwith of an entire T-1 line, whereas distance learning sites only use half of a T-1 line. As a result, the standard telemedicine rate is $2,693.75 per month for 107 hours of usage. Other Funding In addition to the GSAMS Universal Service Fund, there are other state and federal funding sources that may be used for distance learning and telemedicine. Approximately $20 million in Georgia Lottery funds were also spent developing and implementing a satellite system for Georgia's educational institutions. Additionally, state and local governments could have applied for and received one of several federal grants and assistance programs that were available for distance learning or telemedicine. Some of the more prominent federal grants include the Technology Opportunities Program from the U.S. Department of Commerce, the Distance Learning and Telemedicine Grants and Loans from the Rural Utilities Services, and the Rural Health Outreach Grant from the U.S. Office of Rural Health. In terms of federal assistance programs, schools, libraries, and health care facilities also received federal Universal Service funds that reduced their telecommunications costs. Georgia schools and libraries received $60 million per year from 2000 to 2002 in federal Universal Service funds that helped reduce their Internet and telecommunications costs. The DOE and DTAE also received Carl D. Perkins Vocational and Technical Education Grants totaling $37 million in federal fiscal year 2002. DOE and DTAE could not specify how much, if any, was spent on distance learning. Other States Information Our survey of other states was limited to distance learning activities and did not include telemedicine. The review focused on the distance learning activities of seven states that had been identified by GTA and agency personnel as leaders in distance learning. Our review found that there were two primary differences in how state governments were involved in distance education initiatives. One group (Washington, Texas, Alabama, Iowa) constructed a network infrastructure that could be used to provide distance education programming and other services. The other group (Ohio, California, Colorado) primarily provided assistance to distance learning users, such as assisting local school systems in obtaining funding and developing web portals for distance education content sharing. Distance learning programs are divided into these two groups ("networks" and "assistance") and discussed in Exhibit 8 on the following page. Distance Learning and Telemedicine Page 13 Distance Education Networks Exhibit 8 Distance Education Programs and Networks in Other States State Washington Distance Learning Program K-20 Educational Telecommunications Network Description Program Funding Size of Network Washington's K-20 Network was created in 1996 and consists of a high-speed telecommunications backbone enabling the use of Internet, video conferencing, and satellite-delivered-video program services in all public education sectors. The network is used by many local distance education programs for course delivery and staff development. Approximately $61.4 million was appropriated for the network through 1998. Ongoing network operations are paid for, at least partially, with funds from a K-20 technology account and an Education Technology Revolving Fund. 426 public education sites statewide, including community and technical colleges, regional universities, research institutions, and K-12 school districts and educational service districts. Texas Established in 1990, T-STAR is a statewide network providing television communications (one-way video/two- Texas Schools Telecommunications Access Resource (T-STAR) way audio via satellite) to school districts, regional education service centers (ESC), and the Texas Education Agency (TEA). It is used for for-credit courses, curriculum enhancement, and staff professional development. T- T-STAR has received appropriations for state fiscal years 1996 through 2003 totalling approximately $17.2 million. Links over 1,000 Texas school districts, all 20 ESC's and the TEA. STAR programming can also be delivered to desktop computers. Texas Education Telecommunications Network (TETN) Established in 1995, TETN is a statewide network of dedicated T1 lines providing compressed, two-way video/audio conferencing, audio communications and data transfer capabilities between TEA and all 20 ESC's. TETN has received state funding for state fiscal years 1996 through Links TEA and all 20 ESC's. 2003 totalling about $4.7 million. Vianet provides interactive video conferencing by using either dedicated telephone lines or using an Internet video There are appriximately 130 Alabama Videoconferencing in Alabama Network (Vianet) conferencing connection. Vianet is used to deliver classes to high school and college students, provide medical care for patients in isolated communities (telemedicine), as well N/A video sites in Alabama colleges and universities, community colleges, state as to conduct business meetings and training programs for agencies, and K-12 schools. educators. Iowa State Colorado Iowa Communications Network (ICN) Started in 1990, ICN is a network of statewide fiber optic Approximately $183 million was cables which provides high speed communications through spent on constructing ICN. ICN consists of full motion video, high-speed Internet, and telephone Operating expenses are paid for by approximately 3,400 miles of connections to users. ICN is used by schools for course user fees and also by funds from fiber optic lines connecting delivery and supplemental instruction, hospitals for the Iowa General Fund, Tobacco over 750 sites which cover telemedicine, and state and federal government agencies Securitization Fund, and the all 99 Iowa counties. for various initiatives. Pooled Technology Fund. Distance Learning Program Description Colorado Online Learning (COL) COL is a statewide organization created to sponsor online learning for K-12 students and educators. COL consists of providing online courses through a web-based course delivery system which are distributed on the web with streamning video and audio clips, synchronous and asynchronous communications, e-mail and voicemail conversations, and reading and writing assigments. COL is collaboratively managed by over 70 school districts, online learning programs, and the Colorado Department of Education. As of Fall 2002, COL offered 30 courses with a total enrollment of 650 students. California California Technology Assistance Project (CTAP) CTAP is a regional assistance program that provides coordination and services in education technology based on local needs in each of the 11 Californa CTAP regions. CTAP's goal is to "promote effective use of technology in teaching, learning, and overall school administration." In particular, CTAP provides assistance in six areas: 1) Staff Development, 2) Learning Resources, 3) Hardware and Telecommunications Infrastructure, 4) Operating and maintaining infrastructure, 5) Coordination with other programs, and 6) Funding for Technology. California Learning Resource Network (CLRN) CLRN provides a source for supplemental electronic learning resources that meet local instructional needs and embody the California curriculum standards. CLRN contains instructional materials for K-12 courses in video, software, and Internet formats in subjects including math, science, social science, English and languages. Ohio Ohio Learning Network (OLN) OLN was created in 1996 to be a clearinghouse of information on technology in education. OLN promotes statewide development of the technology infrastructure, provides leadership in the Ohio education community, and promotes the development of distance learning opportunities. OLN also assists colleges and universities in creating online and distance learning courses and degree programs. OLN is overseen by an OLN Governing Board. Distance Education Assistance Programs Source: Other state education agencies. Page 14 Distance Learning and Telemedicine Issues Addressed and Evaluation Methodology This program evaluation was conducted in compliance with O.C.G.A. 45-12-178 enacted in 1993 and was conducted in accordance with generally accepted government auditing standards for performance audits. The evaluation was conducted for the Budgetary Responsibility Oversight Committee. Specific objectives of the program evaluation include the following: To evaluate the performance of the Georgia Statewide Academic and Medical Systems (GSAMS); To account for the funding of GSAMS including the use of the Universal Service Fund and other non-state funding sources; To assess the extent to which GSAMS is deployed statewide and linked with other networks nationally and internationally; To assess the impact of the Converged Communications Outsourcing Project (CCOP); To evaluate the performance of other technologies used for distance learning, including the resource tradeoffs that exist between them; To assess the extent to which the state has tracked the design, development, and delivery costs of distance learning technologies; and, To what extent does the state subsidize students from other states who take distance learning courses. The evaluation methodology included interviews with and reviews of documentation of the state agencies that are primarily involved in distance learning, which are the Georgia Technology Authority (GTA), the Georgia Department of Education (DOE), the Board of Regents of the University System of Georgia (Regents), the Georgia Department of Technical and Adult Education (DTAE), and the Georgia Department of Corrections (GDC). The evaluation also included interviews and reviews of documentation of individual institutions under the agencies mentioned above, organizations at the local level and other private organizations. The entire report was discussed with appropriate personnel at GTA, DOE, Regents, DTAE, and GDC, and a draft copy was provided to each agency. Personnel from each agency were invited to provide a written response to the report and to indicate areas in which they planned to take corrective action. Distance Learning and Telemedicine Page 15 GSAMS The Georgia Technology Authority is currently working to replace GSAMS with a more cost-effective alternative. GTA has been working for several years on plans to replace GSAMS. Before being cancelled in February 2003, one part of the Converged Communications Outsourcing Project (CCOP), an attempt to outsource many telecommunications functions within Georgia government, was to replace GSAMS with a more cost-effective video conferencing application. The videoconferencing application was to be developed and operated by a third party vendor. In addition, subsequent to CCOP's cancellation, BellSouth notified GTA it would be increasing the T-1 line rates for the GSAMS network by approximately 40%, equating to an increase in cost of approximately $244 per month / $2,900 per year for each GSAMS site. As a result, GTA planned to issue a new Request for Proposal (RFP) in the summer of 2003 for a new video conferencing system to replace GSAMS. However, subsequent to developing the RFP, GTA negotiated with BellSouth and extended the current GSAMS rate structure through December 2004 and thus cancelled the RFP. Currently, GTA is working on new procurement requests for a voice, video, and data network and new videoconferencing equipment. Since the GSAMS implementation in the early 1990s, rapid technological advances have occurred in distance learning. In particular, Internet-based distance learning technologies have become more accessible and useful. For example, the Board of Regents reported a 150% increase in Internet-based courses offered in Regents institutions from the Fall of 1999 to the Fall of 2001, while GSAMS courses dropped by 20% over the same period. In addition to the availability of new technologies, another reason GSAMS use has declined is its operational costs. Relative to Internet-based technologies and other distance learning alternatives, GSAMS is expensive. One of the reasons for the higher cost is that the GSAMS infrastructure is dedicated for use with the GSAMS network. In particular, the monthly cost for the high-speed T-1 telecommunications lines over which GSAMS conferences operate is currently $611.80 per month per GSAMS distance learning site, which is significantly higher than the monthly cost of a phone line and Internet service, which is typically about $50 to $100 per month. Conversely, Internet-based and other forms of distance learning, such as prerecorded media on CDs, often share infrastructure resources with other functions, such as internet access, e-mail, and computers. Therefore, the incremental cost of these other distance learning applications is lower than that of dedicated applications such as GSAMS. It should be noted that while GSAMS is expensive, this expense does result in a highly reliable, high-quality distance learning technology that is not easily replaced. As shown in Exhibit 2 on page 3, videoconferencing applications such as GSAMS offer a live, interactive, high-quality transmission while other alternatives may offer only one-way communication and/or an inferior quality or reliability of transmission. While many distance learning applications may not require Page 16 Distance Learning and Telemedicine the high quality and reliability of GSAMS, there are applications within Georgia that do require these attributes. For example, Georgia Tech conducts interactive engineering training courses that require a reliable, high-quality connection. Furthermore, two-thirds of GSAMS sites surveyed during the evaluation indicated that they were "very satisfied" with GSAMS. Even though GSAMS is being replaced, there is a need for a highly reliable, high-quality distance learning application in Georgia. In the development and implementation of a new distance learning application to replace GSAMS, it is important that GTA work with the vendor(s) to ensure that the high-reliability, high-quality needs of current GSAMS users are met in the future. Although determining the need for a statewide distance learning network was beyond the scope of this evaluation, given GTA's plan to transition from GSAMS to a new web-based video conferencing application, the Governor, General Assembly, and the primary education agencies should re-evaluate the structure and function of distance learning in Georgia. In particular, they may wish to consider the usefulness of maintaining a statewide distance learning network as well as the development and coordination of distance learning programming among the primary education agencies (GDOE, DTAE, and Regents). In its response, GTA agreed with the finding and stated that the Video Communications Equipment and Network Request for Proposal (RFP) is on track to be issued during the summer of 2003. Subsequent to this initial response to the report, GTA has cancelled the original RFP, extended the current GSAMS rate structure applied by BellSouth through December 2004, and is currently working on new procurement requests for a voice, video, and data network as well as new videoconferencing equipment. DOE's response to the report stated that the estimate of $144.1 million spent by the state and local education agencies since 2002 represents a tremendous investment in distance learning technology with very little return of data of any kind to guide our state in future implementation of the uses of older or more promising newer technologies. The findings and recommendations of the Program Evaluation on Distance Learning and Telemedicine could be greatly enhanced if the factors for the decline of the network included at least one statement on the failure to coordinate any program effectiveness evaluation studies and at least one recommendation on the need for this kind of data to drive state decisions on future distance learning initiatives. DOE stated in its response that it will continue to provide teaching, training and information services via the GSAMS system as long as there are schools that find it cost effective to maintain their GSAMS sites for the purpose of receiving these services. DOE is also, however, exploring more uses for Internet-based interactive meeting and training services. Distance Learning and Telemedicine Page 17 Due to high operating costs, aging technology, and the lack of educational programming and training, the number of GSAMS sites and overall usage of the network has declined significantly in the past few years. Prior to fiscal year 2000, the GSAMS network is estimated to have had over 400 total sites and was recognized regionally and nationally for its efforts and early success. However, since its peak, the network (in terms of the number of GSAMS distance learning sites and usage) has decreased substantially as seen in Exhibit 9 below. From December 2000 through December 2003, the size of the GSAMS network declined by 25%, with approximately 3-4 sites dropping off per month, or approximately 40 sites per year. In addition, usage in terms of actual distance learning teleconferencing time also decreased by over 12,000 hours from FY 2000 to FY 2002, a 10% decrease. Specific examples of entities decreasing their use include: The number of GSAMS sites in K-12 schools decreased from 119 schools in 83 school districts in FY 2000 to 88 schools in 65 school districts in FY 2002. This represents a 26% decrease in the number of schools and a 22% decrease in the number of Georgia's school districts with a GSAMS site. The number of GSAMS sites at DTAE's technical schools decreased from 30 schools in fiscal year 2000 to 19 in fiscal year 2002, a 37% decline. During the evaluation, the Georgia Department of Corrections discontinued using GSAMS distance education sites, likely resulting in an additional 20% decrease in GSAMS distance learning network usage. Exhibit 9 GSAM S Distance Learning Sites 360 340 # Sites (Distance Learning Only) 320 300 280 260 240 220 Page 18 200 Dec-00 Dec-01 Source: GTA's Billing Information. Dec-02 Distance Learning and Telemedicine The decline in the GSAMS network can be attributed to three factors: the cost of operating the system, the need to upgrade to newer technology, and a lack of educational programming/training. Cost: GSAMS technology is expensive in comparison to other forms of distance learning. While the cost of GSAMS may be justified in certain applications, interviews with four institutions that had previously eliminated their sites indicated that the high cost of operating GSAMS was a primary reason for eliminating its use. Monthly operating costs for GSAMS are typically $1,325 for distance education sites (approximately $15,900 annually). This does not include the personnel costs institutions incur for staffing each GSAMS site during its use. Old technology: According to GTA, the typical GSAMS site is still using the original equipment provided by the state approximately eight to 10 years ago. The equipment manufacturer no longer exists and the current maintenance contractor has to salvage parts from surplus GSAMS equipment to keep other GSAMS equipment operating. The cost to purchase new equipment ranges from $12,000 to $40,000 depending upon the type of equipment purchased. Lack of educational programming/training: There has not been a coordinated and sustained effort to effectively promote GSAMS, to train users on the use of the system (i.e., CPE for teachers or other professionals), or to provide programming. The number of GSAMS sites and network usage has declined and the evaluation team projects this decline will continue. Given GDC's elimination of its distance learning sites, the expected continuation of GSAMS network attrition, and GTA's planned alternative, GSAMS may cease to exist. In its response, GTA agreed with the finding and stated that the Video Communications Equipment and Network Request for Proposal (RFP) is on track to be issued during the summer of 2003 and that this RFP is expected to result in service offerings that will reduce the cost of using video conferencing technology. Subsequent to this initial response to the report, GTA has cancelled the original RFP, extended the current GSAMS rate structure applied by BellSouth through December 2004, and is currently working on new procurement requests for a voice, video, and data network as well as new videoconferencing equipment. The Board of Regents agrees that cost and the age of the technology are probably key factors in the decline of the GSAMS network. However, Regents questions whether or not the most important third factor is educational programming/training, but does acknowledge that if there had been key content needs being served by GSAMS, it is likely there would have been more drive to maintain and enhance the system. Regents states that technology support as opposed to programming/training was a more critical factor because while the system is not that difficult to use for teaching, it is more difficult having someone available to handle the scheduling, testing of the equipment and to be available as a site facilitator. Regents states that funds were not Distance Learning and Telemedicine Page 19 made available from the Distance Learning and Telemedicine Fund to institutions for the hiring of personnel and that the funding set aside for the Distance Learning and Telemedicine Program was effectively put on hold in 1999. The response states that there were no funds available for programming, upgrades, or other GSAMS related activities. Since GSAMS is expensive in comparison to other forms of distance learning, state and local government sites that are underutilizing the system should review their need for the system and should discontinue access to the system if their needs do not justify the cost. While the cost of operating GSAMS is justified for some applications, paying for and failing to utilize the system cannot be financially justified. Based on an analysis of GSAMS usage data in Exhibit 10 below, it appears there are sites underutilizing the resource. For example: y An analysis of GSAMS distance learning site usage from January through June of 2002 revealed that 112 (38.6%) of the 290 sites in the network during that time period were either not used at all during the six months or were used 10 hours or less per month on average. In fact, 22 sites (7.6%) did not use their sites at all, which equates to an annualized cost of approximately $340,000. Exhibit 10 Frequency of GSAMS Monthly Usage, Jan-Jun 2002 (Distance Learning Only) 100 90 90 80 70 60 # GSAMS Sites (Total = 290) 50 40 30 22 20 48 43 35 29 23 10 0 0 0.1 - 10 10.1 - 20 20.1 - 30 30.1 - 50 Avg Monthly Usage (Hrs) Source: GSAMS usage records 50.1 - 62.5 62.6+ Page 20 Distance Learning and Telemedicine Examples of different usage levels among GSAMS participants can be seen in Exhibit 11 below. This exhibit details sites that used the GSAMS system on a heavy, moderate, and low basis. Exhibit 11 GSAMS Distance Learning Site Usage Low Users Moderate Users Heavy Users Sites (1) Abraham Baldwin Agricultural College Carroll Technical Institute Columbus State University Jan-02 155.1 154.3 125.1 Feb-02 171.1 140.2 108.5 Hours Utilized Mar-02 Apr-02 May-02 132.0 192.7 113.3 75.4 107.3 93.0 128.6 122.5 115.3 Jun-02 130.8 Average 149.2 44.1 102.4 98.1 116.4 South Georgia College 30.0 22.0 17.0 20.0 17.0 36.4 23.7 Groves High School (Chatham County) 29.4 26.5 23.6 30.9 21.0 3.9 22.6 Zoo Atlanta 43.9 30.9 28.3 32.3 36.7 10.3 30.4 Shamrock High School (DeKalb County) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Albany Technical College 0.0 7.3 2.8 2.0 5.0 3.0 3.4 Apex Museum 0.5 0.0 0.0 1.5 0.0 1.0 0.5 (1) These are individual sites at the sampled institutions. Some institutions may have multiple sites. Source: BellSouth GSAMS Distance Learning Usage Records Each organization currently paying for GSAMS should analyze the costs and benefits of utilizing the system for distance learning versus using less expensive technologies. Consideration should be given to consolidating multiple sites and withdrawing from the network if the system is being underutilized or if other less expensive technologies provide the necessary level of service and quality. The Board of Regents reply to the evaluation stated that in response to the potential increase in GSAMS line charges at a time when budgets are tight, they have already taken steps to support their institutions in their review of the value of the GSAMS installations on their campuses. Regents has asked them to look first at the instructional need and service provided and to determine whether or not there is another methodology that will be equally effective in addressing the instructional needs of their student populations. Additionally, Regents has urged them to look not only at their own instructional needs but if other institutions use their GSAMS installations. If other institutions are using the system then they should engage in conversations with these institutions to discuss future use. Distance Learning and Telemedicine Page 21 As of February 2003, the telemedicine portion of the GSAMS network is no longer operating, with the exception of those sites associated with the Department of Corrections. The goal of developing a statewide, audio and video system that employed interactive technology, according to the 1992 Act, was to provide appropriate means for the continued development and enhancement of educational opportunities and medical care throughout the State of Georgia. To address the medical care goal of the Act, GSAMS was to include a telemedicine function as well as a distance learning function. The telemedicine portion of the network consisted of 39 sites at its height in FY 1996, but had decreased by approximately 50% by FY 2002. Similarly, the number of telemedicine conferences held decreased dramatically from over 1,700 in FY 1999 to around 600 in FY 2002. As of February 2003, there were only 16 GSAMS Telemedicine sites in operation, the largest user being the Georgia Department of Corrections (GDC) with 11 telemedicine sites. In addition, the GSAMS system only held 535 telemedicine conferences amounting to a total usage time of only 1,945 hours in of FY 2002, with GDC accounting for 57% of this usage. In February 2003, the Medical College of Georgia's (MCG) Telehealth Center, which oversaw the telemedicine portion of GSAMS ceased managing the telemedicine network and disconnected its remaining site. The MCG Telehealth Center cited the high cost of the GSAMS network, the inflexibility of the GSAMS system, and a lack of sustained financial support from GTA as the primary reasons for the discontinuation of the GSAMS telemedicine system. Specifically, Creating a system that required BellSouth to bill GTA for each telemedicine site's usage and then for GTA to bill each site prevented users from obtaining available federal subsidies for the monthly T-1 line charges (referred to as the federal Universal Service Fund) because the system was viewed as a state rather than a local-based system. This meant each GSAMS telemedicine site paid $2,693 per month ($32,316 per year) for access to the network instead of amounts as low as $400 to $500 per month (actual discount amount from the federal Universal Service Fund is dependent upon the population of the city served). GSAMS was technologically inflexible and users were forced to pay for bandwidth they did not always use or need. This resulted in telemedicine users paying $1,368 more per month for GSAMS access in FY 2002 than the typical distance learning site, even though most sites did not use the full capacity a T-1 line most of the time. Promotion and active management of the telemedicine system by MCG's Center for Telehealth ceased after the relationship between the Center and GTA deteriorated and GTA cut off funding for the Center for Telehealth in FY 2003. However, it should be noted that as of February 2003, the Department of Corrections still maintained 11 telemedicine sites that it uses to provide healthcare for its inmates. Page 22 Distance Learning and Telemedicine Determining the need for a telemedicine network was beyond the scope of this evaluation. If it is determined that such a system is needed, the design should include a coordinated plan for telemedicine appropriate to its priority, a system developed so that its participants can receive the available funds from the federal Universal Service Fund and federal grants (e.g., the Rural Utilities Service's Distance Learning and Telemedicine Grant and the Rural Health Outreach Grant from the US Office of Rural Health Policy), and a system that is overseen by an entity with a public health focus. In developing this system, the state should examine the activities of successful telemedicine projects such as the one undertaken by the Southeast Georgia Public Heath Section in Ware County. This independent telemedicine project pays significantly less then GSAMS (around $400 per month versus $2,693) for access to the video teleconferencing network. The Southeast Georgia Public Health Section only pays this charge for sites broadcasting the signal as opposed to both the broadcast site and viewing site paying for access. In addition, participating physicians are provided only viewing equipment, which is not only less expensive but is also smaller and can be placed in a physician's office. This has decreased costs and allows physicians more flexibility in scheduling consultations. In response to the report, GDC stated that the telemedicine technology does result in a savings of money and time for GDC. Additionally, telemedicine allows inmates access to medical services without having to be transported thereby contributing significantly to the public safety and security missions of the agency. Efforts between GTA and GDC are underway to replace current equipment with a digital system that will allow for reduced monthly rates, expansion of existing sites, and to establish eligibility for federal grant funding. Lastly, GDC's response stated that the GDC telemedicine model differs in design from the Southeast Georgia Public Health model in that GDC's system is used for the delivery of specialty and primary care services. Consequently, diagnostic peripherals and other equipment are integral parts of the GDC system. Educational, community and governmental institutions in Georgia (public or private) are currently provided equal treatment to the GSAMS network as long as they meet specified minimum standards. Since historical information regarding the applications made by potential GSAMS sites for acceptance into the GSAMS network are not available, the evaluation team was unable to determine if any potential GSAMS sites were inappropriately denied access into the network. In order to assess equal treatment, the audit team examined the minimum standards for acceptance into the GSAMS network imposed by the Governing Board, the number of sites, and the geographic spread. The minimum standards utilized for site setup were that: a GSAMS facility be housed in "a standard classroom environment" or "dedicated room"; Distance Learning and Telemedicine Page 23 a specified site coordinator be identified and they would spend a minimum of 25-50% of their time on GSAMS coordination functions; and, a site has ready access to a BellSouth T-1 telecommunications line. Program staff indicated that historically these were the requirements utilized by the GSAMS network and very few sites (if any) were denied access to the network. Program staff indicated that the standards were easily attainable in order to attract as many participants as possible. These standards were not set to exclude sites, which is evident by the rapid growth in GSAMS to over 400 sites by 1999. However, the number of sites has declined since its height, but even with a reduction in the number of sites to 264 by February 2003, those that remained were located in 86 Georgia counties (54% of Georgia's 159 counties) and in South Carolina (two sites in Aiken, SC). These sites included a variety of institutions that ranged from local public school districts, private schools, medical facilities, and museums. It appears, based upon available information, sites have been given equal treatment in terms of connectivity. GTA should continue to ensure that all educational, community and governmental institutions across Georgia (public or private) are provided equal treatment to the GSAMS network as long as it exists. The Distance Learning Governing Board has not submitted annual reports on the status of the GSAMS network as required by O.C.G.A. 50-5-196(f). Georgia Code section 50-5-196(f) states the governing board shall prepare and submit annually to the Governor and the General Assembly a report detailing its activities and operations for the prior year, to include but not be limited to information as to the number of applications received, the identities of the applicants, the identities of those applicants awarded funding, and the respective award amounts. While GTA claimed that all requests from potential users for acceptance into the GSAMS network were approved and provided documentation showing that funds were authorized by the Governing Board for capital acquisitions of GSAMS infrastructure and initial operating expenses, no annual reports could be located to validate compliance with O.C.G.A. 50-5-196(f). In fact, GTA staff and Governing Board members indicated that they could not remember ever producing an annual report. The General Assembly's Legislative Counsel and Governor's Office confirmed that the required reports were not submitted by the Governing Board. While the Georgia Technology Authority and the Governing Board should have compiled and published an annual report on the activities of the GSAMS network as directed by O.C.G.A. 50-5-196(f), producing this report is no longer necessary since GSAMS is no longer receiving applications, awarding funding, etc. GTA's response to the evaluation agreed with the finding and stated that O.C.G.A. Section 50-5196(f) requires an annual report that details "activities and operations for the prior year, to include but not be limited to information as to the number of applications received, the identities of the applicants, the identities of those applicants awarded funding, and the respective award Page 24 Distance Learning and Telemedicine amounts." GTA has not submitted such a report since GTA has not received any applications for GSAMS awards as contemplated in the Distance Learning and Telemedicine Act. Since GTA did not have any of the content or information requested within the statute, GTA was unable to provide a meaningful report. Distance Learning The degree to which out-of-state students taking distance learning courses are being subsidized by Georgia's universities and technical colleges could not be determined since the actual cost of providing distance learning courses is not known. While the Board of Regents (Regents) and the Department of Technical and Adult Education (DTAE) have established policies regarding the amount of tuition out-of-state students are charged, the degree to which out-of-state students are being subsidized could not be determined because neither Regents nor DTAE have determined the actual costs of providing distance learning courses. While some Regents and DTAE institutions have estimated portions of distance learning course costs, such as development costs, the total cost has not been calculated. As a result, it is not possible to know the subsidy for out of state students for these distance learning courses. The policies that Regents and DTAE have developed on how much out-of-state students should be charged to take a distance learning course are as follows: DTAE - Out-of-state students are charged twice the tuition rate for a distance learning class as in-state students. This is equivalent to the tuition out-of-state students pay for traditional classes. DTAE had only 100+ out-of-state distance learning students during FY 2002. Regents - The Board of Regents has two policies in place regarding the amount of tuition out-of-state students enrolled in distance learning courses are charged. o The first policy charges out-of-state students four times the rate of in-state students if less than 95% of course instruction takes place at a distance. o The second policy allows a college or university to charge the same tuition to out-ofstate students as for in-state students for distance education courses where almost all course instruction is offered at a distance (i.e., 95% or more of "class contact time" must take place at a distance). Distance Learning and Telemedicine Page 25 As shown in Exhibit 12 below, a review of four sampled Board of Regents institutions found that the tuition they charged for undergraduate distance learning courses follows the normal tuition schedule for traditional on-site courses, which is at least four times that of the in-state tuition. There are exceptions to this pattern. For example, certain graduate level courses (i.e., Web-MBA) were identified where in-state and out-of-state students were charged the same amount. This charge was typically much higher than on-site tuition rates. Exhibit 12 Undergraduate Tuition Rates Institution Columbus State University Georgia Institute of Technology Standard In-class Course Tuition for Undergraduate Classes (per hour) In-State Out-of-State $93 $369 $134 $631 University of Georgia $116 $465 Georgia Southern University $93 $369 Distance Learning Course Tuition for Undergraduate Classes (per hour) In-State Out-of-State $93 $369 N/A (1) N/A (1) $116 $465 $93 $369 (1) Georgia Tech's distance learning programs center primarily on graduate engineering programs rather than undergraduate programs according to Georgia Tech personnel, which means all students are charged $642 per hour for graduate level courses. Source: Board of Regents' Institutions. In their response to the evaluation, the Regents stated that just as costs for traditional courses vary by discipline, level of course, and type of institution, so too, will costs of distance education courses vary by these factors as well as how active an institution is in distance education, technologies used, and other factors. The Regents does know from research on costing of distance education courses conducted in national studies, that there is more upfront expense associated with the development and delivery of distance education courses and that the single most important factor to reduce the expense is to increase student participation. The Regents also knows that at this point in time, there is an average retention rate of about 70%. Some of this is due to the fact that there is a good bit of misunderstanding regarding the expectations regarding participation in distance education courses. This upfront expense together with retention factor advocates for the e-tuition model. It is important to maximize enrollments to reduce expense. By providing a standard cost for courses requiring little or no campus traffic, institutions can be more competitive for enrollments thereby ensuring sustainability of this additional delivery format. Page 26 Distance Learning and Telemedicine Distance learning is a competitive environment with a significant number of public and private organizations offering distance learning courses. However, it is not possible to isolate their impact on student enrollment at state institutions considering all the other factors affecting distance learning in Georgia. Distance learning is a growing educational service. A significant number of public and private organizations offer undergraduate degrees, graduate degrees, certified professional education certificates or enrichment courses at a distance. A May 2002, article in State Legislature magazine discussed how traditional colleges and universities are facing new competition for students from for-profit, virtual and corporate universities. According to the article, this new competition has been fueled by both technology, which has transformed distance-education programs into efficient education outlets through the use of the Internet and personal computers, and the fact that traditional non-profit colleges have failed to respond quickly enough to technology changes and the needs of today's corporations. An example of the significant number of organizations offering distance learning can be seen in the Southern Regional Education Board (SREB). SREB is an interstate compact for education among southern states, which provides its members a variety of educational services including an electronic marketplace for distance learning opportunities (Georgia is a member of SREB). The SREB has more than 180 schools in 16 states scheduled to offer distance learning courses during the 2003-2004 academic year. A sample of the SREB institutions offering distance learning programs and some of the degree and certification programs they offer is as follows: Institution Brenau University University of Florida Texas Tech University Type Private College Public College Public College Sample of Online Degrees and Certifications Offered Master in Business Administration in Accounting, Master in Education, Nursing degrees, Master of Business Administration in Health Care Management, and Certificate in Conflict Resolution Bachelor in Business Administration, Bachelor in Fire and Emergency Services, Master of Business Administration, Master in Engineering, Doctor of Audiology, and Doctor of Pharmacy Bachelor of General Studies, Master of Engineering, Master of Science in Software Engineering, and Doctor of Education in Agricultural Education Distance Learning and Telemedicine Page 27 In addition to traditional education institutions, a wide variety of private for profit institutions provide distance learning courses to people throughout the world. Examples of these include: Institution Type Kaplan Higher Education Private Educational Institute Keller Graduate School of Management of DeVry University Private Educational Institute Sample of Online Degrees and Certifications Offered Associate of Arts in Graphic Design, Associate of Arts in Business Administration, Certificate in Computer Networking, and Continuing Education courses Master in Business Administration, Master in Public Administration, and Master of Human Resources Management University of Phoenix Private Educational Institute Bachelor in Accounting, Bachelor in Management, Master in Education, Master in Computer Information Systems, and Master in Nursing It should be noted that these examples represent only a small portion of the organizations offering distance learning in the United States. While these outside organizations may impact participation in Georgia's public education system, it is not possible to isolate their impact among all the other factors affecting distance learning in Georgia. In fact, Board of Regents staff stated that, "it would be difficult to assess to what degree other institutional offerings have impacted participation in University System of Georgia offerings." However, DTAE staff stated that while most distance learning programs offered by other institutions target a different core student population than DTAE schools, the fact that they exist enables many of their students to continue their education by transferring to these programs after they have graduated from a DTAE program of study. Page 28 Distance Learning and Telemedicine Appendix A GSAMS Sites as of February 2003 Site Name Georgia College and State University #6 Georgia College and State University #7 Gsams Site Cost-Milledgeville Macon Technical College - Milledgeville Men's State Prison (Tm) Milledgeville Youth Development Center Scott State Prison Bartow County Schools GSAMS Cass High School Fitzgerald High School Macon State College #2 Central High School NE Health Science Magnet Macon Technical College Central State Prison Macon Youth Developement Center Middle Georgia College #3 Brantley County High School Distance Learning Center Ga Southern Univ / Distance Learning Georgia Southern University Georgia Southern University Georgia Southern University Georgia Southern University Georgia Southern University Georgia Southern Universtiy Ga Diagnostic & Classification Ctr (Tm) Calhoun State Prison Calhoun State Prison (Tm) CGCC - Camden #1 CGCC - Camden #2 Kings Bay Naval Base State University of West Georgia State University of West Georgia Lakeview-Ft Oglethorpe High School Charlton County High School Armstrong Atlantic State University Distance Learning and Telemedicine County Location Baldwin Baldwin Baldwin Baldwin Baldwin Baldwin Baldwin Baldwin Count Bartow Bartow Bartow Count Ben Hill Ben Hill Count Bibb Bibb Bibb Bibb Bibb Bibb Bibb Count Bleckley Bleckley Count Brantley Brantley Count Bulloch Bulloch Bulloch Bulloch Bulloch Bulloch Bulloch Bulloch Bulloch Count Butts Butts Count Calhoun Calhoun Calhoun Count Camden Camden Camden Camden Count Carroll Carroll Carroll Count Catoosa Catoosa Count Charlton Charlton Count Chatham Type BOR BOR BOR DTAE Other Other Other 7 DOE DOE 2 DOE 1 BOR DOE DOE DTAE Other Other 6 BOR 1 DOE 1 BOR BOR BOR BOR BOR BOR BOR BOR 8 Other 1 Other Other 2 BOR BOR BOR 3 BOR BOR 2 DOE 1 DOE 1 BOR Page 29 Armstrong Atlantic State University Armstrong Atlantic State University Armstrong Atlantic State University Armstrong Atlantic State University Armstrong Atlantic State University Armstrong Atlantic State University Armstrong Atlantic State University Coastal Georgia Center Savannah State University Skidaway Institute Of Oceanography UGA - Marine Extension UGA - Marine Extension Groves High School Savannah Technical College Savannah Technical College Memorial Health University Medical Cntr Hays State Prison UGA - Coll Of Agricul & Env Srv UGA - College Of Pharmacy and MCG UGA - College Of Pharmacy and MCG UGA - Georgia Center UGA - Rivers Crossing Center Clayton College and State University Mt Zion High School Kennesaw State College Southern Polytechnic State University #1 Southern Polytechnic State University #2 Chattahoochee Technical College VTEL Maintenance Center South Georgia College South Georgia College Harlem High School Cook Elementary School Cook High School Cook Middle School West GA RESA Crisp County High School Dade Co Primary School Bainbridge College #1 Bainbridge College #2 Ga Perimeter College - Distance Cedar Grove High School Page 30 Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Chatham Count Chattooga Chattooga Count Clarke Clarke Clarke Clarke Clarke Clarke Count Clayton Clayton Clayton Count Cobb Cobb Cobb Cobb Cobb Cobb Count Coffee Coffee Coffee Count Columbia Columbia Count Cook Cook Cook Cook Count Coweta Coweta Count Crisp Crisp Count Dade Dade Count Decatur Decatur Decatur Count DeKalb DeKalb BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR DOE DTAE DTAE Other 17 Other 1 BOR BOR BOR BOR BOR 5 BOR DOE 2 BOR BOR BOR DTAE Other 5 BOR BOR 2 DOE 1 DOE DOE DOE 3 Other 1 DOE 1 DOE 1 BOR BOR 2 BOR DOE Distance Learning and Telemedicine Fernbank Science Center Henderson High School Shadow Rock Elementary School DeKalb Community School Metro State Prison Metro State Prison (Tm) Dodge County High School Dodge Co Hospital Dodge State Prison Dooly County High School Dooly State Prison Dooly State Prison (Tm) Albany State University #1 Albany State University #2 Albany State University #3 Albany State University #4 Albany State University #5 Darton College #1 Darton College #2 Darton College #3 Albany High School Dougherty Comphrehensive High School Sylvester Road Elementary School Albany Technical College Albany Technical College #2 Albany Technical College - Blakely #1 East Georgia College #2 Sandy Creek High School Floyd College Atlanta Metro College #1 Atlanta Metro College #2 Board of Regents Board of Regents Board of Regents Center for Distance Learning Center for Rehablilitation Tech Continuing Education GSU-GSAMS GSU-GSAMS GSU-GSAMS GSU-GSAMS GSU-GSAMS GSU-GSAMS Education, Dept of Frederick Douglas High School Grady High School Distance Learning and Telemedicine DeKalb DeKalb DeKalb DeKalb DeKalb DeKalb DeKalb Count Dodge Dodge Dodge Dodge Count Dooly Dooly Dooly Dooly Count Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Dougherty Count Early Early Count Emanuel Emanuel Count Fayette Fayette Count Floyd Floyd Count Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton DOE DOE DOE Other Other Other 8 DOE Other Other 3 DOE Other Other 3 BOR BOR BOR BOR BOR BOR BOR BOR DOE DOE DOE DTAE DTAE 13 DTAE 1 BOR 1 DOE 1 BOR 1 BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR BOR DOE DOE DOE Page 31 Tri-County High School Technical and Adult Ed, Dept of Apex Museum Center For Puppetry Arts Corrections, Dept of Fulton Community School Ga Technology Authority GEMA Georgia Merit System Georgia Technology Authority - GSAMS Industry, Trade and Tourism, Dept of Morris Brown College Supreme Court of Georgia Zoo Atlanta CGCC #1 CGCC #2 CGCC #3 CGCC #5 UGA - Marine Extension Glynn Academy Oglethorpe Point Elementary School Green-Taliaferro High School Ga Perimeter College /Gwinnett Univ Ctr Gwinnett Center Gwinnett County School System Gwinnett University Center Brookwood Elementary School Buchannan School Meadowcreek High School Simpson Elementary School Taylor Elementary School Trickum Middle School Phillips State Prison Phillips State Prison (Tm) Lee Arrendale State Prison Gainesville College Gainesville College Hancock State Prison Harris County High School Houston Co High School Warner Robins High School Middle Georgia Technical College Irwin County High School Jeff Davis High School Page 32 Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Fulton Count Glynn Glynn Glynn Glynn Glynn Glynn Glynn Glynn Count Greene Greene Count Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Gwinnett Count Habersham Habersham Count Hall Hall Hall Count Hancock Hancock Count Harris Harris Count Houston Houston Houston Houston Count Irwin Irwin Count Jeff Davis DOE DTAE Other Other Other Other Other Other Other Other Other Other Other Other 31 BOR BOR BOR BOR BOR DOE DOE 7 DOE 1 BOR BOR BOR BOR DOE DOE DOE DOE DOE DOE Other Other 12 Other 1 BOR BOR 2 Other 1 DOE 1 DOE DOE DTAE 3 DOE 1 DOE Distance Learning and Telemedicine Jefferson Co High School Jenkins Co High School Johnson Co Community Health Center Wrightsville YDC Gordon College #1 Georgia Southern Univ #7 Dublin Center Georgia Southern University - Dublin Lee State Prison Bradwell Institute Liberty Co High School Moody Air Force Base Valdosta State University #1 Valdosta State University #2 Valdosta State University #3 Valdosta State University #4 Valdosta State University #5 Valdosta State University #6 Valdosta State Prison North Georgia College #1 North Georgia College #2 North GA Technical College Macon State Prison UGA - Sapelo Island Greenville High School Mitchell-Baker High School Autrey State Prison Southwest Georgia RESA Morgan Co High School Coca Cola Space Science Center Columbus State University #1 Columbus State University #2 Columbus State University #4 Carver High School Columbus High School Columbus Technical College Rutledge State Prison Newton High School Distance Learning and Telemedicine Jeff Davis Count Jefferson Jefferson Count Jenkins Jenkins Count Johnson Johnson Johnson Count Lamar Lamar Count Laurens Laurens Laurens Count Lee Lee Count Liberty Liberty Liberty Count Lowndes Lowndes Lowndes Lowndes Lowndes Lowndes Lowndes Lowndes Lowndes Count Lumpkin Lumpkin Lumpkin Lumpkin Count Macon Macon Count McIntosh McIntosh Count Meriwether Meriwether Count Mitchell Mitchell Mitchell Mitchell Count Morgan Morgan Count Muscogee Muscogee Muscogee Muscogee Muscogee Muscogee Muscogee Muscogee Muscogee Count Newton Newton Count 1 DOE 1 DOE 1 Other Other 2 BOR 1 BOR BOR 2 Other 1 DOE DOE 2 BOR BOR BOR BOR BOR BOR BOR Other 8 BOR BOR DTAE 3 Other 1 BOR 1 DOE 1 DOE Other Other 3 DOE 1 BOR BOR BOR BOR DOE DOE DTAE Other 8 DOE 1 Page 33 Fort Valley State University #1 Fort Valley State University #2 Pulaski State Prison Pulaski State Prison (Tm) Rabun County High School Randolph Clay Elementary Augusta College #1 Medical College of Ga Medical College of Georgia Medical College of Georgia Medical College of Georgia Medical College of Georgia Augusta State Medical Prison (Tm) Augusta Youth Development Center Medical College of Georgia (Tm) Medical College of Georgia (Tm) National Science Center-Augusta Rockdale Center UGA - Georgia Experimental Station Stephens Co High School GSAMS Distance Learning GSAMS Distance Learning Georgia State Prison (Tm) Smith State Prison Telfair Middle School Telfair State Prison Thomasville High School ABAC ABAC ABAC ABAC UGA - Rural Development Center Vidalia High Shcool Southeastern Technical College Southeastern Technical College Troup Comprehensive High School Turner Co Elementary School Twiggs Co High School Page 34 Peach Peach Peach Count Pulaski Pulaski Pulaski Count Rabun Rabun Count Randolph Randolph Count Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Count Rockdale Rockdale Count Spalding Spalding Count Stephens Stephens Count Sumter Sumter Sumter Count Tattnall Tattnall Tattnall Count Telfair Telfair Telfair Count Thomas Thomas Count Tift Tift Tift Tift Tift Tift Count Toombs Toombs Toombs Toombs Count Troup Troup Count Turner Turner Count Twiggs BOR BOR 2 Other Other 2 DOE 1 DOE 1 BOR BOR BOR BOR BOR BOR Other Other Other Other Other 11 Other 1 BOR 1 DOE 1 BOR BOR 2 Other Other 2 DOE Other 2 DOE 1 BOR BOR BOR BOR BOR 5 DOE DTAE DTAE 3 DOE 1 DOE 1 DOE Distance Learning and Telemedicine Union Co High School North GA Technical College - Blairsville Upson Lee High School Walker County Science Center Waycross College Waycross College Ware High School Ware State Prison Ware State Prison (Tm) Tri-County Health System - MCG Washington Co High School Washington State Prison Washington State Prison (Tm) Wayne Co High School Altamaha Tech, Poly Techincal Center Wayne Memorial Hospital Dalton College #1 Wilcox State Prison UGA - Savannah River Ecology UGA - Savannah River Ecology Twiggs Count Union Union Union Count Upson Upson Count Walker Walker Count Ware Ware Ware Ware Ware Ware Count Warren Warren Count Washington Washington Washington Washington Count Wayne Wayne Wayne Wayne Count Whitfield Whitfield Count Wilcox Wilcox Count Aiken, South Carolina Aiken, South Carolina Aiken, South Carolina Count Grand Count 1 DOE DTAE 2 DOE 1 DOE 1 BOR BOR DOE Other Other 5 Other 1 DOE Other Other 3 DOE DTAE Other 3 BOR 1 Other 1 BOR BOR 2 264 Source: GTA Billing Data for February 2003. For additional information, please contact Paul E. Bernard, Director, Performance Audit Operations Division, at 404.657.5220. Distance Learning and Telemedicine Page 35