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Presentation on theme: " 1 Rural Telecommunications Congress Springfield IL, October 14-17, 2007 Universal Service Support for Broadband in Rural Health Care William."— Presentation transcript:

1 1 Rural Telecommunications Congress Springfield IL, October 14-17, 2007 Universal Service Support for Broadband in Rural Health Care William England, Ph.D., J.D. Vice-President, Rural Health Care Division Universal Service Administrative Company Washington, D.C.



4 Overview of the USAC Rural Health Care Support Program  Support for urban/rural cost difference of telecom or 25% of Internet (Access, web hosting, ).  Service must be for the provision of health care, or prorated if not 100% health care use.  Support of monthly recurring costs.  Support of “standard” installation cost (excludes wiring, cabling, equipment, or “build-out”), but new Pilot Program will support build-out.





9  Eligible telecommunications providers (ETPs) may provide discounted telecommunications or Internet service.  Internet Service Providers (ISPs), cable companies, or others, may only provide discounted Internet access.  All providers must have a USAC Service Provider Identification Number (SPIN).Service Provider Identification Number Service Provider Eligibility



12 RHC Non-AK Commitments Year HCPs Funding(Mil) Avg/HCP $2.769 $6, $2.436 $4, $4.375 $7, $6.651 $6, $9.361 $7, $ $7, $ $7, $ $9, * 1883 $ $8,658 *Year 2006 is 90% completed (10/6/07)












24 12/17/04 FCC’s Second Order on the Rural Health Care Mechanism: New Definition of Rural New definition of rural for Fund Year 2005 (starting 7/1/05). Based on Core Based Statistical Area (CBSA) & census tracts; All tracts in CBSAs that do not contain an urban area >25,000; Tracts in CBSAs >25,000) that do not contain any part of a place or urban area >25,000. Result: 15,863 RuralCensus tracts and 50,441 Urban Currently funded applicants grandfathered 3 years (to 6/30/08).

25 Old vs. New Definition of Rural New Definition Old Def Rural Partial Urban Total Rural Partial Urban Total








33 Commitments by Applicant Type HCP Type * Educational Inst Comm Health Ctr Local Health Dept Com Mental Hlth Ct Hospital Rural Health Clinic Total *FY06 approx 90% complete (10/6/07)


35 FCC FORM 466

36 Calculations Allowable rural rate = $200 + $20 x 90 = $2000 Urban rate = $240  From RHCD Website Support = $ $240 = $1760 per month HCP pays actual - support = $ $1760 = $440 Maximum allowable distance

37 FCC FORM 466-A

38 Enabling E-Certification (on menu on right of RHC website).



41 RHC/USF Applications (466/466A) Status (9/30/07) Total Approved - Funding Approved - Zero funding Ready for final approval Waiting HCP reply or docs In process by USAC Received and Logged Duplicate Withdrawn Denied - Incomplete Denied - Inelig svc/vendor Denied - Program violation Totals

42 FCC FORM 467


44 Support by Service Type


46 Things can go wrong if you are not careful

47 Appeals to USAC

48 Post Form 465 before the fund year starts. Lost support

49 Appeal Count by HCP

50 Read instructions at: appeals.aspx. Explain clearly why RHCD decision was wrong. Need for support is not a reason to grant an appeal. USAC cannot waive FCC imposed requirements. Appeals

51 FCC RED Light Rule All USF participants need FCC Registration Number including HCPs, svc providers, bill payers, or consultants. Get number at USAC matches applications to “Red Light” list of FCC or USF debtors. No commitments or disbursements to matched entities.

52 Improper Payments Information Act of 2002 (IPIA) Covers all FCC payment programs For , audited 89 RHC applicants Expect audits to continue in Work done by public audit firms Final Report to Congress will be public Audits cover –Competitive bidding process –Timely payment of applicant share –Amounts received and invoiced to USAC –Eligibility of products and services –Record retention (for support received)


54 Improper Payments Information Act of 2002 (IPIA) (Preliminary Results) Statistical results released by FCC 10/3/07 at: /DOC A7.doc /DOC A7.doc Erroneous payments for RHC listed as 20%. Failure to retain documenation (up to 5 years) counted as erroneous payment and was 13%. Compliance with rules was high. 16% of audited commitments are being recovered (but 13% is one applicant).

55 Rural Health Care Site Visit Outreach Initiative Between 3/07 and 8/07, USAC made 50 site visits to: View USF support in use Assess USAC outreach and education efforts Observe best practices Ensure that applicants know regulatory requirements and are using funds appropriately.

56 FOR IMMEDIATE RELEASE September 26, 2006 FCC ADOPTS PILOT PROGRAM UNDER RURAL HEALTH CARE MECHANISM Pilot will Enhance Access Health Care Providers’ Access to Advanced Telecommunications and Information Services Washington, D.C. – Today, the Federal Communications Commission (FCC) adopted an Order that establishes a pilot program to help public and non-profit health care providers build state and region-wide broadband networks dedicated to the provision of health care services, and connect those networks to [a] dedicated nationwide backbone…



59 Pilot Program - Facts Support for up to 85% of cost to construct and operate state or regional broadband network and for “services” provided over the network. Pilot capped at $100M minus current program (~$47-53M) or about $50M/yr for 2 years. Non-eligible HCPs can use network, but must pay their direct or “fair share” of cost. Urban HCPs are eligible, but rural component must be significant. Application deadline was May 7, 2007 for FY 2006.

60 Pilot Program – Application Summary (From public search of FCC website) 81 applications filed. Total requested 1 st year support about $320M. Total project budgets about $665M. Applications represent 42 states and territories and 7,400 health care provider sites.



63 Pilot Program – Application Summary Projects range from 1 to 1,637 sites. 22 are 1-10 sites 24 are sites 18 are 51 to 250 sites 6 are 251 to is 1637 (250 first year)

64 Pilot Program – Application Summary Total project costs range $0.015 to $100M. First year requests range $0.015 to $65M. Per site costs range $1000 to $2.5M 46 projects total <$50M  16 first year are $0.15 to $0.5M  11 first year are $0.5 to $1.0M  26 first year are $1.1 to $3.0M  18 first year are $3.1 to $10M  7 first year are $10.1 to $16M  1 is $65M


66 USAC Rural Health Care Program RHC Service Desk=> Monday-Friday 8 AM-8 PM

67 Ten Ways to Avoid Universal Service Rural Health Care Support 10. Don’t apply. 9. File the application in your desk drawer (only). 8. Leave to become a consultant before filing the application. 7. Request support for a non-existant carrier. 6. Request support for a 5,000 mile circuit. 5. Fail to reapply each year. 4. List the same cost for urban and rural service. 3. Show a rural rate that is lower than the urban rate. 2. File with your home address and disconnected phone #. 1. Send in a blank application.

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