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| Rural Health Care Update
August 2007
This Issue (Click on link to jump to article)
IMPORTANT NOTE:
There will be no monthly conference call in August.
The Rural Health Care Program hosts a monthly outreach conference call for applicants and service providers on the second Thursday of each month at 2 P.M., EST. The monthly conference call will resume September 13.
Funding years in the Rural Health Care Program run from July 1 of one year to June 30 of the next year. For example, Funding Year 2007 runs from July 1, 2007 to June 30, 2008. Below are some statistics for applications received and processed by USAC for Funding Years 2004-2007. In addition, the FCC’s Rural Health Care Pilot Program received 81 applications representing almost 7,000 health care providers from 42 states and territories. Applicants requested over $300 million for the first year of the pilot program. The pilot program is capped at $100 million for two years. USAC is currently awaiting FCC decisions regarding which applications will be supported. Packet Status Update by Funding Year
During the processing of Form 466, the term packet is used to define the processing unit of a telecommunications circuit. On lines 21-38 of Form 466, connection information is required for each segment of a multi-billed circuit. Each segment is processed individually and a packet is created for each segment. In the case of a circuit where there is only one service provider for the entire circuit, a single packet is created. A Form 466 may contain up to four packets. Each packet must have supporting documentation in the form of a service provider’s bill and/or contract for service. For Form 466-A, the term packet refers only to the application and its supporting documentation.
Funding Year 2007
Funding Year 2006
Funding Year 2005
Funding Year 2004 The Funding Year 2004 application window opened March 29, 2004 and closed June 30, 2005, with over 70% of Form 465s e-certified. USAC committed $35.58 million in support for Funding Year 2004. Understanding "Evergreen Status" for ContractsMany applicants to the Rural Health Care Program have contracts with a service provider to obtain the services they need to provide telemedicine. For an applicant to be considered under contract in the program, the contract:
Applicants that submit contracts meeting these requirements will be considered to have "evergreen status" meaning that for the life of the contract (without any optional extension), they need not re-compete the service or post the Description of Services Requested and Certification Form (Form 465), and may annually apply for support of the contracted service by filing a Funding Request and Certification Form (Form 466) or Internet Service Funding Request and Certification Form (Form 466-A). USAC reviews all submitted contracts, determines if evergreen status applies, and logs the contract end date. A health care provider that submits a contract that does not meet evergreen requirements is treated as having a month-to-month, tariffed service and may not receive support prior to selection of the most cost-effective service after the required 28-day posting of Form 465 each Funding Year. Support for a month-to-month service cannot start before this selection and the cost of a service termination should not be a consideration in determining the most cost-effective service. The contract status of an applicant is indicated in the applicant's Funding Commitment Letter, which shows "contract" for applicants with evergreen contract status or "tariff" for applicants not considered to be under contract. Applicants with evergreen contracts need not post Form 465 during the life of that contract, but must post a Form 465 to add service, make cardinal changes, renew, or extend the contract (including optional extensions). Applicants whose contracts have evergreen status are reminded to post Form 465 and re-compete and select a service provider before the life of the contract ends. An optional contract renewal counts as a new contract and must be selected through posting Form 465. Evergreen contract applicants that post a Form 465 should advise any bidders of their contract end date and whether it is after the end of the Funding Year. The contract end date also should be indicated on their new Form 465. USAC Site Visits Well Under Way Rural Health Care Program site visits began in April and include outreach, education, and compliance components. As of June 15, 2007, 30 of the 50 site visits have been completed. Applicants participating in Rural Health Care site visits are provided with outreach focused on the available resources on USAC’s website. The tour of the USAC website includes demonstrations of the various search tools, including searching commitments of Rural Health Care support, how to search for eligible rural areas, and finding the urban rates. Additionally, the USAC website tour covers an overview of the application process, addresses the glossary of Rural Health Care terms, and informs applicants of the monthly outreach conference calls.These visits have identified some trends among applicants.
In the second quarter of 2007, USAC visited six HCPs in Fairbanks, Dillingham, Kodiak, and Ketchikan in Alaska. A representative from one of the health care facilities indicated that the distance separating remote villages in Alaska from the nearest major medical center can cause HCPs to incur extremely high travel and transportation costs to provide appropriate patient care in the absence of telehealth. The HCP representative also stated that the facility would also be unable to provide teleradiology services and would have to send X-rays to radiologists via the U.S. Postal Service, which would mean that “reading” an X-ray would take days or weeks, rather than hours, and would affect the level of care the facility is currently able to provide to its patients. Visit the Rural Health Care Program site visit page for more information. Frequently Asked Questions about Services Eligible for DiscountQ. What services may be discounted for eligible HCPs?
• Mileage Related Charges Usage and toll charges are not eligible for support. Special construction and maintenance charges are not eligible for support. Franchises, zone charges, and surcharges also are not eligible for support. Taxes, as a percentage of the cost paid on a telecommunications service, are eligible for support. Q. Are onetime or installation charges covered for eligible HCPs?
Q. What is meant by limited distance-based charges? Q. Is there a maximum bandwidth for eligible telecommunications services?
Q. What Internet support is available?
Q. What if an eligible HCP requests a service that is not offered in its local area or that could not be supported by the infrastructure or facilities currently in place? Is universal service support available for infrastructure development?
Q. Is there a limit to the number of services for which an HCP may receive support?
Q. Can connections between two rural sites be supported?
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