usac organization

RURAL HEALTH CARE DIVISION

Michigan Telemedicine Policy GroupJanuary 8, 2003

Universal Service Support for Rural Health Care Telecommunications

William EnglandUniversal Service Administrative Company

Rural Health Divisionwww.rhc.universalservice.org, ph 800-229-5476


R ura l H ea lth C a re D iv($400 M illion)

Schools & L ibra ries D iv($2.25 B illion)

H igh C ost / Low Incom e D ivs($2.2 B illion)

U SAC($4.85 B illion)

(Ma inta ins U niversa l Service Fund,B illing , C ollections, a nd D isbursem ent)

FC CIm plem ented U niversa l Service Progra m

of T elecom m unica tions Act o f 1996

USAC Organization


Eligibility

Rural public and non-profit health care providerspost-secondary health care educational

institution or medical schoolcommunity health centercommunity mental health centerlocal health department or agencynot-for-profit hospitalrural health clinic


Telecommunication Services

Eligible services (used to provide health care): T3 & fractional T3 T1 & fractional T1ISDNFrame relayLink extensionOther telecom svcs

Equipment not eligible.

Service must be from telecom carrier and must post Form 465 28 days before choosing carrier.


Avg Monthly Support & HCP Cost

USAC* HCP Service

$600 $310 T-1 1.544 Mbps

$384 $189 Frame Relay 1.544 Mbps

$575 $470 Frame Relay 256 Kbps

$180 $248 Frame Relay 56 Kbps

$124 $86 ISDN 128 Kbps

$428 $251 Average (USAC share 63%)

* Year 2001 averages (excludes Alaska.) Actual support depends on distance or urban/rural difference.


The Application Process

RHCD reviews and postsForm 465 on website

28-day competitivebidding starts

HCP chooses most cost-effective telecom offer

Telco completes Form468, HCP completes

Form 466

HCP submits Form 466/468“packet” to RHCD

RHCD reviews packet, issuesFund Commitment Letter (FCL).

HCP submits Form 467 to verifyservice is on

RHCD reviews 467, issues“Support Schedule” to telco. Telco

issues credit or check to HCP.


Form 465 Applications Posted by RHCD

0250500750

10001250150017502000225025002750

Week (Posting Starts Before Funding Year)

FY1998FY1999FY2000FY2001FY2002


Supported Applicants by Type

HCP Type Year 98 Year 99 Year 00 Yr 01* Yr 02*

Hospital 199 275 302 349 45Rural Health Clinic 187 221 308 456 62Comm Health Center 34 75 78 87 14Comm Mental Hlth Ctr 50 43 30 77 7Local Health Dept. 3 10 21 184 42Educational Institution 10 9 4 0 0Total 483 633 743 1153 170

* Yr 2001 about 95% complete, Yr 2002 about 15% complete.


On 5/15/02, FCC Published NPRM for Rural Health Care Support Mechanism

•Sought comments (due 7/1/02, reply 7/29/02) on:

• Improving and simplifying program operation.

• Increasing # of eligible entities (within $400M cap).

•Eligibility of rural HCPs that have other functions beyond those directly listed in statute.

•Whether/how to provide Internet access discounts.

•Whether/how to change support calculations including:What is comparable service for urban/rural difference?Should rate be that of nearest large city?What should be Maximum Allowable Distance?


Comments Filed on NPRM for Rural Health Care Support Mechanism

•75 comments and 15 reply comments were filed.

•Most HCPs supported modification of program in directions mentioned in NPRM.

•Some carriers and others cautioned that program not be expanded beyond original intent.

•Many comments urged revising of how support is calculated for Pacific territories.

•Final rule likely late spring. Effective date?


Administrative Changes Being Considered for Rural Health Care Support Mechanism

•Eliminate Form 468, merge into Form 466.

•Post Urban Rates for use if rate not submitted by HCP.

• Implement electronic submission of Form 466.

• Implement electronic submission of telco invoices.


WWW.RHC.UNIVERSALSERVICE.ORG800-229-5476 M-F 8AM-8PM

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