Welcome to Healthcare Connect Fund Training!

The FCC s Healthcare Connect Fund Highlights and Overview September 23 24, 2013 Welcome to Healthcare Connect Fund Training! 2 1

Agenda Introduction Important Caveat The Universal Service Fund and USAC Current FCC Rural Health Care programs Highlights of Healthcare Connect Fund Key Features and Goals Benefits of Consortia How Broadband Can Transform Healthcare Skilled Nursing Facility Pilot Program Program Basics Who is Eligible and What is Supported in Healthcare Connect Application Process and Competitive Bidding Funding Caps and Filing Windows Resources 3 Important Caveat This training is just a general overview and starting point for applicants Every applicant s situation is different The training does not cover every program requirement The training does not cover requirements for service providers and consultants It is essential to read the following documents carefully as you proceed through the planning and application process: Healthcare Connect Fund Order (FCC 12 150), located at http://www.fcc.gov/encyclopedia/rural health care, The Rural Health Care program rules, 47 C.F.R. 54.600 680, located at http://www.ecfr.gov, and The Healthcare Connect Fund forms and instructions (FCC Forms 460 463), located at http://www.usac.org/rhc/healthcareconnect/tools/forms/default.aspx. Consult the FCC and USAC websites for additional resources 4 2

The Universal Service Fund and USAC What is the Universal Service Fund (USF)? The USF is money collected from telecommunications companies dedicated to fulfilling the universal service goals; and Helps make telecom access available to all U.S. consumers The FCC s universal service programs provide support to: High cost companies serving remote and rural areas (Connect America Fund), Low income consumers (Lifeline Program), Health care providers (Rural Health Care Program), and Schools and libraries (E rate) 5 The Universal Service Fund and USAC, cont d The Universal Service Administrative Company (USAC) is a not forprofit corporation established by the FCC to administer the FCC s four universal service programs. USAC s functions and responsibilities include: Administering each of the USF programs, including processing of applications; Billing contributors, collecting, contributions, an disbursing universal service support; and Reporting quarterly to the FCC on disbursement of USF support; and Estimating improper payments and conducting audits. 6 3

The Universal Service Fund and USAC, cont d USAC cannot: Make policy, Interpret unclear provisions of statues or rules, Interpret the intent of Congress, or Advocate policy positions before the FCC or FCC staff. 7 Current FCC Rural Health Care Programs Telecommunications Program Funds urban/rural rate difference for telecommunications services for rural HCPs Remains in place after Healthcare Connect Fund is implemented Internet Access Program Provides 25 percent discount on Internet access services for rural HCPs Ends June 30, 2014, as participants transition to Healthcare Connect Fund Pilot Program Supports 50 state wide and regional broadband HCP networks Participants transition to Healthcare Connect Fund as Pilot funds are exhausted 8 4

Key Features of New Healthcare Connect Fund Support for broadband connectivity and broadband networks for eligible health care providers (HCPs) Both consortium and individual HCPs may apply 35% HCP contribution required Funding begins January 1, 2014 (July 1, 2013, for existing Pilot projects) 9 Key Features of New Healthcare Connect Fund (cont d) Covers both broadband services and HCP owned infrastructure Non rural HCPs can participate if in majority rural consortia Multi year funding commitments available to consortia Connections to off site administrative offices and data centers covered 10 5

Key Features of New Healthcare Connect Fund (cont d) Administrative benefits include: Flat rate discount, which simplifies the calculation of discount level Consortia can use a single application Healthcare Connect provides options: HCPs can apply as individuals HCPS can join an existing consortium, either now or after participating as an individual HCP in Healthcare Connect HCPs also can band together and form a new consortium 11 Goals of Healthcare Connect Fund FCC s Performance Goals for Healthcare Connect Fund: Increase access to broadband for HCPs, especially those serving rural areas Foster development and deployment of broadband health care networks Maximize cost effectiveness of the program FCC/USAC will collect data through the application process to help measure progress toward achieving these goals. Consortia will also file annual reports regarding their use of broadband connections, including data on telemedicine, exchange of health information, and remote training. 12 6

Benefits of Consortium Approach Creation and growth of broadband HCP networks Lower administrative costs Sharing of medical, administrative, and technical expertise Lower prices, higher bandwidth, and better quality connections Non rural sites may participate in consortia and receive the discount, as long as they are in a consortium with a majority rural sites. Consortia can include ineligible health care provider sites, who pay their fair share but can be part of the network and benefit from negotiated rates Improved quality and reduced cost of healthcare through leveraging broadband connections in consortia 13 How Broadband Can Transform Healthcare Pilot Program consortia used broadband connectivity to improve the quality and reduce the cost of providing healthcare. Access by rural HCPs to medical specialists at larger HCPs through telemedicine Enhanced exchange of electronic health records and coordination of patient care Remote training of medical personnel Reducing the cost of providing health care Access to broadband can provide similar benefits for individual HCPs. Examples taken from Staff Pilot Evaluation and Healthcare Connect Fund Order follow on next four slides. 14 7

Access by Rural HCPs to Medical Specialists at Larger HCPs through Telemedicine Bacon County Hospital (GA) A young woman s life was saved because the local physicians were able to use their telemedicine connection to a specialist in Savannah, and as a result, administer the clot busting drug TPA. Heartland Unified Broadband Network (IA, MN, NE, ND, SD, WY) Telemedicine enabled a rural critical access hospital to provide $24,456 in services locally that would otherwise have been provided elsewhere, including specialist ordered services such as bone scans, ultrasounds, x rays, CT studies, and various lab tests. North Country Telemedicine Project (NY) Predicted that it will enhance its patient hospital revenue by $4.1 million due to increased retention of patients across five specialties general surgery, cardiology, gastroenterology, oncology and pulmonology. 15 Enhanced Exchange of Electronic Health Records and Coordination of Patient Care Sanford Health Collaboration and Communication Channel (SD, IA, MN) Upgraded from T 1 connections to Ethernet services, which then enabled the project to roll out EHRs. EHRs enable this hospital, which has patients coming from as far as 150 miles away to a number of entry points, to treat patients more efficiently and effectively. Patient outcomes are better because all the patient information is centrally captured. Heartland Unified Broadband Network (IA, MN, NE, ND, SD, WY) Following the implementation of electronic Intensive Care Unit (e ICU) services, HUBNet dropped the average number of days patients spend in ICU, thereby reducing costs, and has reduced the number of patient transfers to other hospitals. 16 8

Remote Training of Medical Personnel Continuing medical education provides rural providers with increased learning opportunities and reduces their sense of medical isolation. Palmetto State Providers Network (SC) Twenty five continuing education courses were offered to 457 health care providers within a 7 month period in 2011, and physician s assistant students on rotation throughout the PSPN sites were trained remotely during July and August 2011. Iowa Rural Health Telecommunications Program (IA, NE, SD) Reported that the network and the telemedicine services provided over it have enhanced physician satisfaction and collegial support. 17 Reducing the Cost of Providing Health Care Palmetto State Providers Network (SC) Emergency Department psychiatry treatment costs dropped from $2,500 to $400 per patient, per day as a result of its tele psychiatry program. As a result, it realized $18 million Medicaid savings. Pennsylvania Mountains Healthcare Alliance (PA) The transmission of clinical and financial information over their network reduced employee turnover because employees are now able to do transcription work from home. Since the network was implemented, the turnover rate for transcriptionists dropped from fifty to zero percent, saving the hospital approximately $20,000 per full time employee. Adirondack Champlain Telemedicine Information Network (NY) Anticipated $9 million in future operating cost savings as a direct result of the provision of tele cardiology, tele trauma, tele mental health, tele neurology, and tele respiratory services. 18 9

Skilled Nursing Facilities Pilot Program Purpose is to test how to support broadband connections for skilled nursing facilities FCC has been soliciting input regarding design of the pilot program Pilot will get underway in 2014 Funding will be up to $50 million total over a three year period Participants will be required to collect data and submit reports 19 Who is eligible to participate in Healthcare Connect? To be eligible, an HCP must be public or not for profit and belong to one of these statutory categories (47 U.S.C. 254(h)(7)(B): Hospitals Rural health clinics Community health centers or health centers serving migrants Community mental health centers Local health departments or agencies Post secondary educational institutions offering health care instruction, teaching hospitals, and medical schools Consortia of the above 20 10

Who is eligible to participate (cont d) Non rural HCPs may participate in Healthcare Connect Fund if they belong to a consortium that has a majority rural HCPs The largest HCPs (400 + patient beds) are eligible, but support is capped if non rural. Consortia may include ineligible HCP sites, who pay their fair share but can be part of the network and benefit from negotiated rates 21 What is supported? For all applicants: Broadband services Reasonable and customary installation charges Equipment necessary to make service functional Connections to off site administrative offices and data centers Connections to research & education networks 22 11

What is supported? (cont d) Consortium applicants also may receive support for: Equipment necessary for network Upfront charges for deployment of new or upgraded facilities, including dark fiber HCP constructed and owned facilities, if shown to be most costeffective option 23 Application Process Usual Steps 1. Get organized Assess technical requirements Organize consortium and design network (consortia) Determine source of 35 percent HCP contribution Obtain and submit letters of agency and network plan (consortia) Determine eligibility (FCC Form 460) 24 12

Application Process Usual Steps (cont d) 2. Conduct Competitive Bidding Prepare request for services (or RFP if applicable) and establish criteria for evaluating competitive bids Submit request for services (or RFP) for competitive bidding (unless exempt from competitive bidding) (FCC Form 461) Review bids and select most cost effective bid Note: There are several exemptions from the competitive bidding requirement 25 Application Process Usual Steps (cont d) 3. Obtain funding commitment, receive services, and invoice Submit request for funding commitment (FCC Form 462) Begin receiving services Receive vendor invoice and pay HCP portion (35 %) Submit invoice for payment by Administrator to vendor (FCC Form 463) 26 13

Application Process Usual Steps (cont d) 4. Comply with other Program requirements which include: Retain documentation and records Support audit requirements and site visits File annual report (consortia) 27 Timeline Pilot Projects Funding became available July 1, 2013, for existing Pilot projects May add new sites to existing Pilot networks New individual and consortium applicants Funding available beginning January 1, 2014 FCC Form 460 available now for online submission Other forms available soon (sign up for HCF Bulletin to be notified) Competitive bidding process may be completed in time for funding to begin January 1, 2014 Deadline for requesting funding commitments is June 30 (the last day of the funding year) 28 14

Funding Caps and Filing Window Cap on total funding for FCC Rural Health Care Programs, including Healthcare Connect Fund and Skilled Nursing Facilities Pilot, is $400 million annually Commission said in Healthcare Connect Fund Order that it was unlikely this cap would be reached in foreseeable future Cap for upfront payments in Healthcare Connect Fund is $150 million annually Under longstanding rule, USAC will process requests for funding commitments on a first come, first served basis, unless it establishes a filing window (47 C.F.R. 54.675(c)(2)) If USAC establishes a filing window, applications filed within the window will be deemed to have been filed at the same time. 29 Resources Details of program and rules are set forth in FCC s Order released December 21, 2012, and in the rules, FCC forms, and instructions For more information: Healthcare Connect Fund order, at http://hraunfoss.fcc.gov/edocs_public/attachmatch/fcc 12 150A1.doc FCC website, http://www.fcc.gov/encyclopedia/rural health care Healthcare Connect Fund FAQs, http://www.fcc.gov/encyclopedia/healthcareconnect fund frequently asked questions USAC website, www.usac.org/rhc Pilot Program map, http://www.fcc.gov/maps/rural health care pilot program Pilot Program Staff Evaluation, http://hraunfoss.fcc.gov/edocs_public/attachmatch/da 12 1332A1.pdf HCF Rules: 47 C.F.R. 54.600 680, located at http://www.ecfr.gov Questions: rhc assist@usac.org 30 15

HCF Program Training Consortia 101 Rural Health Care Program I 2013 HCF Program Training 1 This training is just a general overview and starting point for applicants Every applicant s situation is different The training does not cover every program requirement The training does not cover requirements for service providers and consultants It is essential to read the following documents carefully as you proceed through the planning and application process: Healthcare Connect Fund Order (FCC 12 150), located at http://www.fcc.gov/encyclopedia/rural health care, The Rural Health Care Program rules, 47 C.F.R. 54.600 680, located at http://www.ecfr.gov, and The Healthcare Connect Fund Program forms and instructions (FCC Forms 460 463), located at http://www.usac.org/rhc/healthcareconnect/tools/forms/default.aspx. Consult the FCC and USAC websites for additional resources. Important Caveat Rural Health Care Program I 2013 HCF Program Training 2 1

Consortia 101 Agenda 1. What is a consortium? 2. What is a consortium leader? 3. What is a project coordinator? 4. Potential benefits of a consortium 5. The application process 6. What is supported? Rural Health Care Program I 2013 HCF Program Training 3 What is a consortium? HCF Order, Section IV.B In the Healthcare Connect Fund Program, a consortium can file a single application on behalf of its members. A consortium is two or more health care providers (HCPs) that choose to request support from the Healthcare Connect Fund Program as a single entity. Non rural HCPs may receive support if they are part of a consortium that is a majority rural. A consortium is a majority rural if more than 50 percent of its sites are rural HCPs. Rural Health Care Program I 2013 HCF Program Training 4 2

What is a consortium? HCF Order, Section IV.B Eligible and ineligible HCPs may participate in a consortium. Ineligible entities cannot receive support and must pay their fair share (HCF Order, para. 178 184). Costs shared by eligible and ineligible entities must be allocated in a manner that ensures that only eligible entities receive the benefit of the program discounts. Rural Health Care Program I 2013 HCF Program Training 5 What is a consortium leader? HCF Order, Section VI.A.I.a A consortium leader is the legal entity that will be the lead entity for the consortium. The consortium and the consortium leader can be the same entity (if the consortium is a legal entity), but are not required to be. Rural Health Care Program I 2013 HCF Program Training 6 3

What is a consortium leader? HCF Order, Section VI.A.I.a What else can be a consortium leader? Eligible HCP participating in the consortium Ineligible state organization Public sector (government) entity, including Tribal governments Nonprofit entity Ineligible entities can serve as consortium leader but are prohibited from receiving support from the HCF Program. Rural Health Care Program I 2013 HCF Program Training 7 What is a consortium leader? HCF Order, Para 209 Consortium Leader Responsibilities Legally and financially responsible for the activities of the consortium If the consortium and participating members want to delineate responsibilities, a written agreement must be submitted to USAC for review Designation of a project coordinator responsible for communicating with USAC and the FCC Rural Health Care Program I 2013 HCF Program Training 8 4

What is a consortium leader? HCF Order, Para 209 Consortium Leader Responsibilities Submission of program forms and required documents and verification that all information and certifications submitted are true Ensuring competitive bidding process is fair and open and otherwise compliant with FCC requirements Responsible for invoicing process Recordkeeping, site visits, and responding to audits Rural Health Care Program I 2013 HCF Program Training 9 What is a project coordinator? HCF Order, Para 206 Serves as the point of contact with the FCC and USAC for all matters related to the consortium Officer, director, or other authorized employee of the consortium leader Responsible for signing all forms submitted for the consortium Responsible for responding to FCC and USAC inquiries on behalf of the consortium members throughout the application, funding, invoicing, and post invoicing period Rural Health Care Program I 2013 HCF Program Training 10 5

Consortium Models HCF Order, Para 209 Centralized Leadership Model Decision making by consortium leadership. Master Services Agreement may apply to the entire consortium and may be signed by the consortium/ consortium leader. The consortium is billed for services and the consortium pays the 35 percent contribution requirement. Rural Health Care Program I 2013 HCF Program Training 11 Consortium Models De Centralized Leadership Model Decision making by the entities participating in the consortium Contracts signed at the stakeholder group and/or HCP level Service provider bills the stakeholder group and/or HCP directly HCP or stakeholder group is responsible for paying 35 percent contribution requirement to USAC Rural Health Care Program I 2013 HCF Program Training 12 6

Potential Benefits of a Consortium HCF Order, Section IV.B.I Creation and growth of broadband HCP networks Lower administrative costs Sharing of medical, administrative, and technical expertise Lower prices, higher bandwidth, and better quality connections Access by rural HCPs to medical specialists at larger HCPs through telemedicine Rural Health Care Program I 2013 HCF Program Training 13 Potential Benefits of a Consortium HCF Order, Section IV.B.I Enhanced exchange of electronic health records and coordination of patient care and remote training of medical personnel Improved quality and lower cost of health care Non rural HCPs may receive support only if they participate in consortia that include a majority (more than 50 percent) of sites that are rural HCPs USAC rural look up tool located on the USAC website Rural Health Care Program I 2013 HCF Program Training 14 7

Application Process HCF Order, Section VI Consortium Application Process (Usual Steps) 1. Before You Apply Assess technical requirements Organize consortium Design network 2. Before Competitive Bidding Obtain and submit letters of agency and network plan Certify eligibility of HCP sites (FCC Form 460) Rural Health Care Program I 2013 HCF Program Training 15 Application Process Consortium Application Process (cont d) 3. Competitive Bidding Determine whether claiming exemption from competitive bidding: Annual cost of $10,000 or less Government Master Service Agreements (MSAs) MSAs approved under Pilot Program or HCF Program Evergreen contracts Contracts negotiated under E rate Program Develop evaluation criteria and documents describing service needs Submit FCC Form 461, Request for Services, and supporting documentation, unless exempt Rural Health Care Program I 2013 HCF Program Training 16 8

Application Process HCF Order, Section VII.B Duplicate Funding Requests Applicants cannot request support for the same service from the Telecommunications Program and the Healthcare Connect Fund Program. Rural Health Care Program I 2013 HCF Program Training 17 Application Process HCF Order, Section VI Consortium Application Process (cont d) 4. Evaluate Bids and Select Service Provider Leave bidding window open at least 28 days Review bids received, select most cost effective service provider, and negotiate contract with selected service provider(s) Eligible service providers include any provider of equipment, facilities, or services that are eligible for support under the program Rural Health Care Program I 2013 HCF Program Training 18 9

Application Process HCF Order, Section VI Consortium Application Process (cont d) 5. Submit Funding Requests and Receive Services Submit request for funding, FCC Form 462, and supporting documentation, including evidence of a 35 percent contribution Begin receiving services Rural Health Care Program I 2013 HCF Program Training 19 Consortium Application Process (cont d) Application Process HCF Order, Section VI 6. Invoicing and Payment Process Receive and review service provider invoice Certify accuracy and that HCP has paid its 35 percent contribution After service provider certifies accuracy of invoice, submit it to USAC to initiate disbursement of 65 percent to service provider (FCC Form 463) 7. Submit Annual Report An annual report is due by September 30 of each year in which a consortium receives funding. The report should encompass consortium activity during the prior funding year. Funding years run from July 1 June 30. Rural Health Care Program I 2013 HCF Program Training 20 10

What is supported? HCF Order, Section V Eligible Services and Equipment (Individual and Consortia) Broadband services Reasonable and customary install ( $5,000 undiscounted) Rural Health Care Program I 2013 HCF Program Training 21 What is supported? HCF Order, Section V Eligible Services and Equipment (Individual and Consortia) Connections to research and education networks HCP connections to off site data centers and administrative offices Equipment necessary to make broadband service functional Rural Health Care Program I 2013 HCF Program Training 22 11

What is supported? HCF Order, Section V Eligible Services and Equipment (Consortia Only) Up front payments Indefeasible Rights of Use (IRUs) Pre paid lease(s) Equipment Upfront charges for deployment of new or upgraded facilities HCP constructed and owned facilities Equipment necessary to manage, control, or maintain broadband service or healthcare broadband network Rural Health Care Program I 2013 HCF Program Training 23 What is not supported? HCF Order, Section V.C.3 Ineligible Expenses Administrative expenses Equipment or services not directly associated with broadband services, for example: Medical equipment (hardware and software), such as telemedicine equipment and other general HCP expenses Expenses associated with general computing, software, applications, Internet content development Inside wiring and internal connections Rural Health Care Program I 2013 HCF Program Training 24 12

Funding Caps Cap on total funding for Rural Health Care Program, including Healthcare Connect Fund Program, is $400 million annually Cap for upfront payments and multiyear commitments $150 million annually Rural Health Care Program I 2013 HCF Program Training 25 Required Certifications Certifications HCF Order, Section VII.A Similar to those in existing RHC Program Certify to compliance with certain program requirements, including the requirements to select the most cost effective bid and to use program support solely for purposes reasonably related to the provision of health care services or instruction. An officer, director, or other authorized employee of the consortium leader must sign the required certifications. Rural Health Care Program I 2013 HCF Program Training 26 13

Resources More Information on the Healthcare Connect Fund Program Healthcare Connect Fund Order (FCC 12 150) http://www.gpo.gov/fdsys/pkg/fr 2013 03 01/pdf/2013 04040.pdf USAC s Healthcare Connect Fund Program Home Page (Updated on a regular basis) http://www.usac.org/rhc/healthcare connect/default.aspx FCC s Rural Health Care Program Home Page www.fcc.gov/encyclopedia/rural health care Rural Health Care Pilot Program Evaluation http://www.fcc.gov/document/rural health care pilot program evaluation staff report Subscribe to the HCF Bulletin (Updated monthly) http://www.usac.org/about/tools/publications/subscription center.aspx Healthcare Connect Fund Program Frequently Asked Questions http://www.fcc.gov/encyclopedia/healthcare connect fund frequently asked questions Rural Health Care Program I 2013 HCF Program Training 27 For More Information Healthcare Connect Fund Program Questions or Assistance Email: rhc assist@usac.org Call: (800) 543 1546 Rural Health Care Program I 2013 HCF Program Training 28 14

HCF Program Training Competitive Bidding Rural Health Care Program I 2013 HCF Program Training 1 This training is just a general overview and starting point for applicants Every applicant s situation is different The training does not cover every program requirement The training does not cover requirements for service providers and consultants It is essential to read the following documents carefully as you proceed through the planning and application process: Healthcare Connect Fund Order (FCC 12 150), located at http://www.fcc.gov/encyclopedia/rural health care, The Rural Health Care Program rules, 47 C.F.R. 54.600 680, located at http://www.ecfr.gov, and The Healthcare Connect Fund Program forms and instructions (FCC Forms 460 463), located at http://www.usac.org/rhc/healthcareconnect/tools/forms/default.aspx. Consult the FCC and USAC websites for additional resources. Important Caveat Rural Health Care Program I 2013 HCF Program Training 2 1

Overview Agenda 1. Competitive bidding overview 2. Fair and open process 3. Declaration of assistance 4. Evaluation criteria 5. Requirement to post an RFP 6. Network facilities and equipment 7. Competitive bidding exemptions 8. Evergreen contracts 9. Post commitment activity Rural Health Care Program I 2013 HCF Program Training 3 Competitive Bidding Overview Rural Health Care Program I 2013 HCF Program Training 4 2

Overview HCF Order, Section VI.B.1 All applicants must seek competitive bids for supported services and select the most cost effective provider (unless they qualify for one of the competitive bidding exemptions). Rural Health Care Program I 2013 HCF Program Training 5 Overview HCF Order, Section VI.B.4 Applicants must post request for services for a minimum of 28 calendar days. Applicants can choose to post for longer than 28 days. USAC will post for the length of time requested by the applicant if longer than 28 days. The Allowable Contract Selection Date (ACSD) is the first day that the applicant can choose a service provider. Rural Health Care Program I 2013 HCF Program Training 6 3

Overview HCF Order, Section VI.B.3 USAC will post the applicant s request for services on the USAC website. Posting includes the following documents: FCC Form 461; Participating entity listing; Request for proposals (if applicable); and Network plan. Rural Health Care Program I 2013 HCF Program Training 7 What does most cost effective mean? Overview HCF Order, Section VI.A.4 [T]he method that costs the least after consideration of the features, quality of transmission, reliability, and other factors that the health care provider deems relevant to choosing a method of providing the required health care services. (47 CFR Section 54.642(c)) Price must be a primary factor. No single factor may receive a weight that is greater than price, although another factor may receive the same weight as price. Rural Health Care Program I 2013 HCF Program Training 8 4

Competitive Bidding Fair and Open Process Rural Health Care Program I 2013 HCF Program Training 9 Fair and Open Process HCF Order, Section VI.B.1 Service providers that intend to bid are prohibited from: Preparing, signing, or submitting an applicant s FCC Form 461 and supporting documents; Serving as consortium leader or other points of contact on behalf of applicants; Being involved in setting bid evaluation criteria; and Participating in the bid evaluation or service provider selection process (except in their role as a potential service provider). Rural Health Care Program I 2013 HCF Program Training 10 5

Fair and Open Process HCF Order, Section VI.B.1 Consultants, other third party experts, or applicant employees who have an ownership interest, sales commissions arrangement, or other financial stake with respect to a bidding service provider are also prohibited from performing any of the four functions outlined in the previous slide on behalf of the applicant. Rural Health Care Program I 2013 HCF Program Training 11 Fair and Open Process HCF Order, Section VI.B.1 All potential bidders must have access to the same information and must be treated in the same manner. If an applicant modifies anything on any documents posted by USAC, the applicant must notify all potential bidders at the same time using a uniform method. Applicants are required to immediately notify USAC of the modification. USAC will modify the original posting accordingly. All applicants and service providers must comply with any applicable state or local competitive bidding requirements. Rural Health Care Program I 2013 HCF Program Training 12 6

Fair and Open Process HCF Order, Section VI.A.1.a State organizations, public sector entities, or nonprofit entities may serve as lead entities or provide consulting assistance to consortia only if they do not participate as potential service providers during the competitive bidding process. (47 C.F.R. 54.631 (b)) Such entities may request an exemption from this prohibition if they are sufficiently large and can demonstrate an organizational and functional separation of relevant staff. (HCF Order para. 205) Rural Health Care Program I 2013 HCF Program Training 13 Competitive Bidding Declaration of Assistance & Evaluation Criteria Rural Health Care Program I 2013 HCF Program Training 14 7

Declaration of Assistance HCF Order, Section VI.B.3 Applicants are required to identify any consultants, service providers, or other outside experts who aided in the preparation of the FCC Form 461 and supporting documentation. Whether paid or unpaid FCC Form 461, Block 4 Rural Health Care Program I 2013 HCF Program Training 15 Evaluation Criteria HCF Order, Section VI.A.4 Applicants must certify that they have selected the most cost effective bid on their request for funding. (47 C.F.R. Section 54.603(b)(4)) See slide 8 for the definition of cost effective. Rural Health Care Program I 2013 HCF Program Training 16 8

Evaluation Criteria HCF Order, Section VI.A.4 Applicants are required to establish evaluation criteria: Block 5 of FCC Form 461 Cost (price) of service must be a primary factor. No criteria can be weighted higher than cost, but can be weighted equal to cost. Total weight must equal 100 percent. Evaluation criteria should include most important criteria needed to provide healthcare, as determined by the applicant. Rural Health Care Program I 2013 HCF Program Training 17 Evaluation Criteria HCF Order, Section VI.A.4 Smaller consortium applicants may find the following criteria to be sufficient to determine the most cost effective bidder: Price; Bandwidth; Quality of transmission; Reliability; Prior experience with the service provider; and Technical support. Rural Health Care Program I 2013 HCF Program Training 18 9

Evaluation Criteria HCF Order, Section VI.A.4 More complex projects, such as those that involve designing or constructing a new network or building upon an existing network, may include non cost factors in their evaluation criteria, such as: Prior experience, including past performance; Personnel qualifications, including technical excellence; Management capability, including solicitation compliance; and Environmental objectives (if appropriate). Rural Health Care Program I 2013 HCF Program Training 19 Competitive Bidding Requirement to Post a Request for Proposal (RFP) Rural Health Care Program I 2013 HCF Program Training 20 10

Requirement to Post an RFP HCF Order, Section VI.B.2 What is an RFP? An RFP is a formal bidding document that describes a project and requested services in sufficient detail so that potential bidders understand the scope, location, and any other requirements. (HCF Order para. 234) There is no FCC prescribed format for RFPs, but the HCF Order provides guidance and required elements for RFPs. Rural Health Care Program I 2013 HCF Program Training 21 Requirement to Post an RFP HCF Order, Section VI.B.2 Applicants must file an RFP with the FCC Form 461 if: It is required by state, Tribal, or local procurement rules and regulations, A consortium is seeking more than $100,000 in program support in a funding year, or A consortium is seeking support for infrastructure (HCP owned facilities) or other long term capital investment. Any other applicant can choose to utilize an RFP in conjunction with its competitive bidding process. Rural Health Care Program I 2013 HCF Program Training 22 11

Requirement to Post an RFP Unless exempt from competitive bidding, USAC advises all consortia to post an RFP. Why? Future contract modifications and site/service substitution implications Rural Health Care Program I 2013 HCF Program Training 23 Requirement to Post an RFP Sample RFPs Available on USAC Website Small Consortium Leased Services RFP Medium Consortium Leased Services RFP Large Consortium Leased Services RFP Rural Health Care Program I 2013 HCF Program Training 24 12

Competitive Bidding HCP Owned and Leased Network Facilities and Equipment Rural Health Care Program I 2013 HCF Program Training 25 Network Facilities and Equipment HCF Order, Sections IV.C, V.A.3, V.A.7, and V.B Consortium Applicants Eligible to Receive Support for: HCP owned infrastructure (HCP owned fiber), Indefeasible Rights of Use (IRUs) or pre paid leases, Dark or lit fiber, Equipment necessary to make broadband service functional, and Upfront charges for the deployment of new or upgraded facilities. Rural Health Care Program I 2013 HCF Program Training 26 13

Network Facilities and Equipment HCF Order, Sections IV.C, VI.B.2 Special considerations when requesting support for HCP owned facilities (47 C.F.R. Section 54.636): The applicant must include an RFP with FCC Form 461 for posting. If seeking support for long term capital investments (such as HCP constructed infrastructure or a fiber IRU), the applicant must also seek bids in the same RFP from service providers who propose to meet their needs via services provided over service provider owned facilities for a comparable time period. To receive support, applicant must show that self construction is the most cost effective option. Rural Health Care Program I 2013 HCF Program Training 27 Network Facilities and Equipment HCF Order, Sections IV.C, VI.B.2 Special considerations when requesting support for HCP owned facilities (47 C.F.R. Section 54.636): If self construction is the most cost effective, the applicant must: Submit a sustainability plan with the FCC Form 462 (47 CFR Section 54.634 (a)(iv)), Meet the annual reporting requirement for the life of the asset (47 CFR Section 54.647), and Maintain records to document compliance with rules for five years after the end of the useful life of the facility (47 CFR Section 54.648(b)(1)). Rural Health Care Program I 2013 HCF Program Training 28 14

HCP Owned Infrastructure Network Facilities and Equipment HCF Order, Sections IV.C, V.A.3, VI.B.2 Solicitation in an RFP must be sufficiently detailed and include all expenses to operate, maintain, and manage the network so that the relative cost effectiveness can be evaluated over the useful life of the facility. Examples of expenses may include: Pole rights and/or right of way expenses, Maintenance contracts, Equipment necessary to make service functional, and Expenses necessary to operate the network. Rural Health Care Program I 2013 HCF Program Training 29 What is an IRU? Network Facilities and Equipment HCF Order, Section V.A.3 An IRU is a right to use facilities for a certain period of time that is commensurate with the remaining useful life of the asset (usually 20 years, although parties may negotiate a different term). An IRU differs from a lease for services because it confers the grantee the vestiges of ownership. Rural Health Care Program I 2013 HCF Program Training 30 15

What is a pre paid lease? Network Facilities and Equipment HCF Order, Section V.A.3 Pre payment for services provided by a third party for an agreed upon period. Typically carrier provided services for a period of 10, 15, or 20 years. USAC will require the inclusion of liquidation clauses in any pre paid lease arrangement. Rural Health Care Program I 2013 HCF Program Training 31 Competitive Bidding Competitive Bidding Exemptions & Evergreen Contracts Rural Health Care Program I 2013 HCF Program Training 32 16

Competitive Bidding Exemptions Exemptions to Competitive Bidding Process HCF Order, Section VI.B.6.d Annual undiscounted cost less than or equal to $10,000 (unlikely for consortium applicants) Purchasing from government negotiated Master Services Agreement (MSA) MSAs approved under Pilot Program or HCF Program A multi year contract deemed evergreen by USAC Contracts negotiated under Schools and Libraries (E rate) Program Rural Health Care Program I 2013 HCF Program Training 33 What is an evergreen contract? Evergreen Contracts HCF Order, Section VI.B.6.d If USAC has designated a multi year contract as evergreen, then for the life of the contract, HCPs do not need to annually re bid the service or post an FCC Form 461. (47 C.F.R. Section 54.642(h)(4)) Rural Health Care Program I 2013 HCF Program Training 34 17

What is an evergreen contract? (cont d) Evergreen Contracts HCF Order, Section VI.B.6.d A new contract can be designated as evergreen if it meets all of the following criteria: Signed by the HCP or consortium lead entity; Specifies service type, bandwidth, and quantity; Specifies term of the contract; Specifies cost of services to be provided; and Includes physical address or other identifying information of HCPs purchasing from contract. Rural Health Care Program I 2013 HCF Program Training 35 Evergreen Contracts Voluntary Extensions (47 CFR 54.642(h)(4)(iii)) HCF Order, Section VI.B.d.6 Participants may exercise voluntary contract extensions without undergoing additional competitive bidding if: The voluntary extension is memorialized in the evergreen contract, The decision to extend the contract occurs before the participant files its funding request for the funding year when the contract would otherwise expire, and The voluntary extension(s) do not exceed five years in the aggregate. Rural Health Care Program I 2013 HCF Program Training 36 18

Competitive Bidding Post Commitment Activity Rural Health Care Program I 2013 HCF Program Training 37 Post Commitment Activity HCF Order, Section VI.E Contract Modifications HCPs should first look to state or local procurement laws to determine whether a proposed contract modification would be considered minor and therefore exempt from state or local competitive bidding processes. If the state or local procurement laws are silent or inapplicable, an eligible HCP may seek to modify a contract without undertaking the competitive bidding process if the proposed modification is not a cardinal change. A cardinal change doctrine looks at whether the modified work is essentially the same as that for which the parties contracted. Rural Health Care Program I 2013 HCF Program Training 38 19

Contract Modifications (cont d) Post Commitment Activity HCF Order, Section VI.E If it is not a cardinal change, HCPs must file revised commitment requests within 30 days of the modification. NOTE: Parties are not guaranteed support for modified services. Examples of contract modifications may include: Consortium applicants requesting to add new HCPs to an existing MSA if contemplated in the RFP; and Consortium applicants requesting to modify bandwidth speed of member HCPs, if contemplated in the RFP. Rural Health Care Program I 2013 HCF Program Training 39 Post Commitment Activity HCF Order, Section VI.F Site and Service Substitutions (47 CFR Section 54.646) A consortium leader may request a site and service substitution if: The requested change is within the scope of the controlling request for services, including any RFP used in the competitive bidding process; Substitution is provided for in the contract, within the change clause, or constitutes a minor modification; The site is an eligible HCP and the service is eligible for support under the HCF Program; and The substitution does not violate any contract provision or state or local procurement laws. Rural Health Care Program I 2013 HCF Program Training 40 20

HCF Program Training My Portal Overview for Consortia Rural Health Care Program I 2013 HCF Program Training 1 This training is just a general overview and starting point for applicants Every applicant s situation is different The training does not cover every program requirement The training does not cover requirements for service providers and consultants It is essential to read the following documents carefully as you proceed through the planning and application process: Healthcare Connect Fund Order (FCC 12 150), located at http://www.fcc.gov/encyclopedia/rural health care, The Rural Health Care Program rules, 47 C.F.R. 54.600 680, located at http://www.ecfr.gov, and The Healthcare Connect Fund Program forms and instructions (FCC Forms 460 463), located at http://www.usac.org/rhc/healthcareconnect/tools/forms/default.aspx. Consult the FCC and USAC websites for additional resources. Important Caveat Rural Health Care Program I 2013 HCF Program Training 2 1

My Portal Overview Agenda 1. My Portal The Basics 2. Accessing My Portal 3. Navigating My Portal Rural Health Care Program I 2013 HCF Program Training 3 My Portal The Basics What is My Portal? Where applicants can apply to the Telecommunications and Internet Access programs Where both individual health care provider (HCP) and consortium applicants can apply to the Healthcare Connect Fund (HCF) Program Enables applicants to create, submit, and manage their forms and supporting documentation Rural Health Care Program I 2013 HCF Program Training 4 2

My Portal The Basics Using My Portal Between Programs Similarities: My Portal will have the same look and feel for all users, and similar administrative functionality, such as account management. Differences: Each program has its own forms, requirements, and steps in My Portal. Rural Health Care Program I 2013 HCF Program Training 5 My Portal The Basics Security Access to an HCP s account requires individual account holder registration. The primary account holder is responsible for managing who has access to the HCP s information, and what level of access they have. The primary account holder authorizes all other account holders. Consultants are required to provide letters from HCPs authorizing access to account information. Rural Health Care Program I 2013 HCF Program Training 6 3

My Portal The Basics Convenient Account holders who manage multiple HCPs only log in once to access all authorized HCPs. Account holders can update contact information online. Forgot your password? Reset it online. Information is stored in a tab structure. Rural Health Care Program I 2013 HCF Program Training 7 My Portal The Basics Forms The My Forms tab is structured to group forms by funding year. Current status of all forms (whether drafted or submitted) Ability to open or review drafted or submitted forms Forms tied to the originating FCC Form 460 Details specific to each form, such as the Allowable Contract Selection Date (ACSD), and the Funding Commitment Letter (FCL) issue date Rural Health Care Program I 2013 HCF Program Training 8 4

My Portal The Basics Documents Drafted and submitted forms as well as: Documents uploaded with the submitted forms Emails from the RHC Program requesting additional information or clarification Funding commitment letters Automated emails sent by the RHC Program Rural Health Care Program I 2013 HCF Program Training 9 My Portal The Basics My Consortium For consortium applicants, the My HCPs page is replaced by the My Consortium page which displays the following information: HCPs that have been added to the consortium, their entity type, rurality, and status (active/inactive) within the consortium, and HCPs that have not been added to the consortium, but a Letter of Agency has been created with the HCP listed. Rural Health Care Program I 2013 HCF Program Training 10 5

My Portal The Basics Account Holders Settings Primary account holder is responsible for all other account holders (secondary, tertiary, draft) in this tab they can manage details of other account holders, such as: Account holder name (link provides contact details); Account holder employer; Account Type (Primary, Secondary, Tertiary, Draft); Modifying account holder information or removing an account holder s permissions; and Adding a new account holder. Rural Health Care Program I 2013 HCF Program Training 11 My Portal The Basics Document Upload Upload supporting documents during forms completion Supporting documents are linked to the form and visible in the Documents tab. Rural Health Care Program I 2013 HCF Program Training 12 6

My Portal Overview Agenda 1. My Portal The Basics 2. Accessing My Portal 3. Navigating My Portal Rural Health Care Program I 2013 HCF Program Training 13 Accessing My Portal Terms In This Section User ID Applicant or account holder s email address Primary Account Holder Person with full access for HCP information and manage access of other account holders Secondary Account holder who can certify, sign, and submit forms (similar to primaries) but cannot assign or modify other account holders Draft Account holder who can complete certain sections of forms but cannot certify, sign, and submit Tertiary Account holder who can complete the forms and can submit the forms on behalf of the primary account holder Rural Health Care Program I 2013 HCF Program Training 14 7

Accessing My Portal New Applicant Registration New applicants can register for a My Portal account by submitting an FCC Form 460. Submit the form online. The RHC Program will send an email confirming receipt. The RHC Program will create an account for the HCP and send the account holder the next steps to finalize the registration process. Rural Health Care Program I 2013 HCF Program Training 15 Accessing My Portal New Applicant Registration Go to www.usac.org and click E FILE. New applicants must submit an FCC Form 460 to register for My Portal. Rural Health Care Program I 2013 HCF Program Training 16 8

Accessing My Portal New Account Holders: Select New RHC Applicant in E File. Rural Health Care Program I 2013 HCF Program Training 17 Accessing My Portal New Account Holders: Enter your email and the HCP zip code. If the email is already registered, you will be asked to log in. Rural Health Care Program I 2013 HCF Program Training 18 9

Accessing My Portal New Account Holders: Select your HCP from the list. Select your HCP from a list of Available HCPs associated with the zip code entered. Click on the HCP Name to open an FCC Form 460 for that HCP (if Available ). Rural Health Care Program I 2013 HCF Program Training 19 Accessing My Portal New Account Holders: No matches? Select New HCP button to open a blank FCC Form 460 Once the form is submitted, approved, and posted, the account holder will receive an email with a user ID and temporary password to access My Portal. Rural Health Care Program I 2013 HCF Program Training 20 10

Accessing My Portal Existing Account Holders Log in through E File: Enter your user ID and password. Check the box to accept the system notice. Click on the Login button to begin. Rural Health Care Program I 2013 HCF Program Training 21 Accessing My Portal Existing Account Holders: Change Temporary Password Minimum of six characters At least one must be a non alphanumeric character, such as @, #, %, or! You will return to the E File page to log back in with your new password. Rural Health Care Program I 2013 HCF Program Training 22 11

Accessing My Portal Existing Account Holders: Review and accept the terms and conditions. Rural Health Care Program I 2013 HCF Program Training 23 Accessing My Portal My Portal Landing Page All account holders will see the My Portal landing page after login. When in My Portal, access the landing page by clicking on the About My Portal link. Rural Health Care Program I 2013 HCF Program Training 24 12

Accessing My Portal Consultants: Authorization Required Consultants must provide authorization from an HCP to access the consortium s account information. Consultants will then be authorized as an account holder with full rights, allowing the consultant to complete certify, sign, and submit forms on behalf of the consortium. Consultants cannot be a primary account holder, and cannot add, remove, or modify account rights for any account holder. The project coordinator (PC) will receive copies of official correspondence (forms posted, FCLs, etc.). Rural Health Care Program I 2013 HCF Program Training 25 My Portal Overview Agenda 1. My Portal The Basics 2. Accessing My Portal 3. Navigating My Portal Rural Health Care Program I 2013 HCF Program Training 26 13

Navigating My Portal Structure These are the components of My Portal: My Consortium A list of all HCPs within the consortium Account Holders Account holder contact info and level of access Forms Find links to copies of forms, including the status of and details about each Documents Contains submitted documents Rural Health Care Program I 2013 HCF Program Training 27 Navigating My Portal: My Consortium My Consortium Lists all HCPs for which you have authorization Includes the HCP number, HCP name, and street address to help differentiate between similar HCPs Shows your account type (primary, secondary, etc.) Rural Health Care Program I 2013 HCF Program Training 28 14

Navigating My Portal: My Consortium My Consortium After selecting Consortium Project Coordinator Healthcare Connect Fund from the My Portal landing page, you will select an HCP from your list of authorized HCPs. Rural Health Care Program I 2013 HCF Program Training 29 Navigating My Portal: Account Holders Manage Account Holder Info Lists all account holders and account information Update or correct contact information (email changes require re verification of account authority) Manage secondary and other account holders: Change level of access Delete all access or access to selected HCPs Add access to new HCPs Rural Health Care Program I 2013 HCF Program Training 30 15

Navigating My Portal: Account Holders Modifying Account Holders Click on the account holder name to change account holder information. To add account holders, click on Add New Applicant. Rural Health Care Program I 2013 HCF Program Training 31 Navigating My Portal: Account Holders Modifying Account Holders Account Holder Details show at the top of the screen. Modify access for this applicant in the Role dropdown. Rural Health Care Program I 2013 HCF Program Training 32 16

Navigating My Portal: Account Holders Modifying Account Holders Remove access to all HCPs by clicking Remove. Remove access to one or more HCPs on the account holder page. Change access levels Add access to an HCP under list of HCPs for this applicant Rural Health Care Program I 2013 HCF Program Training 33 Navigating My Portal: Account Holders Add New Account Holders Provide the requested information for a new account holder. Select account holder rights for available HCPs. Adding a consultant as a tertiary account holder requires a letter authorizing access to the HCP s account. Consultants cannot be made the primary account holder. Select the new account holder s level of rights for each HCP. Rural Health Care Program I 2013 HCF Program Training 34 17

Navigating My Portal: Forms Forms Selecting an HCP from the My HCPs tab will direct you to the Forms page. All forms will be stored by funding year. Each FCC Form 461, 462, and 463 will be electronically linked to the parent FCC Form 460. Rural Health Care Program I 2013 HCF Program Training 35 Navigating My Portal: Forms Forms My Portal maintains the following information regarding the FCC Form 460: The Form Application Number (click on hyperlink to open) The account holder who last edited the form The status of the FCC Form 460 Once the FCC Form 460 is approved, click on the appropriate button to create an FCC Form 461 or 462. Rural Health Care Program I 2013 HCF Program Training 36 18

Navigating My Portal: Forms FCC Form 460 Status Codes Draft: In draft status but not yet submitted to USAC Received: Received by USAC but not yet reviewed Denied: Submitted but denied by USAC Approved: Reviewed and approved Rural Health Care Program I 2013 HCF Program Training 37 Navigating My Portal: Documents Documents Information is structured by funding year first, then by the form type. All required supporting documentation is also stored in the Documents tab. Rural Health Care Program I 2013 HCF Program Training 38 19

HCF Program Training Overview of FCC Forms: Consortia Rural Health Care Program I 2013 HCF Program Training 1 This training is just a general overview and starting point for applicants Every applicant s situation is different The training does not cover every program requirement The training does not cover requirements for service providers and consultants It is essential to read the following documents carefully as you proceed through the planning and application process: Healthcare Connect Fund Order (FCC 12 150), located at http://www.fcc.gov/encyclopedia/rural health care, The Rural Health Care Program rules, 47 C.F.R. 54.600 680, located at http://www.ecfr.gov, and The Healthcare Connect Fund Program forms and instructions (FCC Forms 460 463), located at http://www.usac.org/rhc/healthcareconnect/tools/forms/default.aspx. Consult the FCC and USAC websites for additional resources. Important Caveat Rural Health Care Program I 2013 HCF Program Training 2 1

Agenda 1. FCC Form 460: Eligibility and Registration Form 2. FCC Form 461: Request for Services Form 3. FCC Form 462: Funding Request Form 4. FCC Form 463: Invoice and Request for Disbursement Form Rural Health Care Program I 2013 HCF Program Training 3 Forms Overview FCC Form 460 Rural Health Care Program I 2013 HCF Program Training 4 2

FCC Form 460 Differences Between Online Application and Paper Form All forms and documentation must be submitted online through My Portal. Not every line/block of the paper form will appear in My Portal. The form process in My Portal does not follow the exact order of the paper form. Rural Health Care Program I 2013 HCF Program Training 5 FCC Form 460 Purpose of the FCC Form 460: To determine eligibility of the consortium and all health care provider (HCP) sites to participate in the Healthcare Connect Fund (HCF) Program To register: Off site data centers Off site administrative offices Ineligible HCP sites All HCPs, consortia, and consortium members must obtain an eligibility determination, even if deemed eligible for another program. Rural Health Care Program I 2013 HCF Program Training 6 3

FCC Form 460 Before You File A consortium using a consultant to file FCC Form 460 must first submit a third party authorization agreement with USAC. Agreement assigns legal responsibility for representations a consultant may make in application to the consortium Assemble required FCC Form 460 information: Agreement assigning legal and financial responsibility to any entity other than consortium leader if applicable Consortium FCC Registration Number (if a legal entity) Account holder contact information Rural Health Care Program I 2013 HCF Program Training 7 FCC Form 460 Getting Access Enter through E File and select New RHC applicant. Follow the directions at the Create FCC Form 460 page. Select New HCP. Select the radio dial button that best describes why you are submitting the FCC Form 460 (Line 2), Determine eligibility of consortium. Rural Health Care Program I 2013 HCF Program Training 8 4

FCC Form 460 FCC Form 460 Options Rural Health Care Program I 2013 HCF Program Training 9 FCC Form 460 Information Required to Submit through My Portal Consortium information Consortium leader information Contact information HCP eligibility category Certifications Signature Rural Health Care Program I 2013 HCF Program Training 10 5

FCC Form 460 Consortium Information FCC Form 460 application number and HCP number will be automatically generated. Enter the name of the consortium. If the consortium is a legal entity, select Yes. If the consortium is a legal entity, enter the entity s FCC Registration Number and nonprofit tax ID. Rural Health Care Program I 2013 HCF Program Training 11 FCC Form 460 Consortium Information Rural Health Care Program I 2013 HCF Program Training 12 6

FCC Form 460 Consortium Leader Information If the consortium leader has assigned legal and financial responsibility to another entity, check yes and upload a copy. Select Consortium Leader Type from drop down menu Include the HCP number for an eligible HCP participating in the consortium. Government organizations, public sector entities, and non profit entities, must upload a request for an exemption from USAC in order to be a consortium leader if they also plan to participate as a service provider during the competitive bidding process. Enter consortium leader contact information, including name and address Rural Health Care Program I 2013 HCF Program Training 13 FCC Form 460 Consortium Leader Information Enter all the pertinent information for the consortium leader. Rural Health Care Program I 2013 HCF Program Training 14 7

FCC Form 460 Contact Information Rural Health Care Program I 2013 HCF Program Training 15 FCC Form 460 Contact Information Enter contact information for the consortium project coordinator. The project coordinator will serve as the primary account holder for the consortium. Secondary account holders can also be added at this time Check the radio button and click the New Secondary Account Holder box. Rural Health Care Program I 2013 HCF Program Training 16 8

FCC Form 460 HCP Eligibility Category Rural Health Care Program I 2013 HCF Program Training 17 FCC Form 460 HCP Eligibility Category Consortium of the above is automatically selected for Line 43 for consortium applicants. Provide a brief explanation that describes why the entity qualifies as a consortium. Rural Health Care Program I 2013 HCF Program Training 18 9

FCC Form 460 Signature Provide name and contact information of the person authorized to submit the FCC Form 460, including FCC RN number of their employer. Reminder: The project coordinator is required to be an officer, director, or authorized employee of the consortium leader. Rural Health Care Program I 2013 HCF Program Training 19 FCC Form 460 Certifications The project coordinator or an authorized designee must provide the certifications and electronic signature. Rural Health Care Program I 2013 HCF Program Training 20 10

FCC Form 460 Signatures New applicants: password not required to submit the form Applicants with existing My Portal credentials: your current password will be populated in the Signature section Rural Health Care Program I 2013 HCF Program Training 21 FCC Form 460 Previewing the Form Carefully review information you provided on the form. If you need to make changes, click Save and Go Back or select the applicable section of the form at the top. If no changes are needed, click Certify to sign and submit the form. Rural Health Care Program I 2013 HCF Program Training 22 11

FCC Form 460 Sign and Submit Electronic signature = a hand written signature Click Certify to complete the process. A confirmation page will alert you that the form was successfully submitted. The project coordinator will receive a confirmation that the FCC Form 460 was submitted. (Note: the confirmation is not an approval of the form.) Rural Health Care Program I 2013 HCF Program Training 23 FCC Form 460 Participating Entities After USAC determines that the consortium and consortium leader are eligible, the consortium leader can add HCP sites to the Form 460 on Line 24. A consortium can submit an FCC Form 460 for sites on its network if is has received a Letter of Agency (LOA) covering each of those sites. A consortium must submit an FCC Form 460 for all ineligible entities, off site data centers, and off site admin offices on its network. Rural Health Care Program I 2013 HCF Program Training 24 12

Forms Overview FCC Form 461 Rural Health Care Program I 2013 HCF Program Training 25 FCC Form 461 Purpose of the FCC Form 461 Used to initiate the competitive bidding process Provides necessary information to potential service providers about the requested services, network equipment, and/or facilities to enable effective competitive bidding Rural Health Care Program I 2013 HCF Program Training 26 13

FCC Form 461 6 Blocks of Requested Information Block 1: General Information Block 3: Consortium Request for Services Block 4: Declaration of Assistance Block 5: Bid Evaluation Block 6: Additional Documentation Block 7: Certifications (and Signature) Rural Health Care Program I 2013 HCF Program Training 27 FCC Form 461: Block 1 Block 1: General Information Complete Block 1 with site specific information. Note: For multi year funding requests, use the first year for which funding will be requested on Line 1. Rural Health Care Program I 2013 HCF Program Training 28 14

FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 14: List the HCP numbers for all eligible and ineligible sites participating in this request for services. Rural Health Care Program I 2013 HCF Program Training 29 FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 15: Indicate whether a request for proposals (RFP) will be submitted. Line 15a: If submitting an RFP, indicate why Line 15b: Requested contract period Line 15c: Expected time period to evaluate bids after the close of the posting period (after the ACSD ) Rural Health Care Program I 2013 HCF Program Training 30 15

FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 16: Indicate how long the FCC Form 461 should be posted May enter number of days or a posting end date Posting end date will change based on when USAC actually posts the request services Recommendation: Use number of days to post either selection must provide for a minimum of 28 days An applicant can sign a contract after the posting closes (the Allowable Contract Selection Date (ACSD)) Rural Health Care Program I 2013 HCF Program Training 31 FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 17: Select the appropriate category of expense. Applicants can select more than one category of expense. Line 17a If requesting only infrastructure, enter the FCC Form 461 application number in which the consortium also solicited bids for leased/tariffed services. Rural Health Care Program I 2013 HCF Program Training 32 16

FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 18: Provide a brief summary of the RFP: If the consortium is not submitting an RFP, provide a description of services sufficient to enable the competitive bidding process. USAC always recommends consortia utilize an RFP. Rural Health Care Program I 2013 HCF Program Training 33 FCC Form 461: Block 3 Block 3: Consortium Request for Services Line 19: Identify primary point of contact for potential service providers, who can provide technical details and answer questions about requested services The point of contact may be the project coordinator, assistant project coordinator, or other (must then provide required contact information) Rural Health Care Program I 2013 HCF Program Training 34 17

FCC Form 461: Block 4 Block 4: Declaration of Assistance Indicate if any consultants, service providers, or other outside experts aided in the preparation of the FCC Forms 460, 461, RFP, and/or bid evaluation, or network plan on Line 20. If yes, Provide their contact information on Line 21. Rural Health Care Program I 2013 HCF Program Training 35 FCC Form 461: Block 5 Block 5: Bid Evaluation List all criteria that will be used to demonstrate how the most cost effective bid will be selected. Assign a weight to each. If there is an RFP, criteria must be included in the RFP. Rural Health Care Program I 2013 HCF Program Training 36 18

FCC Form 461: Block 5 Block 5: Bid Evaluation Price must be a primary factor, but need not be the only factor. No other factor may be weighted greater than price. Other criteria could include bandwidth, reliability, technical support, previous experience, etc. Rural Health Care Program I 2013 HCF Program Training 37 FCC Form 461: Block 6 Block 6: Additional Documentation RFP Network plan Letters of Agency (if not already submitted) Rural Health Care Program I 2013 HCF Program Training 38 19

FCC Form 461: Block 7 Block 7: Certifications (and Signature) Certifications should be by an officer, director, or other authorized employee of the consortium leader. (Lines 24 30) Rural Health Care Program I 2013 HCF Program Training 39 FCC Form 461: Block 7 Block 7: Certifications (and Signature) Complete lines 31 38 with the information of the person authorized to submit the form for the consortium leader. Rural Health Care Program I 2013 HCF Program Training 40 20

Forms Overview FCC Form 462 Rural Health Care Program I 2013 HCF Program Training 41 FCC Form 462: Block 1 Block 1: General Information Funding year Lines 2 through 4 will auto populate Rural Health Care Program I 2013 HCF Program Training 42 21

FCC Form 462: Block 2 Block 2: Competitive Bidding Information Line 5: FCC Form 461 application number Line 6: Allowable Contract Sign Date Line 7: Number of service providers who bid Rural Health Care Program I 2013 HCF Program Training 43 FCC Form 462: Block 2 Block 2: Competitive Bidding Information Line 8: Request for competitive bid exemption Rural Health Care Program I 2013 HCF Program Training 44 22

FCC Form 462: Block 3 Block 3: Vendor Information Enter selected Service Provider Identification Number (SPIN) Applicant must submit a separate FCC Form 462 for each service provider Same service provider, multiple SPINS = multiple forms Rural Health Care Program I 2013 HCF Program Training 45 FCC Form 462: Blocks 4 and 5 Block 4: Type of Funding Request Block 5: Single Eligible Expense Request for Funding Consortia do not have to fill out Block 4 or Block 5 Rural Health Care Program I 2013 HCF Program Training 46 23

FCC Form 462: Block 6 Block 6: Network Cost Worksheet Complete Block 6 and the Network Cost Worksheet if you are seeking support for multiple expenses. The fields in Block 6 cannot be edited. Once you complete the Network Cost Worksheet, lines 29 and 30 will be calculated for you. Rural Health Care Program I 2013 HCF Program Training 47 FCC Form 462: Block 6 Block 6: Network Cost Worksheet Will be part of the FCC Form 462 Must include information for each participating entity; eligible and ineligible, must be reported. Column A: HCP Number Column B: Site Name Rural Health Care Program I 2013 HCF Program Training 48 24

FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns C H: Contract Information Column C: Contact ID assigned by USAC Column D: Friendly name assigned by applicant Column E: Date contract with service provider was signed Column F: Length of initial contract term Column G: Number of contract extensions Column H: Length of each optional extension Rural Health Care Program I 2013 HCF Program Training 49 FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns I P: Eligible Expense Information Column I: Billing Account Number Column J: Category of expense Column K: Expense type Column L: Explanation of eligible expense Note: NCW is not posted on USAC website Rural Health Care Program I 2013 HCF Program Training 50 25

FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns I P: Eligible Expense Information (cont d) Columns J and K: Category of Expense and Expense Type Network Design Network Equipment owned and leased Routers, firewalls, switches, servers Includes maintenance contracts for equipment Infrastructure/outside plant owned by HCP Leased/tariffed facilities Irrevocable Right of Use Pre paid lease Network management/maintenance/operations costs Rural Health Care Program I 2013 HCF Program Training 51 FCC Form 462: Block 6 Columns I P: Eligible Expense Information (cont d) Column L: Explanation of Eligible Expense Provide information about exactly what the service/widget is: Example: Network switch to be used to make broadband service functional for eastern HCPs on network Example: Point to cloud connection for MPLS network Do not write, because the Order says it is eligible. Rural Health Care Program I 2013 HCF Program Training 52 26

FCC Form 462: Block 6 Columns I P: Eligible Expense Information (cont d) Column M O: broadband connection speed information Column P: expected date service will start, the network equipment will ship to the customer, or the work will be completed as an eligible expense Rural Health Care Program I 2013 HCF Program Training 53 FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns Q U:Quality of Service Guarantees Applicant should fill this section out if applicant s contract with vendor includes a Service Level Agreement (SLA) Rural Health Care Program I 2013 HCF Program Training 54 27

FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns V Z: Circuit information Rural Health Care Program I 2013 HCF Program Training 55 FCC Form 462: Block 6 Columns V Z: Circuit Information (cont d) Column V: Circuit ID, provide if available Column W: Physical location of where circuit will begin Column X: Physical location of where circuit will end One point of the connect must touch an eligible HCP; data center or administrative office to be eligible for funding Rural Health Care Program I 2013 HCF Program Training 56 28

FCC Form 462: Block 6 Columns V Z: Circuit Information (cont d) Column Y: If applicable, provide the total number of fiber strands. This should be filled out only when fiber strands are being purchased/leased. This does not need to be filled out if a service provider is providing recurring services. Column Z: If data is provided in Column Y, then Column Z must be completed (number of fiber strands eligible for support). Rural Health Care Program I 2013 HCF Program Training 57 FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns AA AI: Financial Information Column AA: Quantity of items requested If applicant is requesting support for a single connection (i.e. circuit); enter 1 If two routers; enter 2 Column AB: Indicate whether applicant is seeking a multi year commitment (Yes/No) Rural Health Care Program I 2013 HCF Program Training 58 29

FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns AA AI: Financial Information Column AC: Select how frequently the applicant will be billed by the vendor Quantity of expense period: the number of expense periods for which (one time, monthly, quarterly, semi annual, annual, etc.) the applicant is requesting funding Rural Health Care Program I 2013 HCF Program Training 59 FCC Form 462: Block 6 Block 6: Network Cost Worksheet Columns AA AI: Financial Information Column AE: Undiscounted price, per item, per expense period If total undiscounted price is $100.00, enter $100.00 Column AF: Percentage of expense eligible If entire expense is eligible, enter 100 percent Column AG: Percentage of usage eligible Column AH: Total eligible undiscounted costs calculated by USAC Column AI: Source of HCP contribution Rural Health Care Program I 2013 HCF Program Training 60 30

FCC Form 462: Block 6 Eligible Source of HCP Match Funds from the applicant or eligible HCP participants State grants, funding, or appropriations Federal funding, grants, loans, or appropriations Except for other universal service funding Tribal government funding Other grant funding, including private grants Rural Health Care Program I 2013 HCF Program Training 61 FCC Form 462: Block 7 Block 7: Additional Documentation Competitive bidding documents: Upload by service provider as a single document for the competitive bid response (do not upload multiple documents) Written description of cost allocation (if applicable) Contract: Upload main document and all attachments as a single document Rural Health Care Program I 2013 HCF Program Training 62 31

FCC Form 462: Block 8 Block 8: Request for Confidentiality Line 32: Requests for confidentiality are determined by the FCC on a case by case basis Rural Health Care Program I 2013 HCF Program Training 63 FCC Form 462: Block 9 Block 9: Certifications Must be signed by an officer, director, or other authorized employee of the consortium leader Rural Health Care Program I 2013 HCF Program Training 64 32

FCC Form 462: Block 9 Block 9: Certifications Rural Health Care Program I 2013 HCF Program Training 65 FCC Form 462: Block 9 Block 9: Certifications Rural Health Care Program I 2013 HCF Program Training 66 33

FCC Form 462: Block 9 Block 9: Signature Rural Health Care Program I 2013 HCF Program Training 67 Forms Walkthrough FCC Form 463 Rural Health Care Program I 2013 HCF Program Training 68 34

FCC Form 463 Purpose Serves as the request to USAC for the disbursement of funding for services, equipment, and/or facilities set forth in the applicant s funding commitment letter Certifies HCP has made required 35 percent contribution from eligible sources of funds FCC Form 463 is filed jointly by the applicant and the service provider Rural Health Care Program I 2013 HCF Program Training 69 FCC Form 463 When to File The FCC Form 463 may only be submitted after: A funding commitment is received, Service has begun/equipment installed, and The HCP/consortium has been billed by the service provider. Applicant and service provider must file the FCC Forms 463 within six months after the end date of the funding commitment Rural Health Care Program I 2013 HCF Program Training 70 35

FCC Form 463: Block 1 Block 1: General Information Line 1: RHC invoice number is generated by USAC Line 2: Enter Funding Request Number (FRN) contained in the funding commitment All remaining line items will pre populate, except Lines 6 and 9. Rural Health Care Program I 2013 HCF Program Training 71 FCC Form 463: Block 1 Block 1: General Information Line 6: Enter Applicant Invoice Number if desired Line 9: Amount USAC will pay the service provider for the services on the invoice Amount is calculated based on values contained in the FCC Form 463 Rural Health Care Program I 2013 HCF Program Training 72 36

FCC Form 463: Block 2 Block 2: Eligible Expenses Select the Funding Request ID (FRN ID) in Column A (found in the funding commitment letter) FRN ID is a separate and unique identifier associated with each line item for which the applicant is seeking support Rural Health Care Program I 2013 HCF Program Training 73 FCC Form 463: Block 2 Block 2: Eligible Expenses (cont d) Once FRN ID is entered, complete remaining columns (using information contained in FCC Form 462) Must be an FRN that is associated with FRN in Block 1 Rural Health Care Program I 2013 HCF Program Training 74 37

FCC Form 463: Block 3 Block 3: Dates, Quantities, and Costs Column H: Enter service start date, the date the equipment was shipped to the customer, or the last day work was completed. Columns I and J: Enter the first and last date of the billing period for this invoice. If it is a non recurring expense, enter N/A. Rural Health Care Program I 2013 HCF Program Training 75 FCC Form 463: Block 3 Block 3: Dates, Quantities, and Costs Column K: Enter the numeric quantity of items billed. Column L: Enter the actual total undiscounted cost for the billing period. If the applicant is invoicing for a single month of recurring service, the applicant should enter the total actual cost for service including taxes or surcharges. Rural Health Care Program I 2013 HCF Program Training 76 38

FCC Form 463: Block 4 Block 4: Calculation of Support Columns M and N: Information in these columns will be pre populated based on the FRN ID information Column O: Automatically calculated by multiplying columns L by M, and by column N of the FCC Form 463 Rural Health Care Program I 2013 HCF Program Training 77 FCC Form 463: Block 4 Block 4: Calculation of Support Column P: Total amount that USAC will pay for this line item Calculated by multiplying Column O by the discount percentage, as specified on the funding commitment Rural Health Care Program I 2013 HCF Program Training 78 39

FCC Form 463: Block 4 Block 4: Calculation of Support Sum of line items in column P are shown in Line 9: Total Invoice Amount (located in Block 1) USAC will pay the lesser of (per line item): Value calculated in Column P; or Support amount for the billing period specified in the FCL Rural Health Care Program I 2013 HCF Program Training 79 FCC Form 463: Block 5 Block 5: Supporting Documentation Line 10: Applicants and service providers may attach supporting documentation, including, but not limited to, copies of bills for the line items being submitted. Submitting supporting documentation will ensure that such information is available for any future audit. Rural Health Care Program I 2013 HCF Program Training 80 40

FCC Form 463: Block 7 Block 7: Applicant Certifications and Signatures Rural Health Care Program I 2013 HCF Program Training 81 FCC Form 463: Block 7 Block 7: Applicant Certifications and Signatures Each certification must be completed by representative of consortium leader, including: Information on FCC Form 463 is true and correct Consortium members have received related services, network equipment, and facilities itemized on FCC Form 463 Rural Health Care Program I 2013 HCF Program Training 82 41

FCC Form 463: Block 7 Block 7: Applicant Certifications and Signatures (cont d) Each certification must be completed by representative of consortium leader, including: Verification that 35 percent minimum contribution was funded by eligible sources and that required contribution was remitted to the service provider Rural Health Care Program I 2013 HCF Program Training 83 FCC Form 463: Block 7 Block 7: Applicant Certifications and Signatures Lines 26 33 normally are completed by an officer, director, or other authorized employee of the individual HCP or consortium leader (Block 4). Letter of authorization must be on record if not an employee of the HCP or consortium leader Rural Health Care Program I 2013 HCF Program Training 84 42

FCC Form 463: Block 6 Block 6: Vendor Certifications and Signatures Acknowledges that the service provider must credit health care providers and FRN/FRN IDs listed in this invoice Rural Health Care Program I 2013 HCF Program Training 85 FCC Form 463: Block 6 Block 6: Vendor Certifications and Signatures (cont d) Each certification must be completed and signed by an authorized representative of the service provider. Note: If revisions are made, the HCP must review and recertify the form before USAC can begin processing. Rural Health Care Program I 2013 HCF Program Training 86 43