Healthcare Connect Fund Program FCC Form 460 for Consortia Rural Health Care Program I Healthcare Connect Fund Program 1
FCC Form 460 for Consortia Today s Speakers Paloma Costa RHC Program Outreach Camelia Rogers Manager of Consortia Applications Thomas Beyle Program Analyst of Consortia Applications Rural Health Care Program I Healthcare Connect Fund Program 2
FCC Form 460 for Consortia Housekeeping Use the Audio section of your control panel to select an audio source and connect to sound Turn on your computer s speakers, or Use the call-in instructions in your confirmation email All participants are on mute Submit questions at any time using the Questions box Slides attached to event reminder email Rural Health Care Program I Healthcare Connect Fund Program 3
This presentation is just a general overview and starting point for applicants. Every applicant s situation is different The presentation does not cover every program requirement The presentation 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.Section 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 Healthcare Connect Fund Program 4
FCC Form 460 for Consortia Agenda 1. Form overview 2. Accessing My Portal 3. Submitting the form in My Portal for consortium leaders 4. Submitting the form in My Portal for consortium members 5. Submitting letters of agency (LOAs) and letters of exemption in My Portal 6. Required supporting documentation for the form Rural Health Care Program I Healthcare Connect Fund Program 5
FCC Form 460 for Consortia Form Overview Rural Health Care Program I Healthcare Connect Fund Program 6
Form Overview Forms 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 Healthcare Connect Fund Program 7
Form Overview 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 component of the RHC Program. Rural Health Care Program I Healthcare Connect Fund Program 8
FCC Form 460 for Consortia Accessing My Portal Rural Health Care Program I Healthcare Connect Fund Program 9
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 Healthcare Connect Fund Program 10
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 Healthcare Connect Fund Program 11
Accessing My Portal New Account Holders: Select New RHC Applicant in E-File. Rural Health Care Program I Healthcare Connect Fund Program 12
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 Healthcare Connect Fund Program 13
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 Healthcare Connect Fund Program 14
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 Healthcare Connect Fund Program 15
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 Healthcare Connect Fund Program 16
Accessing My Portal New 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 Healthcare Connect Fund Program 17
Accessing My Portal New Account Holders: Review and accept the terms and conditions. Rural Health Care Program I Healthcare Connect Fund Program 18
Questions? Submit questions at any time during the presentation using the Questions box in your user controls. Rural Health Care Program I Healthcare Connect Fund Program 19
FCC Form 460 for Consortia Submitting the Form in My Portal Rural Health Care Program I Healthcare Connect Fund Program 20
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 21
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 22
Submitting the Form in 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 Healthcare Connect Fund Program 23
Submitting the Form in My Portal FCC Form 460 Options Rural Health Care Program I Healthcare Connect Fund Program 24
Submitting the Form in My Portal Information Required to Submit through My Portal Consortium information Consortium leader information Contact information HCP eligibility category Certifications Signature Rural Health Care Program I Healthcare Connect Fund Program 25
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 26
Submitting the Form in My Portal Consortium Information Rural Health Care Program I Healthcare Connect Fund Program 27
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 28
Submitting the Form in My Portal Consortium Leader Information Enter all the pertinent information for the consortium leader. Rural Health Care Program I Healthcare Connect Fund Program 29
Submitting the Form in My Portal Contact Information Rural Health Care Program I Healthcare Connect Fund Program 30
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 31
Submitting the Form in My Portal HCP Eligibility Category Rural Health Care Program I Healthcare Connect Fund Program 32
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 33
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 34
Submitting the Form in My Portal Certifications The project coordinator or an authorized designee must provide the certifications and electronic signature. Rural Health Care Program I Healthcare Connect Fund Program 35
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 36
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 37
Submitting the Form in My Portal 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 Healthcare Connect Fund Program 38
Questions? Submit questions at any time during the presentation using the Questions box in your user controls. Rural Health Care Program I Healthcare Connect Fund Program 39
FCC Form 460 for Consortia A short discussion about submitting the FCC Form 460 in My Portal for consortium members. Rural Health Care Program I Healthcare Connect Fund Program 40
Questions? Submit questions at any time during the presentation using the Questions box in your user controls. Rural Health Care Program I Healthcare Connect Fund Program 41
FCC Form 460 for Consortia A short discussion about submitting letters of agency (LOAs) and letters of exemption in My Portal. Rural Health Care Program I Healthcare Connect Fund Program 42
Questions? Submit questions at any time during the presentation using the Questions box in your user controls. Rural Health Care Program I Healthcare Connect Fund Program 43
FCC Form 460 for Consortia A short discussion about required supporting documentation. Rural Health Care Program I Healthcare Connect Fund Program 44
Questions? Submit questions at any time during the presentation using the Questions box in your user controls. Rural Health Care Program I Healthcare Connect Fund Program 45
FCC Form 460 for Consortia Thank You! Thanks for joining us at today s webinar Join us for HCF Program monthly webinars Go to www.usac.org and click subscribe in the upper-right corner for reminders via email For additional assistance with the HCF Program, contact rhc-assist@usac.org Rural Health Care Program I Healthcare Connect Fund Program 46